Britain is sicker and poorer than before. Sunak’s response? Attacking disabled people | Frances Ryan

WWhen a prime minister knows he is headed for electoral defeat, he has two options. He can opt for dignified statesmanship and use his remaining months in power to achieve as much unity and stability as possible. Or he can choose desperation, grab votes by scapegoating marginalized people, and leave division and misery in his wake.

Rishi Sunak has chosen the second option. On Friday he announced a new crackdown on disability benefits, which charities have described as “an outright attack on people with disabilities”. The country has a “culture of disease” that needs to be addressed, the Prime Minister said. Britain “cannot afford” its record levels of social spending and it is “not fair” to the taxpayer.

It is not simply that such rhetoric is cruel or misleading; it’s not even original. Attacking sick and disabled people is a method that has been used again and again over the past fourteen years under conservative rule. It is the equivalent of the party’s emergency button: if there are problems, ministers can sound the alarm and the right-wing press will make headlines about removing the “unemployed” from the “welfare”.

As the dust from Sunak’s speech has settled, much of the media has focused on his desire to reform the “fit note” system. It’s definitely worth mentioning. The plan to shift responsibility for issuing health certificates from GPs to other “work and health professionals” in order to encourage more people to return to work is a classic piece of conservative welfare thinking. If there are too many sick people in the country, don’t bother addressing the causes; just let someone who is not a doctor declare that he is not really ill after all.

It’s also worth noting how disjointed much of the plan is. Sunak appears to be torn between criticizing those who are fit (people who have a job but are temporarily off work and receive statutory sick pay) and those who are said to be milking the benefits system (people who are unemployed due to long-term health problems and unemployment benefits). I guess the point is that nuance doesn’t matter as much as the general mood music. Recall that barely 48 hours after Sunak announced his push to take people off disability benefits, it emerged that the government had scrapped a key scheme that helps people with disabilities into work.

As with asylum seeker and trans rights policies, this is less about actually tackling the problem and more about confusing and angering enough voters.

What has largely flown under the radar, however, is a major reform: a review of Personal Independence Payments (Pip), the flagship non-means-tested benefit designed to help cover the extra costs associated with disability. Proposals include asking for more medical evidence before granting benefits, looking at whether some payments should be one-off rather than ongoing, and taking money from some people with mental health problems and replacing it with treatment.

This would represent a break with the principle of social security for people with disabilities: instead of a recurring right, this is cash that can be withheld or exchanged at the whim of the state.

It would also be hugely impractical. Offering treatment to people with mental illnesses in lieu of benefits means little if treatment is not available. There are currently 1.9 million people waiting for mental health care in England 15,000 have died under strained community care. I suppose it’s hard for Sunak to understand being on an NHS waiting list if he’s paying for a private GP practice to see patients on the day. Moreover, we live in a country with universal healthcare. Benefits do not have to be redeemed for medical treatment; that’s what we pay our taxes for.

At the same time, making Social Security a “one-time payment” leads to a fundamental misunderstanding about how people use disability benefits or how the cost of health problems works (Scope argues the average monthly extras for a household with at least one disabled adult or child from £975). Whether it’s taxis when public transport is overwhelming and inaccessible, or a private therapist when the NHS mental health system is overwhelmed, the vast majority of disability expenditure is frequent and long-term. The fact that two-thirds of people currently living in poverty have a health problem, showing how inadequate the safety net already is.

The bleakest part of Sunak’s plan is that there is a real crisis being obscured by his misleading rhetoric. Britain is a significantly sicker and poorer country than it used to be. The Institute for Fiscal Studies (IFS) estimates that one in ten working-age Britons now receive health-related benefits, and this is only expected to increase. We hear a lot about the costs of this to taxpayers, but perhaps it’s time we also focus on the costs to human lives: the unnecessary pain, the sleepless nights, the broken relationships and the mounting bills. Contrary to popular belief, every ‘benefit recipient’ is a human being and not an expense on a spreadsheet.

In the coming years, tackling the growing number of long-term ill people will have to be the priority of every government. To do that, however, ministers will have to abandon the fiction that hordes of workers are feigning illness and admit the facts. Britain does not have a ‘disease culture’. It has a record high NHS waiting list, widespread food poverty, stagnant wages, low benefit rates, crippling housing costs, a broken social care system, poor long-term Covid support and inadequate mental health care.

It is easier for the architects to blame the individual for such chaos. And yet these are structural issues – issues that did not arise overnight, but are the all-too-predictable consequences of a public space destroyed by years of austerity, Brexit and a carelessly handled pandemic.

The real disease in this country is not found in a benefits office or a doctor’s surgery, but in Downing Street. It’s a political culture whose default setting is to demonize and impoverish people who are already suffering, and a right-wing media that has spent decades parroting the lies and bigotry they fuel. There may be no simple recipe to cure this particular condition, but it starts with a general election – and voting out the Conservatives.