Budget pressures are being blamed on rising levels of disability and illness. What is going on?
Like many others earlier today I tuned in to the IFS post-budget webinar (some working life habits die hard!). As always, it was insightful and erudite. (The lack of recognition of devolution was pretty annoying but that’s for another post).
My big takeaway wasn’t about fiscal headroom, taxes, deficits or any of the other issues discussed. It was about what a sick society the UK has become.
Throughout the webinar, speakers made clear that pressures from pensions, disability benefits and children with special educational needs (in England) are driving public spending upwards. And while several people in the webinar (and elsewhere) talked about ways to cut public spending, such as scrapping the pensions triple lock or “welfare reform”, nobody asked how come so many more children and adults have additional needs or are disabled?
Maybe I have missed something, but I’m pretty sure that there hasn’t been a huge increase in disabling medical conditions. According to the Office for National Statistics, more people in Wales reported being in very good or good health in 2021 compared with 2011, and the proportion who reported that their health was fair, bad or very bad declined. While the incidence of some diseases is up, such as diabetes or high blood pressure, for many people these conditions require (careful) management rather than preventing people from working altogether.
So what’s driving the increases?
This is a genuine question and it seems that nobody knowns the answer. While there has been an increase in the number of people claiming disability benefits for mental health conditions, it doesn’t explain all the rise. It is also suggested that the rise in state pension age may be a factor, but again this doesn’t account for increase in full. And of course some suggest that more people are gaming the educational or benefits system for financial gain, although this too is unlikely to be significant.
If it is indeed the case that a lot more people are sick or disabled, surely this is a major social problem, the root causes of which need to be tackled. Changing pensions, disability benefits or educational reforms will just push people who may already be unwell into hardship and do little to improve their health.
A society with the levels of sickness and disability that have been suggested is in deep trouble. Aside from the individual suffering, it creates huge demand for public services, affects economic activity and output, and has knock-on impacts for carers. It is a genuinely horrible prospect. A review by Stephen Timms, Work and Pensions Minister, is expected to report on disability and PIP shortly, but the issues are wider than PIP.
A solution?
I suspect that a radical change in what public health folk call the ‘social determinants of health’ is needed to shift the dial – improvements in people’s housing, standards of living, conditions of work, and general environment, as well as healthier lifestyles and better health services. Sadly, the 2020s are likely to be another lost decade on living standards and there is no sign of the shortage of decent, affordable housing easing. Legislation is on its way that is intended to improve job security, but I am not holding my breath. Meanwhile waiting lists for health care continue. Grim.
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