Shifting the Goalposts: A Longitudinal Mixed-Methods Study of the Health of Long-Term Incapacity Benefit Recipients during a Period of Substantial Change to the UK Social Security System

Abstract

The UK social security safety net for those who are out of work due to ill health or disability has experienced significant change, most notably the abolition of Incapacity Benefit (IB) and the introduction of Employment and Support Allowance (ESA). These changes have been underpinned by the assumption that many recipients are not sufficiently sick or disabled to ‘deserve’ welfare benefits – claims that have been made in the absence of empirical data on the health of recipients. Employing a unique longitudinal and mixed-methods approach, this paper explores the health of a cohort of 229 long-term IB recipients in the North East of England over an eighteen-month period, during a time of significant changes to the UK welfare state. In-depth interviews with twenty-five of the survey cohort are also presented to illustrate the lived experiences of recipients. Contributing to debates surrounding the conceptualisation of work-readiness for sick and disabled people, findings indicate IB recipients had significantly worse health than the general population, with little change in their health state over the eighteen-month study period. Qualitative data reinforced the constancy of ill health for IB recipients. Finally, the paper discusses the implications for social policy, noting how the changing nature of administrative definitions and redefinitions of illness and capacity to work can impact upon the lives of sick and disabled people.

Work or welfare after cancer? Explorations of identity and stigma

“…Qualitative data from the same study reinforced the finding that ill health is constant (Garthwaite et al . ). In this article we use longitudinal qualitative data to explore how experiencing the fluctuations of cancer treatment impacts on negotiations over welfare, employment and returning to work.…”

Fear of the Brown Envelope: Exploring Welfare Reform with Long‐Term Sickness Benefits Recipients

“…Yet such portrayals in the media and within government rhetoric also serve to create divisions between sick and disabled people themselves, fostering resentment and developing increased shame and stigma for those identified as ‘undeserving’ (Garthwaite et al . , forthcoming). Whilst IB recipients spoke of how they felt stigma about receiving the benefit, they also identified other sickness benefits recipients as ‘scroungers’, ‘fake’ and ‘lazy’.…”

Assessing the Evidence Base on Health, Employability and the Labour Market – Lessons for Activation in the UK

“…Rather, evidence from in‐depth research with DB claimants finds recurring themes of poverty and insecurity whilst struggling financially to survive on benefits, with experiences of the benefits system (and especially increasing conditionality) defined by stigma and distress (Garthwaite et al . ).…”

“…National Health Service (NHS) professionals working with DB claimants confirm evidence of a broad range of interacting and comorbid health problems and disabilities (Lindsay and Dutton 2013). Other researchers have similarly used accepted clinical tools (such as the 'Hospital Anxiety and Depression Scale') to identify significantly poorer health among the DB claimant population that appears resistant to increasing exposure to conditionality and/or 'incentives' as part of changes to the benefits system (Garthwaite et al 2014). Purdie and Kellett (2015) evidence the pre-treatment severity of health problems and also register rates of associated clinically significant improvements following interventions to enable claimants to better manage their conditions.…”

“…Such findings enhance a long-established evidence base contradicting the rhetoric of individual claimants 'choosing to live on benefits' and popular myths of families defined and populated by multiple generations of the unemployed (Shildrick et al 2012). Rather, evidence from in-depth research with DB claimants finds recurring themes of poverty and insecurity whilst struggling financially to survive on benefits, with experiences of the benefits system (and especially increasing conditionality) defined by stigma and distress (Garthwaite et al 2014).…”