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Thoughts on ESA

Author: Simon Duffy, on behalf of Frances Kelly and the Cumulative Impact Assessment Discussion Forum

This article is an attempt to review internal debates within the disability movement about the failure of the Employment Support Allowance (ESA) and the Work Capability Assessment (WCA). It is an early piece which aims to support further discussion and analysis.

The current discussion, as I read it, covers a lot of ground and reveals some quite radical differences of opinion and strong emotions. To say that it is a defining issue for the disability movement is something of an understatement. It is clear that for many of us this debate is very much about defining important aspects of who we are and what we think this should mean to the wider community. At times the debate reflects the emotions we feel when we find that others - both within and without the discussion - share very different views about us. It is an inevitably a toe-treading conversation.

I didn’t sense any consensus, although there were some powerful and sharp observations made by many. I also noted some things that didn’t get discussed.

1. An Introduction to the ESA

I am going to ignore the the full history of the Employment & Support Allowance (ESA) and details of the previous system. The current government has ripped up so much of the old system that it hardly seems worthwhile to look backwards. Instead I offer a very basic introduction to the ESA as I understand it:

1. Purpose:

Employment and Support Allowance (ESA) is money for working-age adults who have limited capability for work because of their sickness or disability, but who do not get Statutory Sick Pay.

2. There are two types of ESA:

  • Income-related ESA is means-tested, but not-taxable and 
  • Contributory ESA is non-means-tested but taxable

Means-testing benefits is a form of double-taxation - and a way of ensuring that benefit recipients are impoverished. Contribution is a form of state-run insurance that offers some modest benefits to those lucky enough to have been in employment so they can build up enough National Insurance (NI) payments. However, you can only be on Contributory ESA for one year, you will then be moved to the means-tested system. Notice that you will also be ineligible if your partner is claiming Job Seekers Allowance (JSA) or Income Support (IS). Hence the system also taxes families.

3. Currently (2013-14) the benefit is:

  • First 13 weeks (under 25) £56.80 pw. (£2,954 pa.)
  • First 13 weeks (over 25) £71.70 pw. (£3,728.40 pa.)
  • From 14 weeks (for those in Work Related Activity Group) up to £100.15 (£5208 pa.)
  • From 14 weeks (for those in Support Group) up to £106.50 (£5538)

In other words this system provides a modest additional payment on top of the very low amount which can be claimed simply because of a low income (Income Support, currently £71 pw.) or by people seeking working without a disability and entitled to Job Seekers Allowance (JSA). Cynically one might argue ESA has effectively become an enhanced form of income security - a low level income guarantee for the ‘deserving poor’.

4. The Work Capability Assessment (WCA):

Obtaining ESA depends upon being found to have ‘limited capability for work’ (LCW). The assessment process - controversially tendered out to Atos - also then separates out those who have capacity for work related activities (WRAG). This leaves the rather peculiarly named ‘Support Group’ where there is no expectation of work, but the added benefit of £6 per week.

5. The Work Programme:

If you are within the WRAG you will then be subject to the centrally commissioned Work Programme which empowers private and charitable organisations to support people into work - support here including the application of punitive rules, sanctions and ‘workfare’ - ie. enforced work. However, many in the WRAG do not get this promised support if providers have deemed them too complex to support (ie. undermining the whole logic of the system itself and implying some kind of further assessment within the WRAG group by the providers).

6. Costs:

The system is currently still moving towards the full implementation of ESA. In 2013 the DWP reported that it expected 2 million people to be claiming £11.5 bn. of ESA by 2017.[1] That would be:

  • 6% of the benefit bill
  • Less than 1% of GDP
  • Less than 10% of the NHS

In addition it is worth noting that much of this money is returned directly to the government in direct and indirect taxes. The poorest 10% currently pay 45% of their income in taxes. So the net cost of ESA is likely to be much lower - between £6-8 bn. That is about £4,000 per capita.

Furthermore, in 2009-10 the DWP reported that there were up to 620,000 people failing to claim up to £2 bn. in income support, and employment and support allowance.[2]

7. Performance:

The failings of the Work Programme - particularly for those in the WRAG are well documented. It is highly questionable that the money spent on these programmes is money well spent. It seems likely that similar numbers of people would find work even if the programme did not exist.[3]

Of those on ESA only 5.3% have found work - and the current target is 16.5% - this suggests that the concept of ‘work related activity’ is confused. The target is so low that one struggles to understand the purpose of the concept.[4] 

Paradoxically the ‘payment by results’ contracting formula also means that providers are punished for trying to support those who are harder to find work for. This seems to undermine the whole logic of the WRAG concept.[5]

2. Points of Debate

I will try to distinguish some of the main policy options that you have already discussed, but first here are some initial observations. In the lively debate I noted 10 major issues:

1. The WRAG/Support Group Distinction

The point is rightly made that splitting the group of people in the way the WCA does seems problematic. A line is drawn across a rather complex group of people with many different conditions, impairments, aspirations and support systems. The WCA - for all its supposed ‘social model’ credentials seems essentially to be making a simplistic professional judgement about people, largely in isolation from their preferences and social circumstances. Roughly this is the judgement about whether Atos/DWP/society thinks you could work - with the right support.

Underlying this is:

  • a political judgement that too many people are deemed unable to work
  • the desire to save money
  • the efforts to increase access to work for disabled people

There is a strong sense that worthy moral goals have been undermined by political and economic realities.

2. Assessments

This then raises questions about the assessment process:

  • The fear of ‘incentivised’ providers, like Atos
  • The worry about competence of any professional to make a sensible judgement
  • The problem that self-assessment is deemed to lack ‘credibility’
  • The possibility of objective proxies - e.g. blood tests
  • The possibility of adding an Independent Disabled Observer or Advocate

3. Identity

The debates about identity were fascinating:

  • Should we distinguish disability from sickness?
  • Should we go back to terms the general public understand, e.g. handicap?
  • How do we think about disability when many don’t recognise the term or its application to themselves?
  • How do we think about intellectual disabilities or mental health problems?

It seems that noble aspiration to build a united movement has a tendency to simplify the many different ways we can be different from each other. Yet when we try to distinguish different dimensions of difference (e.g. sickness vs disability) we are also likely to create less unity in the movement demanding change.

4. Poverty trap

An important point was the sense in which WRAG also creates increased levels of fear. If you overcome sickness/disability and get a job then it seems that you are capable of work. Should you then fall out of work again, might you not be treated as capable for work. Might this actually leave you less willing to work.

This same criticism could even be made of ESA as a whole. Creating a better low income benefit for disabled - as opposed to non-disabled - people has the effect of increasing the risk of ‘coming off benefits’. However, given the extremely low level of both this is unlikely to be a significant factor. It is however a further reason for trying to avoid means-testing where possible.

5. Work

Some observed that the most important forms of work - bringing up children, supporting other family members, contributing to your community - don’t count as work because they don’t provide an income. This is a theme in the work of the New Economics Foundation. Many of us worry that the commodification of all human activities as ‘paid work’ only serves government and employers. Might one challenge this badly founded paradigm by uniting with others whose ‘work’ isn’t recognised - mothers, carers, volunteers?

6. Volunteering

Connected to this is a discussion as to what extent voluntary activity can act as a valid alternative to work. Volunteering as defined by charities is often a poor proxy for real community contribution and is often itself lacking in dignity.

7. Capacity

Given the data we’ve seen there seems little evidence that the WRAG represents a hidden workforce and many in the discussion would like to return to a more common-sense - ‘many of us just can’t work’ position.

There is a long-standing debate here: Will modern economies naturally be able to offer everyone well-paid work - or is the economy always going to have to be ‘managed’ and incomes secured? 

The rhetoric of politicians implies the former, the reality suggests the latter. However, we often collude with politicians in accepting that - with the next policy improvement - full well-paid employment is just around the corner. What would it mean if we simply challenged this and set out - as our starting point - the need to ensure adequate income security for all - whatever the current economic circumstance?

8. Sanctions

What WRAG really means is that people will face more punitive measures and that the notion of ‘work-shy’ can be readily used against many disabled people - whether or not the prospect of work is realistic. It is noticeable that the press coverage on WRAG effectively treated this group as the ‘less deserving poor’. However we didn’t all agree that that sanctions were always wrong.

9. Employers and the labour market

Views differ on whether a focus on employer responsibility would help improve access to work.

10. Means-testing

Views differ about whether means-testing of entitlements is right or wrong. 

3. Other issues that were not discussed

However I also noted some things that were not discussed:

1. The local factor

The UK has the most centralised welfare system in the world. There was no discussion of localisation - although some Northern authorities, like Barnsley have argued that the DWP has no business commissioning providers to support people in communities

2. Poverty

There was no discussion of the basic income. The current system is premised on an incredibly low income - less than £3,000 per year - if you are under 25 and only £3,700 per year if you are over 25. This compares with a state pension of £5720 (which is itself just a tad greater than the ESA level).

3. The central purpose of ESA

I am not sure whether we are all clear what the purpose of the ESA is. It seems the whole system is working to the following assumption: 

  1. Society can guarantee a basic income at a very low level only so long as we also associate that level with a certain level of stigma - those who could and should work - but for some reason aren’t. [And even this guarantee is weak and subject to sanctions.]
  2. Any higher level of income must only given to those who are worthy of extra money - not because the money is necessary for some defined purpose - but as a kind of ‘reward’ for not being amongst the most stigmatised group - those who can’t work.
  3. The ESA reform has added a third group - those who probably can work, if we give them a lot of support. This group now faces more stigma, more fear and a somewhat lower income - and yet no realistic additional probability of finding work.

Notice how these distinctions create stigma, and an increasingly nuanced sense of stigma, just as they also divide the interests of the different groups from one another.

Jane Young did observe that what would be more attractive would be a sickness benefit - and this is feasible and logical - i.e. what people who are sick would be entitled to when they are not entitled to Statutory Sick Pay. However we have travelled a long way from something sensible like that.

4. Policy Proposals

Some observations: 

  1. Offering policy proposals to politicians is important - but hazardous (at least in my experience). What you end up with is often many miles from what you suggested. But, if you have influence, you should certainly use it.
  2. The most important thing may not be the actual proposal, but the development of a wider movement that can back the proposal - and keep it on track if the politician forgets the real purpose of the proposal. (e.g. this is what the Campaign for a Fair Society is trying to achieve.)
  3. Politicians like people to be pragmatic - give them something they can use. That is nice, if it’s possible. But it’s more important to know where you really want to get. This is how you win wider support and measure the actual proposals and their implementation.

Your options:

If there was an underlying consensus in this discussion, apart from what a dreadful mess we’re in, I didn’t get it. But the discussion did suggest some non-exclusive options:

1. Develop a sickness supplement system

The existing policy is so confused it may be worth just abandoning the whole notion of enhanced income support for the deserving poor and instead seek a nationalised system of sickness income supplements. This opens a whole can of worms, but ideally they would not be means-tested. You could try to define some of the key features of the system - at least in terms of broad principles.

2. Raise the basic level of income

More than 50% of ESA is just the incredibly low basic income guarantee. Should not disabled people and other allies be battling to raise this alongside other disadvantaged groups - rather than trying to create your own system? [Obviously this strategy could be combined with the sickness benefit strategy.]

3. Challenge means-testing

Although the desire to means-test benefits is such common ground for Left and Right I still think its worth trying to make an issue out of something that is essentially bad economics, bad administration and ultimately unjust:

  1. Means-tests just create additional taxes for the poor instead of integrating everyone into the same tax system when incomes are sufficient
  2. Means-tests add to the poverty trap and damage incentives
  3. Means-tests are more administratively complex and expensive
  4. Means-tests increase overall income inequality

4. Disconnect the benefit from the employment support systems

One lesson you could draw from the discussion is that whether people are ready or willing to work, in full-time, part-time or other forms of employment, is an essentially personal matter. Determining whether someone’s condition is likely to pose an effective barrier to work is an objective and empirical question - some conditions correlate with unemployment. Determining whether a specific individual is in the right personal situation to look for work or even find work is an entirely different question and depends on a whole of host of personal factors:

  • State of any condition
  • Personal mental health
  • Family circumstances
  • Local community support
  • Networks of relationships
  • Personal valuation of objective incentives

The current system is muddling these two very different questions and is linking ‘support into work’ with ‘capacity for work’. Perhaps members of the group would unite around something like this:

  1. A system that gave higher incomes to those objectively less likely to find work in the market, plus
  2. A separate system that was open to anyone who felt they needed help to get work

5. Challenge professional assessment

Curiously I am not aware of any evidence that people systematically over-assess their own needs or over-claim benefits. It is professionals who tend to do that. Moreover the idea that we make claims when our objectives circumstances entitle us is quite commonplace. I’m afraid I am left thinking that unless you go back to an assumption of citizen competence, plus objective tests, you will be battling the myth of professional competence for a long time.

Clearly not everyone agrees on this - but it seems like one of the arguments where you can make a strong case on the basis of:

  • Cost effectiveness of process
  • Low risk of over-claiming
  • Low risk of stigma
  • High transparency of criteria for determining eligibility

6. Challenge WRAG

Another area where you are on strong ground is the WRAG. Currently the system divides the group of people with lower capacity for work into two groups - but then fails to find work for those who are ‘nearer to work’. In the process it divides disabled people from one another and legitimises an illegitimate assessment process.Clearly the process is crude and it splits a complex group at an arbitrary point, but given everything we’ve explored, I can see no argument for further dividing ourselves into even smaller groups.

7. Challenge employment support

There were some very specific proposals about changing employment support - based on personal experience and expertise. I won’t replicate them here, in essence they propose much better systems for engaging with employers through incentives, adaptations, funding, information and regulations. I also know of peer support systems being used to help people find work.

As I noted above there was no discussion about the highly centralised nature of employment support. As far as I can tell the systems we have work very badly, but are managed from Whitehall on the assumption that local government, local communities, local businesses are all incompetent and do not care about the employment of people with disabilities. However the best place in the country - to my knowledge - at finding disabled people work is North Lanarkshire Council.

I may be alone in thinking that employment support cannot be competently commissioned from Whitehall. But it is perhaps an issue worth considering. It is also an issue where you could make common cause with advocates of increased power for local government.

Conclusion

When Frances asked me to review this debate I was nervous that I would add nothing. After reading the debate I am also nervous that my own views are too strong and that our disagreements are too wide. However I am grateful for the opportunity to think harder about the issues.

My overall sense is that we have one thing to be grateful for - the system is such a mess that it may help us get the energy to lobby for something better. But I’m sceptical that this will be done by simply offering little nuggets of wisdom to the Labour Party. 

I am left even more sure that we need to build a wider network of support for a welfare system that is genuinely respectful and enabling. We need to ensure we are thinking of people who are very sick, just as we think about disabled people who are ready and willing to work. But we also need to think about others who are very poor, women with families who are working incredibly hard just to keep things together, people struggling with mental illness or asylum seekers who are denied even the minimum. All of these folk are currently under attack - ESA is just one more damaging and divisive non-reform. We should challenge it - but with our eyes wide open.

Notes and links

[1] https://www.gov.uk/government/publications/benefit-expenditure-and-caseload-tables-2013

[2] http://www.bbc.co.uk/news/business-17139088

[3] http://www.independent.co.uk/news/uk/politics/three-out-of-four-longterm-unemployed-on-work-programme-havent-found-a-job-yet-8665874.html

[4] http://www.mind.org.uk/news/show/9140_work_programme_is_failing_people

[5] http://indusdelta.co.uk/story/work_programme_performance_stat

http://www.telegraph.co.uk/news/uknews/10136741/63000-on-sickness-benefit-for-more-than-10-years.html

http://www.telegraph.co.uk/news/politics/conservative/10136768/Welfare-a-brief-illness-shouldnt-lead-to-decades-out-of-work.html

http://www.telegraph.co.uk/news/politics/9434271/Half-of-recipients-of-sickness-benefit-return-to-work-if-ruled-fit.html

http://disabilitynewsservice.com/2013/06/miliband-offers-work-hope-for-long-term-disabled-unemployed/

http://www.telegraph.co.uk/news/politics/10087598/25000-disabled-people-given-help-to-find-work.html

http://www.theguardian.com/voluntary-sector-network/2013/jul/24/business-of-being-charitable

http://www.scope.org.uk/sites/default/files/Disability-Charities-Consortium.pdf

http://www.centreforwelfarereform.org/library/by-az/the-reality-of-disability-benefits.html


The publisher is The Centre for Welfare Reform.

Thoughts on ESA © Simon Duffy 2013.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.