Rishi Sunak has been accused of making mental health problems “a new front in the culture wars” as critics warned his plan to curb benefits for some with anxiety and depression was an attack on disabled people.
In a speech on social security, the Prime Minister said he wanted to explore whether a large cash benefit claimed by people with mental health problems could be withdrawn and replaced with treatment.
However, charities pointed out that treatment is now unavailable for many: 1.9 million people are on the NHS mental health waiting list and some are experiencing worsening conditions while left without help.
Scope, the disability equality charity, said the proposals are “dangerous and risk leaving people with disabilities destitute” and will worsen people’s poor health by increasing their anxiety. James Taylor, the charity’s director of strategy, said the speech “feels like a direct attack on people with disabilities”.
Sunak launched a review of the Personal Independence Allowance (Pip), a non-means-tested benefit that helps disabled people with the extra costs of their health problems. He said Britain was suffering from a ‘sick letter culture’.
He added that the review would consider asking for more medical evidence before granting benefits, looking at whether some payments should be one-off rather than ongoing, and exploring whether out-of-pocket payments for certain mental health conditions should be stopped.
The Prime Minister said it would try to be “more precise about the type and severity of mental health conditions that should qualify Pip”, and that it was “not clear that they have the same degree of higher cost of living as people with physical conditions. ”.
Sunak added: “If you look at the figures, half of people have become inactive in the past year citing depression and anxiety, and a threefold increase in the number of people reporting sick in the past decade, which is don’t quite understand us. as well.”
The announcement sparked outrage from disability charities, who said the number of people becoming unemployed and claiming benefits was being driven by crumbling public services, poor quality jobs and high poverty rates among disabled households.
Charities also raised the alarm about Sunak’s rhetoric on mental health issues, after the Prime Minister said there was a “risk of over-medicalisation of what are essentially life’s everyday concerns and challenges” in the welfare system.
Dr. Sarah Hughes, director of mental health charity Mind, said rhetoric that portrays a “mental health culture that has gone too far… is harmful, inaccurate and at odds with the reality for people across the country”.
“The truth is that the mental health system is at a breaking point after years of underinvestment, with many people becoming increasingly ill as they wait for support,” she said.
Labor said people were already calling for support for NHS mental health care, and that there was an “unprecedented mental health crisis”.
Wes Streeting, the shadow health secretary, said: “It’s not just tone-deaf for the Conservatives to try to make mental health issues a front for their culture wars, it’s shameless and irresponsible. “Rather than trying to cover up the scale of the problem, the next Labor government will give people the support they desperately need.”
Sunak set out his proposed reforms to disability benefits at the Center for Social Justice in London. He said “something has gone wrong” since the pandemic that has increased the number of economically inactive people suffering from long-term illnesses, especially with mental illness.
“The most worrying thing is that the majority of long-term illness cases are coming from young people… who are on welfare,” Sunak said.
He said the country could not afford the £69 billion “spiraling” disability bill, which was now more than the basic budget for schools, and claimed the Pip budget was expected to rise by 50% over the next four years.
Other measures he outlined included:
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Shifting responsibility for issuing fit notes, previously known as sick notes, from GPs to other “work and health professionals” to encourage more people to return to work.
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Confirmation of plans to legislate “in the next parliament” to cut off benefit claims for anyone who has been claiming for 12 months but does not meet the conditions for accepting available work.
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More people on Universal Credit who work part-time are asking to find more work by raising the income threshold from £743 per month to £892 per month, meaning people paid below this amount will have to find extra hours.
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Confirmation of plans to tighten work capacity assessments so that more people with “less serious conditions” have to seek some form of work.
Mel Stride, the Work and Pensions Secretary, told Sky News on Friday: “If you go to the GP and say you’re feeling a bit depressed, and they sign you off, in 94% of cases a box will be ticked that says that you are not able to work at all.
“What we want to do is change the system so that that person is referred to – the government is setting up something called Work Well – where they not only get the healthcare support they need, but also a work coach involved will be either helping them stay in work if they have work, or helping them stay in work if they don’t.”
Doctors’ and nurses’ unions raised concerns about Sunak’s suggestion that there was a risk of “over-medicalisation” of mental health problems, although he insisted that clinical decisions about diagnoses were always a matter for professionals.
The British Medical Association said the Prime Minister should focus on getting people access to the medical care they need to return to work, rather than “spreading hostile rhetoric about ‘sick letter culture’”.
Prof Pat Cullen, General Secretary of the Royal College of Nursing, said: “Nurses are the largest workforce in health and care, but they themselves are suffering from increasingly poor long-term health.
“The Prime Minister’s overtures about ‘sicknote culture’ will be deeply offensive to a profession hit hard by the long Covid-19 crisis and a spiraling mental health crisis. Public health issues are not issues that a government can simply take away.”
The Institute for Fiscal Studies said the current and next administration should find a way to finance or reduce the rising disability benefits bill, but it is still unclear what is behind the increase in claims.
Sam Ray-Chaudhuri, economist at the IFS, said: “About a year ago, it seemed likely that the rapid increase in the number of people claiming health benefits was a temporary pandemic-related phenomenon. That explanation now seems unlikely, and today’s new predictions reflect this fact.
“The rising cost of these benefits, and what can be done in response, will be a pressing concern for the next administration and make the already difficult budget situation even more difficult. Unfortunately, designing the right policy response is made much more difficult by the lack of clarity about what is fueling the increase.”