Changes to the Work Capability Assessment: What they mean for mental illness

The government announced changes to the Work Capability Assessment in the Autumn Budget. Jonathan Andrew, Head of Public Affairs at Rethink, looks at how they impact people living with mental illness.

In the Budget on Wednesday 30 October, the Chancellor said that the government will “deliver the savings” set out by the previous government with changes to the Work Capability Assessment.

While her language was not completely clear, it seems that the government is intending to significantly change the criteria which determines if you are deemed too ill to work, and entitled to additional benefits to cover your daily cost of living. This policy was originally proposed by the last government, and by the then Secretary of State for the Department for Work and Pensions Mel Stride.   

This policy change would have a huge impact on people living with mental illness. We are working with others across the mental health and wider voluntary sector to oppose these changes and make sure any adaptations to the benefits system balance the need for public savings with vital protections for those who are unable to work because of their mental illness. 

How the current system works (in a nutshell)

If you become unwell you can receive Statutory Sick Pay from your employer in the first instance. This payment is £116.75 a week, and requires evidence of sickness from your GP. Statutory Sick Pay is unrelated to welfare spending, as sick notes from GPs do not provide anyone with taxpayer funded support. 

If illness persists and you are unable to remain in employment, the Department for Work and Pensions requires you to undergo a Work Capability Assessment (WCA). If, in that assessment, you are found to have “Limited Capability for Work and Work-Related Activities” (LCWRA) you may receive £416.19 per month from the Government, in addition to any existing Universal Credit payments, to help you live during the period when you do not have capacity for work. 

The Work Capability Assessment is highly stringent. People are often found to be fit for work while quite severely unwell, and a majority of legal appeals on the outcome of WCA assessments are found against the government and in favour of the claimant.  

The proposed reforms 

The purpose of the reforms is to cut the amount of money the government spends on welfare for people who are unwell. It seems likely they will aim to achieve this by tightening the criteria of how someone can be found to have Limited Capability for Work and Work-Related Activities (LCWRA).

It is important to note that these reforms would likely only apply to new assessments, rather than undoing people’s existing LCWRA status without a reassessment. 

The Department for Work and Pensions estimate that by reforming the assessment criteria, an additional 424,000 people will be denied LCWRA status by 2028/29.

As well as the significant financial implications of being denied LCWRA status, those affected would also be expected to adhere to strict conditions about work preparation activities, and risk losing more money through sanctions if they do not fully comply.

There is a risk that subjecting people to these sorts of conditions will result in numerous sanctions against those who are not well enough to adhere to all the processes. 

There are a few mechanisms through which the proposals would reduce LCWRA numbers. The most relevant to our beneficiaries is by watering down rules which currently stipulate that you are not eligible for work if working would pose “a substantial risk to yourself and/or others”.

This criteria is essentially a safety net to ensure that if the assessor thinks it is unsafe for someone to be working, they are sorted into the LCWRA category. Proposed changes would rely less on the judgement of the assessor and instead be more prescriptive, with indications that an assessor would not be allowed to claim there is a substantial risk, even if they think there is one, unless a number of other criteria are met.  

Economic inactivity and rising sickness levels 

‘Economic inactivity’ has increasingly emerged as a key theme in political debate and is a huge problem for the Government and the economy.

As has been widely reported, there has been an increase in people out of work since the pandemic, including for health reasons. This increase is not being driven specifically by mental illness but covers all manner of conditions. 

Source: ONS

We are keen to be part of the solution to these challenges because a healthy economy is necessary to fund the public services that keep us healthy and treat us when we are unwell. We think the answer lies in supporting people who can work into suitable employment, and that pulling a safety net from under people who can’t work will not do anything but make matters worse.

It is notable that the Office for Budget Responsibility does not forecast that this policy will lead to any significant change in the numbers of people in the workforce. As such, it seems more like a straightforward cut rather than a measure to combat economic inactivity. 

We fully understand the difficult economic situation the government finds itself in, and the menu of tough choices they will need to choose from. However, we remain steadfast in our view that this is the wrong choice, which will have a profound impact on our beneficiaries, and will not help with the underlying problem of economic inactivity and sickness levels.

On the contrary, measures which make people poorer while they are already struggling with their health, will likely have the inverse effect and put more pressure on the health system, as people’s illnesses get worse.