Women’s Policy Group calls out DWP’s medical-model approach to the experience of disability
Previous WPG consultation documents and research commissioned by the WRDA, have highlighted the gendered nature of poverty in Northern Ireland, the additional impact of the cost of living crisis and the inadequacy of the current system for those in receipt of benefits. Modernisation of independent living support must be considered against the backdrop of increased poverty and precarity.
The green paper takes a medical-model approach to the experience of disability and to the lives of Disabled people. Focusing on how their disability may be “cured” or “fixed” through different interventions, ignoring the role of social security as social infrastructure, which removes barriers to the participation of disabled people in society. The introduction of any of the policies in this green paper would lead to even higher numbers of attitudinal, institutional, environmental and information barriers.
The green paper frames the need for change around an “unsustainable” rise in PIP claimants. But it fails to address the clear reasons why PIP claims have increased, such as the cost-of-living crisis. A household with at least one Disabled adult or child needs an additional £975 a month to have the same standard of living as non-disabled households, according to Scope. Yet, even at its highest rate (of £800 a month), PIP is not paid at this level. The aim of the Green Paper is to reduce spending on PIP and not ensure that PIP payments meet the true extra costs of Disabled people. In March 2024, the Work and Pensions Committee of MPs reported in published its report examining the level of benefits in the UK.When considering PIP, it found that “many claimants experienced a significant shortfall between the levels of support provided and the cost of additional health and disability-related costs” and that “the support provided through health and disability benefits were found to have a negative physical and mental health impact on claimants, which in turn could affect their ability to work.” However, in its response to the committee reports, the Government said that “the DWP has ‘no plans’ to commission research to understand the impact of benefit levels on the health and wellbeing of claimants”. The UK Government said that there are “no plans to commission further research to understand the impact of benefit levels on the health and wellbeing of customers and its relationship with economic productivity.”
Worse, it holds that there is “no objective way of deciding what an adequate level of benefit should be” and so has “no plans to commission independent research into the extent to which current benefit levels are meeting its objectives for what benefit levels should achieve in relation to living costs.
Two independent reviews of the PIP assessment process undertaken in Northern Ireland (in 2018/17 and 2020), suggest that d/Deaf and disabled people have lost trust in the PIP process and the work capability assessment associated with entitlement to employment support allowance. The PIP assessment process is a fragmented process that impacts negatively on both claimants and those who seek to support them. The assessment causes fear, anxiety, stress, and frustration. This has a knock-on impact on the health and well-being of claimants, their family and wider support networks, and places even more demands on already stretched services.
Many d/Deaf and disabled people are subject to repeat face-to-face assessments on average every three years for the duration of their claim. This includes people with physical disabilities and neurological disabilities, whose health condition is unlikely to change. For example, cerebral palsy is an impairment acquired at birth, yet people with this impairment are subject to three-year reviews to guarantee continuation of their benefit entitlement. It is of note that in 8 PIP cases known to the Northwest Forum of People with Disabilities, 2 people with cerebral palsy who were unable to work received what are known as 10-year light touch reviews and that in 6 other cases where people with cerebral palsy were in work they received 3-year reviews. There appears to be an inherent bias against d/Deaf and disabled people who are in work and the review period for their claim. It is important to recognise that whatever award is granted to d/Deaf and disabled people in this instance. that cerebral palsy is acquired at birth and its effects are unlikely to change. Only those d/Deaf and disabled people who have received a ten-year review are not subject to ongoing repeated assessments but instead will have a light touch review at the end of the ten year period.
Evidence has demonstrated that PIP assessments may not always accurately present information provided by claimants. DPOs have suggested that there is an inherent bias against people with mental health issues within the PIP process, an issue highlighted during a successful legal challenge when the court found that the amendments to the mobility component criteria was discriminatory towards those with mental health issues (psycho-social disabilities).
In addition, the present system subjects disabled people to a series of often humiliating tests that, in many cases, do not accurately capture the nature of the disability they live with, seemingly without considering that many conditions do not present continually in the same way. They are overturned in approximately 72% of appeals, which indicates that they are recognised as not being an effective way of capturing the ways that a disability may impact the person living with it.
More than £10 million has been spent by the Department for Communities on processing PIP appeals over the last 3 years. From April 2019 to June 2021, there were 9,999 PIP related appeals lodged in Northern Ireland and, of these, 5,969 cases (60%) were won by the d/Deaf or disabled claimant . Furthermore, a PIP award was revised down in only 58 cases. These statistics highlight a significant and ongoing problem with the PIP assessment process. Many d/Deaf and disabled people are being forced to appeal for their rightful entitlement to disability benefits while others are enduring high levels of stress and anxiety due to income uncertainty.
The requirement to be subjected to similar tests across many years when a condition is life-long is not only an unnecessary expense to the public purse but an exercise inillustrating the lack of trust that DWP seems to have in people with disabilities, and the tendency to declare very severely disabled people, including those nearing the end of life, as “fit for work” seems a Kafkaesque approach to human lives and wellbeing. It is also not an effective or responsible use of public money to continue to use a system that costs more money than it saves, on top of its impact on human life, wellbeing and dignity. Our position is that the entire process needs to be reconsidered.
There are also concerns that the current practice by which so many disabled people lose access to their disability benefits if they marry or cohabit with a partner. This is a concern for a number of reasons; from a WPG perspective; it is particularly concerning because of the way that it impacts the work towards Gender Equality that forms the bedrock of our work, but it also contributes in a meaningful way towards the inequalities that disabled women face, including disproportionate rates of VAWG, which is borne out in WPG’s 2022 research28 on the topic, and in many other pieces of research.
The fact that those in receipt of disability benefits risk losing all or part of their benefits is a significant intrusion on their right to a private and family life. Should they choose to cohabit or marry anyway, they become entirely financially dependent on their partner, which we know increases a person’s vulnerability to abuse and limits their access to escape routes should they choose to leave. A lack of available and adapted social housing is also an issue that contributes to trapping disabled women in abusive homes, but as a first priority we must guarantee the financial independence of disabled adults – something the current system explicitly does not do.
This is an excerpt from the WPG NI Response to Modernising support for independent living: the health and disability green paper.
