Independent Living, ESA and the Green Paper on Work and Health

The Spartacus Network will be making a full response to the Green Paper on Work and Health consultation, which closes in February 2017.

In the meantime here are two blogs which look at Employment and Support Allowance through a broader framework of independent living.

The first argues that, as a result of austerity policies, social security programmes in the UK are insufficient in amount, coverage, and duration to ensure an adequate standard of living, which is the cornerstone of independent living for disabled people

The second looks at independent living as defined by the UNCRPD, and finds that the Green Paper fails to uphold it because it considers paid employment to be the only pathway to full inclusion in society. It warns of continuing, invisible cuts to disability benefits in the form of shrinking eligibility, and argues that we need to reject the premise of the WCA and demand a new model of work capability based on disabled people’s accounts of work and health.


The Green Paper on Work and Health

A rights based response

There’s lots to say about the Green Paper on work and health – on how the DWP proposes to improve its employment support offer for disabled people at the same time as a cut in funding for services; on extending conditionality for benefits to groups assessed as being furthest from the labour market.

But this response will consider the implications of the Green Paper for disabled people’s right to independent living. The issue I’m going to take up is the way the Green Paper, as well as some charities response to it, sets up an opposition between full inclusion in society on the one hand and reliance on benefits on the other – a kind of moral dichotomy between inclusion and dependence.

The recent UN report on disability rights in the UK makes clear that this opposition is false.

The right to Independent Living enshrined in Article 19 is inseparable from the right to an adequate standard of living in Article 28 and the right to work in Article 27. The report says, Without an adequate income and standard of living, disabled people risk isolation and segregation from the community.

We might add that, however much choice and control someone has over their care provision, they will never achieve independent living if they are too poor to afford food or fuel.

The Green Paper talks about improving lives and creating a country that works for everyone. But the only gateway to aspiration and equality it offers to disabled people is that of paid employment.

It mentions protecting those who need help the most. But it doesn’t uphold the right to an adequate standard of living as a requirement to full inclusion and participation in the community, set out in the UNCRPD.

As well all know, disabled people’s income has taken a hit through the Bedroom Tax, benefit cap, changes to Housing Benefit and the forthcoming cut to the ESA WRA component.

The Green Paper promises no more cuts to disability benefits. But at the same time DWP has been actively developing ways to restrict entitlement to ESA even further, through measures that haven’t been consulted on, like revising guidance to assessors on interpreting the regulations on risk. So the category of what it calls those “who need help the most” is ever shrinking.

This is where we need to focus our attention in the Green Paper. Sometimes the most toxic cuts come in the form of shrinking eligibility.

The Work Capability Assessment

This is where I’m going to talk about the WCA because I think it’s not well understood by people who haven’t been through it. Its eligibility criteria seem to live in a black box that’s too technical for social policy analysis. Whereas in fact the WCA is pure ideology, there’s nothing technical or even medical about it.

The model of disability developed by Gordon Waddell and Mansell Aylward which underpins the WCA has been a key tool in undermining the rights of disabled people to an adequate standard of living. In a theory that Tom Shakespeare says is neither coherent nor evidence based, it contrasts genuine disease or impairment with so called “common health problems”, everyday aches and pains which, combined with negative attitude and lifestyle choice, create benefit dependency. This is how it creates a distinction between the deserving and the undeserving disabled in order to disqualify, initially, a million people from entitlement to social protection.

It is a pseudo-scientific rationale for denying support to people. And it’s dangerous because it’s legitimacy is almost never called into question by policy makers or the charities who speak to government on behalf of disabled people.

We all need to reject Waddell and Aylward’s version of the Biopsychosocial model outright. The tweaks to the WCA offered by DWP, like the halt to repeated assessments for a small group, are not enough.

We want a new model of work capability. One that is based on disabled people’s accounts and experiences of work and health and the relationship between them; on our own accounts of the barriers we face and the solutions that could remove them.

The Green Paper offers a consultation on the WCA but does not call into question its underlying model of disease and disability, and how it determines who “needs help the most”.

I want to finish with this thought:

Out-of-work disability benefits are not charity or a form of pity; they’re a right for those who face disadvantage in the labour market. DPOs must fight to take ownership of social security policy in the same way they have fought to influence and inform social care. We must fight the idea that financial dependence on the state makes us less than full citizens, in the same way we have fought the idea that dependence on personal assistance gives us less right to control our daily lives.

Catherine Hale.


ESA does not permit independent living for disabled people in the UK

An adequate income is the foundation upon which all independent living is based. Current rates of ESA and its equivalent under Universal Credit are not adequate in terms of coverage (who is entitled to ESA),amount or duration to ensure independent living for disabled people in the UK.

In Maslow’s hierarchy of needs, housing needs are met by housing benefit and all the other essential needs are met by ESA. ESA is not adequate to cover all the essential needs contained in Maslow’s lowest tier. However much social care someone receives, they will never be independent if they are so poor that they cannot afford food or fuel for heating.

According to the Joseph Rowntree Foundation’s Minimum Income Standard measure, the income required to achieve an adequate standard of living – for a healthy, able-bodied person is £184.66 per week for a single person, excluding rent, mortgage or the proportion of Council Tax covered by Council Tax Support. A basic living income can be estimated by removing from the budget those costs that are associated with social participation, clothing and household repairs; this comes to £114.25. Jobseeker’s Allowance, SSP, ESA WRAG and ESA SG are all  inadequate even for short-term subsistence living, let alone for an adequate standard of living. This means that people who are unable to work because of chronic disabling illness or disability are forced, by the political choices of the country, to live in destitution.

Sickness benefit Amount Shortfall in short-term Shortfall in long-term Shortfall for adequate living
SSP £88.45 £25.80 £45.21 £96.21
ESA assessment phase £73.10 £41.15 £60.56 £111.56
JSA £73.10 £41.15 £92.51 £111.56
ESA WRAG £102.15 £12.10 £31.51 £82.51
ESA SG £109.30 £4.95 £24.36 £75.36


But this is not all. The government of the last six years has ensured that:

  • Benefit levels have been frozen benefits at 2016 levels for four years, so that as food, utilities and ticket prices rise benefits become even more inadequate;
  • Housing benefit no longer covers the cost of rent, so tenants have to make up the rest from their ESA, live in housing that is so damp or cold as to damage health, or rent from rogue landlords;
  • The assessment for ESA has been designed in a way that is incapable of assessing chronic illness. It cannot account for the significant disabling effect of having some difficulty with all activities, as opposed to specific, discrete incapacity such as the effect of sight loss on reading. Consequently, many people who are too ill to work are assessed as fit for work.
  • People on JSA or ESA WRAG have to take part in activity in order to retain their benefit. Research on WRAG confirms that this activity is largely irrelevant and detrimental to their health.
  • People with chronic disabling illness typically have extra costs, such as needing help with personal care or household chores, or for additional utility bills. Extra-costs benefits do not cover households chores other than basic cooking, nor more expensive items. The assessment is unable to assess the extra costs of chronic illness, so people struggle to get the benefits they need even for the costs that are assessed.
  • ESA become means-tested after certain time limits. People who do not have enough National Insurance credits in the previous two years are dependent upon means-tested payment, and ESA WRAG claimants after twelve months. After this, people can’t receive benefits if their partner has too much income (£5-10k/yr) or savings.
  • ESA recipients are regularly reassessed, usually at intervals of under two years. Because of the strictnrss and inconsistency of the assessment, individuals can lose their benefit without any improvement in health – and even with a deterioration – and then have to go through a lengthy appeal process to reinstate their benefit. In this time, increased poverty and stress lead to worsened health and indebtedness.

All of this means that sickness benefits are not adequate in:

  • Coverage (many people unfit for work are told that they are fit for work, or made to carry out prescribed activity to retain their benefit);
  • Amount – ESA does not cover the cost of an acceptable living standard, including social participation for people who would otherwise be permanently locked out of society. Housing benefit does not cover the cost of housing, and extra-cost benefits do not cover the extra costs incurred by chronically ill people;
  • Duration – benefits are means-tested, and repeatedly re-assessed. They do not last as long as the chronic illness, and are not stable.

Stef Benstead and Caroline Richardson.