Friday, 18 January 2013

Disability policy 1990 and 2010 - an evidence-free zone.



If anyone doubts that evidence has little part to play in influencing government policy, they only have to compare the origins of Disability Living Allowance in 1990 with the circumstances of its demise in 2010, when the government published its proposals to replace DLA with Personal Independence Payment.

In 1990 we had a Conservative government who wanted to reform disability benefits.  Their White Paper, The Way Ahead, identified that there had been large increases in the numbers successfully claiming the two additional costs benefits – Attendance Allowance and Mobility Allowance – over the previous ten years: a sixfold increase in Mob A recipients between 1978/9 and 1989/90;  and threefold increase in AA recipients.

A national survey of disabled people had also identified that the additional costs that they incurred were only a fraction of the amount paid to those qualifying for these benefits. AA was £20.45 and £30.60 per week and Mob A £21.40, whereas a government survey found that average extra costs ranged from £3.20 for people in severity category 1 to £11.70 in severity category 10. Disability organisations had challenged these figures but the government response was that their challenge related to people with highest needs and took into account care needs which should be met by either local authority services or the Independent Living Fund.

So – did the government respond by cutting the amount of money spent on these benefits?  In the same way that the current government aims to cut today’s budget for additional costs disability benefits by 20%?

On the contrary, the Conservative government of 1990 proposed to replace Mobility Allowance and Attendance Allowance with a new benefit, Disability Living Allowance, which would be extended to larger numbers of people, increasing the amount of money spent.

Unlike the current government, the 1990 government recognised the demographic reasons for the increase in numbers claiming disability benefits: although “there is no reason to suppose an increase in the incidence of disability at all ages” there are, they said “more old people and they are living longer” and this “will have contributed to the rise”.  And, they said, there was greater awareness of the benefits so more people were claiming.

In contrast, the current government argued in 2010 that the 30% increase in the numbers receiving DLA since 2002 is ‘inexplicable’, concluding that “The complexity and subjectivity of the benefit has led to a wider application than originally intended”. Their focus was on those of working age, arguing that DLA can act as a disincentive to seeking work and the June 2010 Budget announced their intention of reducing the numbers of 18-64 year olds receiving additional help by 20%.

In fact, as Declan Gaffney has shown, only 8% of additional working age claims cannot be easily explained.  All the rest of the increase is explained by either demographic factors (primarily that recipients keep DLA after reaching retirement age) or by the rise in under 20 year olds receiving the benefit because of mental ill health or learning difficulties (probably because of increased awareness of the benefit).  Moreover, the number of new claims amongst 18-64 year olds has in fact been falling since 2002.  In addition, evidence that disability benefits do not cover disabled people's costs of living has not figured at all in the government's policy deliberations.

Whereas the current government argues that too many people are receiving help with the additional costs associated with impairment and disability, the 1990 Tory government felt that not enough people were being helped.  Their White Paper argued that the OPCS surveys showed that there were people under pension age with “moderate to severe disabilities and corresponding costs, but who fail to qualify for AA or Mob A.”   The new benefit, Disability Living Allowance, was therefore intended to encompass people who were ‘less severely disabled’ for whom “the government believes more help is needed”.

In contrast, the current government believes that help should only be available to “those that need the greatest help”.  The lower rate of the care component is therefore abolished and anyone who can walk more than 20 metres will be ineligible for the higher rate of the mobility component – with very significant consequences for people who can currently lease a Motability car using their DLA. 

How do we explain these differences in approach?

One important factor is the role played by the Treasury.  In 1990, the Chancellor was persuaded to agree to the new benefit by offering up savings in the form of abolishing the Additional Pension element of Invalidity Benefit and the Reduced Earning element of Industrial Injury benefits.  This was in spite of the fact that the calculations set out in The Way Ahead make clear that these savings did not, in the short-term, come anywhere near the additional expenditure that the new DLA would cost (although they were more significant in the longer-term).  The argument which won the day was the government’s case that disabled people of working age needed more support than they were currently getting.

In contrast, the proposals developed during 2010 to replace DLA with PIP, were motivated by the Treasury’s demand that each government department offer up substantial savings on current budgets. The arguments made about ‘inexplicable increases’ in DLA recipients, the case made for a more ‘objective’ assessment to determine eligibility were merely fig leaves for the prime motivation – to cut the budget by 20%. As Maria Miller, the then Minister confirmed to the House of Commons on 18th October 2010, “One factor being considered in developing options for the new assessment is the need for reform of disability living allowance to deliver savings of 20% of working age expenditure”.

In this context, it is likely that the recent change in the proposed criteria for eligibility for the mobility component of PIP – the reduction from 50m to 20m in terms of ability to walk – has come about because someone has calculated that this reduction in eligibility is necessary in order to make the savings required.

But the most important lesson from the comparison of government proposals in 1990 and 2010 is that in neither situation were their policy decisions based on evidence.  In 1990, the government ignored (albeit probably faulty) evidence that the additional costs of impairment/disability were less than the value of the benefits received. And in 2010, the government ignored evidence that the increase in DLA recipients was almost entirely explained by demographic and other reasons – and that there is no evidence that people have been awarded DLA who didn’t need it; on the contrary there is evidence that disability benefits do not cover people's costs of living.

In both instances, policy was driven by political intent – in 1990 the government wanted to show that it was extending more help to disabled people; in 2010 the government wanted to cut the amount of money spent on supporting disabled people.  As someone once said, everything else is just noise.

5 comments:

  1. Long life the medical model and we it keep the corrupt disability movement oppressing disabled people with hypocritical lies for another 20 years.

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  2. Wish I could have had my WCA today, I'm having trouble walking 20m let alone 50m, but then again, the DWP say I'm fit for work!

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  3. It's probably worth noting as well that DLA was created by legislation in 1991. In 1993 when creating Incapacity Benefit (the first benefit to include the forerunner of WCA), the government AGAIN ignored evidence about the reasons for the increase in claims. The Tories used the rise in claimant numbers to introduce a new form of testing, ignoring demographic and labour market changes which accounted for the vast majority of the increased cost.

    This denied benefit to many out-of-work disabled people, just as the changes to ESA did in 2008 and 2010. So, in just 2 years the rhetoric had changed.

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  4. more on those years http://t.co/sgfQpVjk

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  5. In his book, Anatomy of an Epidemic, Robert Whitaker describes and quantifies the iatrogenic effects of the pharmacological era of psychiatry in the US. In 2007 the numbers of people receiving disability benefits in the US due to mental illness was almost 4 million, about 1 in every 76 of the population. This was more than double the rate in 1987 and six time the rate in the mid 1950s. Furthermore, the numbers of children considered disabled by virtue on mental illness rose thirty-five fold between 1987 and 2007 to more than half a million. He has found a similar picture on other countries and the UK is likely to be similar.

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