When a prime minister finds himself heading for a crushing election defeat, he has two choices: he can choose dignified statesmanship and spend the rest of his term trying to bring as much unity and stability as he can, or he can make the desperate choice of scapegoating the marginalized to grab votes, leaving division and misery in his wake.
Chancellor Rishi Sunak has chosen the second option. On Friday he announced a new crackdown on disability pay, which charities have described as an “all-out attack on disabled people”. He said the country has a “sick pay culture” that needs to be addressed, and that the UK “cannot afford” record welfare spending and that it is “unfair” to taxpayers.
It’s not just that this rhetoric is cruel or misleading. It’s not even original. Attacking the sick and disabled has been a recurring tactic of every Conservative government over the past 14 years. It’s the party’s equivalent of a panic button: if there’s trouble, ministers can sound the alarm and the right-wing media can churn out headlines about freeing the “unemployed” from “unemployment benefits.”
As the afterglow of Sunak’s speech wears off, much of the media is focusing on his desire to reform the “health certificate” system. This is certainly worth mentioning. His plans to shift responsibility for issuing health certificates from GPs to other “work and health experts” to encourage more people to return to work are typical of Conservative welfare thinking. If there are too many sick people in the country, don’t worry about the cause – just get someone who is not a doctor to declare that they aren’t sick after all.
It’s also worth mentioning how contradictory large parts of the plan are. Mr Sunak appears to be criticising both those who are in good health (those who are employed but temporarily off work and receiving statutory sick pay) and those who are said to be abusing the benefits system (those who are unemployed with long-term health problems and need unemployment sick pay). Perhaps it’s the overall tone that matters more than nuance. Consider that just 48 hours after Mr Sunak said he wanted to take people off disability pay, it was revealed the government was scrapping a key scheme to help disabled people get into work.
Like policies on asylum seekers and transgender rights, this is more about confusing and angering enough voters than actually addressing the issues.
But what has received little attention is a major reform: a review of Personal Independence Payment (PIP), the flagship non-means-tested benefit designed to cover the extra costs of disability. Proposals include requiring more medical evidence before payments are made, considering whether some payments should be made one-off rather than ongoing, and taking funds away from some people with mental illnesses to pay for their treatment instead.
This would mean a departure from the very principle of social security for the disabled: it is not a regular payment but a cash payment that can be withheld or replaced at the whim of the state.
It’s also wildly unrealistic. There’s little point offering treatment rather than benefits to people with mental illness if they can’t get treatment. There are currently 1.9 million people on waiting lists for mental health services in England, and 15,000 deaths due to strained community care. It will be hard for Mr Sunak to understand how he pays for private GPs to see patients on the same day yet languishes on NHS waiting lists. Besides, we live in a country with universal health care. We don’t need to trade benefits for healthcare. That’s what our taxes are for.
At the same time, making social security a “lump sum” fundamentally misunderstands how people use disability benefits, or how the costs of health conditions work (Scope puts the average extra monthly cost at £975 for a household with at least one disabled adult or child). Whether it’s taking a taxi because public transport is too crowded or using a private therapist when NHS mental health services are overwhelmed, the majority of disability-related costs are frequent and long-term. The fact that two-thirds of people currently living in extreme poverty have a health condition suggests how inadequate the safety net already is.
The darkest thing about Sunak’s plan is that there is a real crisis hidden by misleading rhetoric. The UK is a much sicker and poorer country than it was before. The Institute for Fiscal Studies (IFS) estimates that one in ten working-age Britons is now on health-related benefits, and this number will only rise. We hear a lot about the cost to taxpayers, but perhaps it’s time to also focus on the cost to people’s lives – the unnecessary pain, the sleepless nights, the broken relationships and the mounting bills. Contrary to popular sentiment, all “benefit recipients” are human beings, not expenses on a spreadsheet.
Tackling the rise in long-term sickness will be a top priority for any government over the next few years. But to do so, ministers need to drop the myth that hordes of workers are faking illness and accept the facts: the UK does not have a “sick pay culture”. We have NHS waiting lists at record highs, widespread food poverty, stagnant wages, low benefit rates, soaring housing costs, a dysfunctional social care system, poor long-covid support and inadequate mental health services.
It is easier for those who engineered this mess to blame individuals, but these are structural problems that did not arise overnight but the all-too-predictable outcome of a public sphere ravaged by years of austerity, Brexit and a careless pandemic response.
The real ills of this country lie not in social welfare offices or GP practices but in Downing Street, a political culture whose default setting is to demonise and impoverish those who are already suffering, and a right-wing media that has repeated decades of lies and prejudice. There may not be an easy prescription for curing this particular condition, but it starts with a general election and getting rid of the Conservative Party.