Missing the point: an independent review into the impact of drug or alcohol addiction, and obesity on employment outcomes

6 August 2015

Last week the Government published a call for evidence for an independent review into the impact of drug or alcohol addiction, and obesity on employment outcomes. The purpose of this review is to evaluate the causal link between worklessness and these conditions, estimate the associated cost to the taxpayer, and assess how best to support these people into work.

The rationale is sound: not enough is being done to ensure people get medical help for long term, treatable issues. As of November 2014, there were almost 2.4 million people claiming out-of-work incapacity-related benefits (Employment and Support Allowance (ESA) and Incapacity Benefit (IB)), a significant proportion who are likely to be suffering from ‘mild/moderate’ health problems and currently receive limited back to work support. For those with common mental health, musculoskeletal or cardio-respiratory conditions, appropriate support could help them to improve and manage their health better, enabling them to make the transition from welfare to work.

Data on the cohort composition for those claiming out-of-work incapacity-related benefits shows 45 per cent of people have “Mental and Behavioural Disorders”. The second largest disability group is Musculoskeletal Diseases, which stands at 14 per cent. While drug or alcohol addiction and obesity may underlie some of these reported primary conditions, the focus of the new review is unhelpful. Not only does it reinforce the stereotype of people on benefits, but it may not reflect who is claiming incapacity-related benefits and the types of support they need.

The call for evidence states 1 in 15 working-age benefit claimants is dependent on drugs such as heroin and crack cocaine. The accuracy of this assertion must be questioned on two counts. Firstly, it is an estimation for the years 2004/05 to 2006/07. The types of people currently claiming ESA and IB, together with national factors including health and the economy, have changed in the last decade and could significantly alter this estimate. Secondly, the original report depends on the assumption that uptake of DWP benefits by Problem Drug Users (PDUs) who seek treatment for their drug use is similar to that of PDUs not in treatment. There is no evidence to support this assumption which could lead to wide disparity between estimated and actual problematic drug usage by people claiming benefits. Instead of stigmatising particular conditions, the focus must be shifted to how to create a benefits system which, as far as possible, personalises health and employment support.

Up until now conditionality for out-of-work incapacity-related benefits has been low. Those placed in the ESA Work Related Activity Group (WRAG) are expected to undertake activities to increase their employability such as CV writing classes and mock job interviews, and are subject to limited conditionality. Contrary to popular belief, few ESA claimants are sanctioned- just two per cent of claimants are sanctioned on average each month. The 1.2 million claimants in the ESA Support Group (SG) are not subject to conditionality. Given the physical, mental and social benefits of being in work, including for many sick and disabled people, and that labour market detachment increases over time, the low levels of conditionality within ESA are potentially harmful. Reforming conditionality could help ensure that recipients are engaging, as quickly as possible, in the personalised, rehabilitative employment support needed to move them into work.

The new review could help with this “by consider[ing] the case for linking benefit entitlements to take up of appropriate treatment or support.” While the review looks at only a handful of ‘behavioural’ conditions, practical recommendations to engage people in health treatment would hold weight in informing the next steps for welfare reform.

The call for evidence runs until September. Putting the narrow focus aside, the review has potential to add real value to the debate. Identifying ways to better engage people in health and employment support, while at the same time enabling discretion in the application of conditionality, could help transform the employment outcomes for people on incapacity-related benefits.

Hannah Titley, Researcher, Reform

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