Employment and Support Allowance – a flawed design?

A recent report on the UK’s main disability benefit, Employment and Support Allowance (ESA) said that the current system for assessing benefits was ‘flawed’. This report by the House of Commons Work and Pensions Committee Employment and Support Allowance and Work Capability Assessments First Report of Session 2014-15 HC302 brings into sharp focus the problems of attempting to measure people’s ‘incapacity for work’.

A controversial procedure

ESA was introduced in 2008 as the latest attempt by governments to find a way of assessing whether or not someone was unfit for work. ESA has been controversial since it was first introduced and concerns with it have multiplied as researchers, disability campaigners and support organisations for people with long term health conditions have shown how the system has impacted on real people. For many people it has meant a loss of much-needed income, leading to hardship and distress. Even when people have successfully claimed the benefit, the assessment procedures and delays have caused considerable anxiety and financial hardship for claimants.

Demonstration against cuts in disability benefits

Much of the criticism of the system has been directed at ATOS, the organisation contracted to carry out assessments but this report reminds us that implementation by ATOS is only part of the problem. There are fundamental problems with the policy itself, which a change to a different provider in late 2014 will not solve. One of the key difficulties has been the way in which a points based system of assessment, where people are awarded points for different levels of impairment, cannot take account of the complexity of people’s experience in the real world of work.

Looking to the past

If we look at the question in its historical context we can see why this is. Ever since the first introduction of sickness benefits in 1911, policy makers have worried about how to assess whether someone was ‘really’ unfit for work. In 1951, after forty years of attempting to define what ‘incapacity for work’ meant, legal decision makers came up with a working definition:

‘A person is incapable of work … if, having regard to his age, education, experience, state of health and other personal factors, there is no work or type of work which he can be reasonably expected to do. By ‘work’ in this connection we mean remunerative work that is to say work whether part-time or whole time for which an employer would be willing to pay, or work as a self-employed person in some gainful occupation’ [National Insurance Commissioners’ Decision R(S)11/51, para 5]

This definition was not perfect and the benefits system in the mid-twentieth century left many disabled people without access to income but at least it attempted to take account of the varieties of social experience which combine with poor health and disability to make finding work difficult.

Taking account of the real world of work

The current system which is used to assess Employment and Support Allowance cannot do this. The House of Commons report makes this point by emphasising that many people who are found ‘fit for work’ (and refused benefits), or who qualify for benefits but are expected to look for work, are being failed by the system. The procedure does not take account of the support that they would need to find work in the real world. The report says that the statement that someone is ‘fit for work’ should be ‘conditional on this support being available’ (para 141). While criticising the current assessment process for ESA and calling for a fundamental review of the mechanisms, the report does not suggest replacing the points system altogether. It continues in its search for an ‘accurate’ measurement of people’s incapacity (p3) but it does this within an understanding that real people’s experiences of attempting to find work depend on a range of social circumstances which go a long way beyond the simplistic measures that a points system can assess. The report also recognises that refusing people benefits is not the same as helping them to find work, a first step in moving beyond the current government’s view of the problem.

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