1. What is being proposed?

On 15 March 2023, the government published a health and disability white paper, which contained a range of policies designed to support the long-term sick and disabled into work. The white paper said its proposals were intended to help more disabled people “start, stay and succeed in work”. The reforms were also announced in the spring budget the same day. Chancellor Jeremy Hunt said that two million people in the UK are economically inactive due to a disability or long-term health condition. He claimed that “half the vacancies in the economy” could be filled by people in that group who “say they would like to work”.

The white paper proposed to reform disability benefits by abolishing the work capability assessment (WCA), which currently provides access to additional health-related payments in employment and support allowance and universal credit. Instead, those benefits would be accessed through the personal independence payment (PIP) assessment. The WCA is an assessment of someone’s fitness to work. The PIP assessment is used to calculate eligibility for payments that reflect the additional costs of living with a disability.

Among other measures, the white paper also proposed to:

  • allow benefit recipients with a disability to try work without the threat of losing their benefit entitlement
  • increase the funding for work coaches in the benefits system to support claimants with disabilities and health conditions into work
  • introduce a voluntary “universal support” scheme to match those with a disability who want to work to job vacancies

The white paper stated that the benefit reforms would require primary legislation, which would be introduced after the next general election. The reforms would then be gradually rolled out, initially to new claimants only, from 2026. The Office for Budget Responsibility has estimated the package of disability employment support announced in the budget and white paper could increase employment by 10,000 people by 2027/28.

2. What have organisations said about the proposals?

In its analysis of the budget, the Institute for Fiscal Studies (IFS) estimated that one million people receive additional health benefits through the WCA, 0.8 million receive PIP only, and 1.6 million people receive both benefits. The IFS warned that implementing the measures announced in the white paper would entail several “risks and trade-offs”. The one million people who receive WCA-related benefits “could potentially lose out” by £354 per month. The IFS also estimated that the reforms could increase the number of people applying for the PIP assessment, which has waiting times “which are already at 14 weeks” and in some cases five months. The IFS said that shifting the resources of the WCA to assessing PIP claims “will be a key challenge” of implementing the reforms.

Several disability charities have welcomed the abolition of the WCA but have raised concerns about the use of the PIP assessment to replace it. They have also raised concerns about the chancellor’s comment in his budget speech that, as part of the disability reforms package, “sanctions will be applied more rigorously” to those who do not take up reasonable job offers.

Setting out its response, the disability charity Scope said it welcomed the scrapping of the WCA, which it had long called for. However, it said it was “concerned” by the proposal to use the PIP assessment to judge whether somebody should receive disability-related benefits. It said the PIP assessment is not designed to assess someone’s capability to work, but to “capture the extra costs disabled people face in life”. In addition, Scope argued that the PIP assessment is “already not doing a very good job of that”.

Scope welcomed plans to reform universal credit to allow disabled people to try out work without losing their benefits, but said “the devil will be in the detail” of how the scheme works. On proposals to increase benefits sanctions for those deemed fit for work, Scope said:

We are deeply concerned about this. We know far too many disabled people are wrongly found fit to work. Sanctions and the threat of sanctions push disabled people further away from work.

The disability advocacy group Disability Rights UK raised similar concerns about the potential sanctions regime which may be associated with the abolition of the WCA. While it welcomed the support package targeted at those disabled people who may wish to work, the group said that disabled people “who can’t work or can only work limited hours need protection from sanctions”.

The mental health charity Mind cited evidence on the impacts of different benefits assessments on those with mental health conditions. Its March 2023 report ‘Reassessing assessments’ found that 46% of respondents felt their PIP assessor did not understand mental health problems, compared with 36% assessed under the WCA. A higher proportion (69%) of those who had undergone a PIP assessment felt their mental health had declined as a result, as opposed to 62% for the WCA. Mind said that although the abolition of the WCA was “positive”, it was “very concerning” that the PIP assessment would be used instead.

The right-of-centre thinktank the Centre for Social Justice (CSJ) welcomed the announcement that the “universal support” programme within universal credit would be targeted at those economically inactive due to disabilities and health conditions. The CSJ said it was “delighted” that the chancellor had heeded what it had long been campaigning for. The CSJ said that the universal support programme could “help hundreds of thousands more people reap the financial, social and health benefits of work” if delivered properly.

3. What political reaction has there been?

Reacting to the chancellor’s budget speech in the House of Commons, Labour leader Keir Starmer said he welcomed the abolition of the WCA. However, the shadow minister for disabled people, Vicky Foxcroft, has subsequently told disability groups that she shared their concerns about the package of reforms in the white paper.

On 14 April 2023, the House of Commons Work and Pensions Committee published its report ‘Health assessments for benefits’. It noted that the committee had reported in 2018 that there were “significant problems” with the health assessments process and said it was “deeply concerned” that five years later claimants were still experiencing “psychological distress” as a result of undergoing health assessments. The report stated that the PIP assessment had a rate of 69% of decisions reversed on appeal. Although the committee noted that the government intended to abolish the WCA, it argued that “retaining the status quo” in regard to the PIP assessment “is not an option”. At the time of writing, the government had not published a response to the report.


Cover image by J J Ellison on Wikimedia Commons.