I was delighted to be asked to speak at the launch of the Work Foundation’s new report ‘Is welfare to work, working well? Improving employment rates for people with disabilities and long-term conditions’.
Is welfare to work, working well - a review by Debbie Abrahams MP
Authors: Debbie Abrahams MP
13 June 2016
People with long-term conditions (LTCs) and disabilities experience disproportionately low employment rates relative to their peers without health conditions; 46.1% of people with disabilities are employed, compared to a 73.5% national rate. These figures do not reflect the fact that many people with disabilities and ill health conditions want to work, would be able to given appropriate support, and could derive significant personal and economic benefit from doing so.
The Work Foundation’s paper focusses on how we support people to get into work – reflecting on how current welfare-to-work provision is working for those whose health may be barrier, and highlighting how support might be improved.
In my speech responding to the report and its recommendations, I commented on how I found the contextual analysis of active labour market policies in the UK thorough, although it may have been useful to contrast this with international comparisons. For example, although all EU member states support active labour market policies, their approaches differ.
In addition I think we also need to reflect on the drive for ‘flexible’ labour markets and what this means for supporting people with LTCs back into work, and most probably, out of work, and then back into work and so on. There also needs to be a recognition of geographical variations of not only of LTCs but also of the strength of the economy and the availability of jobs. There is a clear evidence that the prevalence and geographical pattern of sick and disabled people reflects the industrial heritage of our country. Contrary to the Government’s shirkers and scroungers narrative, Incapacity Benefit and Employment and Support Allowance are recognised as good population health indicators.
What is also clear is that local economic conditions – whether the economy is thriving or not – will determine how readily people with LTCs will return to work. Geographical analysis shows that people with equivalent conditions in the economically buoyant London and South East are more likely to be in work that those in the North East, North West or Wales.
Although I appreciate the Work Foundation’s report is focusing on back to work support, policymakers must not look at this in isolation of national and local industrial strategies. We must also ensure that interventions work. There has to be an evidence-base to support the significant public investment into these approaches, rather than their being driven by political whim, as we’re now seeing with the roll out of ‘in-work conditionality’ for Universal Credit recipients.
The report highlights how ineffective current interventions are in helping support people with long term conditions back into work. Although the specialist support programme, Work Choice, has been shown to be much more effective than the generic Work Programme, the DWP’s own evaluation has shown that this is far from impressive.
Also, studies on longer-running welfare to work programmes in the US indicate that it is difficult to attribute the transition from social security to employment to these interventions rather than favourable economic and labour market conditions; and any increases in employment were usually into low paid, poor quality jobs with limited earnings growth potential or employment retention prospects.
We therefore must ensure that recommendations to support people with LTCs back into work are coupled with recommendations for a growing economy committed to tackling labour market inequalities.
I visited a number of specialist programmes when I was a member of the Select Committee and although I was impressed with those that I saw I was conscious that they didn’t necessarily represent the experience of the majority of people and certainly not the constituents and others from around the country who contact me.
On the assessment process and Jobcentre Plus (JCP), the Labour Party has said since before the last general election that we believe the WCA process which assesses eligibility for social security support is not fit for purpose and should be completely overhauled.
Since I have been Shadow Minister for Disabled People, I have said I want to see a more personalised, holistic assessment which focuses on the needs of the individual and not on determining social security eligibility. However, this would also then need to be reflected in Departmental and JCP Key Performance Indicators that don’t just related to getting people ‘off flow’ as a successful outcome.
Since so many of the same people also have PIP assessments I also want to look at how we could bring these together. The need to look at comprehensive barriers to work in the assessment as opposed to just looking at eligibility for social security is really worth developing and certainly reflects international models I’ve seen.
I believe that it is also essential to maintain and increase specialist Disability Employment Advisers in JCPs. Less than 1 DEA to 600 as it currently stands won’t contribute to halving the Disability Employment Gap (which increased last year). I would also like to see their role extended to working with businesses.
Although the report refers to Access to Work I was surprised that this wasn’t included as part of the recommendations. The Government may have committed to extending Access to Work support, but it still only supported 37,000 people with LTCs & disabilities last year out of the 1.3m people who are fit and able to work.
On welfare to work commissioning and payments, the report identified some of the issues with the current commissioning and payments for welfare to work programmes, which I also agree with. The use of small, local charities as ‘bid candy’ for contracts and then not using them is just one example.
I would want to see an overhaul of commissioning including contracting and monitoring. I would want to see more evidence of options of how we could do this, including the pros and cons of local, devolved arrangements.
In terms of improving specialist support, again I want to use what works. Work Choice while it has better outcomes than other programmes, may not be the only solution. I also recognise the point being made about these programmes also being made available to people on JSA who are furthest from the labour market.
The IPS (Individual Placement and Support) model for people with mental health conditions including severe mental illness is one I am very keen to explore. As I understand this has been developed and trialled with psychiatrists which gives me some confidence in terms of both its efficacy and that it will have gone through the rigour of Ethics Committee consideration. I have concerns that some health and work programmes currently being piloted have not and, for example, have involved compelling people with LTCs to take part.
Finally in relation to supporting local innovation, I thoroughly support the drive for more devolved commissioning and delivery of DWP programmes that are both value for money for the taxpayer whilst delivering effective, personalised support for people with LTCs.
As I’ve said before we also need greater integration with DWP, the NHS and with economic development so that, for example, someone who has a musculoskeletal issue or mental health condition and has to take time off work, gets an appropriate early intervention to help them back to work. We need to understand the bottlenecks in the local system that may impact on this.
All blog posts for this author