DLA reform consultation: Great Expectations, Worst Apprehensions

The coalition government today published its consultation on the reform of Disability Living Allowance (DLA). The headline is that DLA is going to be replaced by a "Personal Independence Payment" (PIP) from 2013/14.

DLA has been in the news a considerable amount since the emergency budget in June this year, primarily because it has been the main disability-focused benefit the government has looked to cut. I've blogged quite a lot on the topic: see here, here and all posts here.

As such, today's consultation on the reform of DLA is of huge significance and interest because it provides far more detail and intent of what is planned for DLA. Below, I summarise what I think are the key issues. (Via delicious you can keep track of other reactions via my tag DLAreform.)

1. The foreword states that:

We are committed to a sustainable and fair system that allows people to work when they can and provides unconditional support to those who are unable to work (emphasis added).

The idea that the reformed DLA system provides "unconditional" support is palpably nonsense. Moving from the system (where people can self-assess) to one where the explicit aim of the reform is to reduce the number of recipients and spend by 20% is quite the opposite.

2. These proposed reforms suggests introducing "conditionality" into the system (paragraph 2.35). The idea is that as part of the PIP, recipients will be required to discuss their circumstances with a professional who offers advice and "helps them access specialist support". I'll explore the intention behind this in point 3 below, but introducing conditionality into the DLA process is a huge shift. Whilst there's been some debate about whether conditionality in employment benefits is right or wrong, introducing it in a disability setting - where people have already passed through so many tests based on their often intimate and personal circumstances - will feel to many like they're being kicked when they are down.

3. Throughout the reform consultation there are references and suggestions that DLA should no longer cover the sorts of support it used to, to take account of the fact that aids, adaptations and equipment are now more part of the general landscape. So, where the mobility test used to be based on ability to walk, the mobility test will now be based on being able to get around - and if there's a wheelchair involved, that will suffice.

The question of how that wheelchair has been paid for - private money, health money, social care money - appears not to matter, which is obviously wrong. If an individual has paid for it, then they clearly had a mobility need. If the NHS or a Council has paid for it, then they obviously thought there was a mobility need. Though it seems innocuous, the intention of the conditionality above will actually require a potential recipient of DLA to explore what "specialist support" is avaliable apart from DLA. By introducing this, and the very narrow focus on what support is in place at the time of assessment, the impression is created that, so long as the need isn't met by the DLA budget, it doesn't matter where it's met from. What wider impact this will have on NHS and social care spending is currently unknown, but I'll bet they won't be pleased by this subtle but important chance.

4. The idea that DLA itself is a barrier for disabled people into employment (para 1.19) just isn't credible. Indeed, the DWP's own evidence (pdf) suggests otherwise. Even if we take this assertion at face value, I'm already hearing of restrictions of what Access to Work will and won't fund to enabled disabled people into employment. Thus, with the government also seeking to reduce what proportion of DLA is spent on aids, equipment etc., these two changes combined means the government significantly risks undermining its own policy of supporting people back into work.

5. The reform paper paints a very confused picture on costs and numbers. It states that over 3m people receive DLA - of which 1.8m are of working age (16-64) - with total spend this year being "forecast as £12bn". But the Dilnot Commission, based in the Department of Health, says that DLA for 16-64 year olds costs £5.487bn (in 2009/10). Furthermore, the DWP's own figures said that DLA cost £6.2bn in 2009/10. In the emergency budget, the government said they would save £1bn (or 20%) of the DLA budget, suggesting they were using the £5.487bn figure. If that's right, why quote the £12bn figure? (Quite aside from this, the government fails to mention that Attendance Allowance currently costs £7.505bn. More on that another time.)

6. A massive change - different to anything we've heard before - is that the DLA reforms are to extend beyond working age to cover children and those over 65 (paras 0.3, 1.14 and throughout). I don't recall the government saying that the DLA cuts will affect this group of 1.2m people, in either the CSR or the Budget. If this is true, the impacts will be huge (and go some way to explaining why the £12bn figure above is included.)

7. There is a mixed picture on the role of self-assessment. The government appears not to trust people applying for DLA under the current system, but thinks that self-review under the new one is fine (para 2.32). If self-assessment in social care, with its considerably larger budget, is acceptable (under the banner of personalisation), then why isn't it acceptable for DLA assessments?

8. In paragraph 1.10, the reform consultation states that "measuring each individual's expenditure would be administratively complex and expensive". And yet they think that checking everyone's needs won't be.

9. Paragraph 2.4 notes that the PIP will require a "new, fairer, objective assessment, which will allow [the government] to identify those who face the greatest need, in a more consistent and transparent manner". Transparency is, of course, to be welcomed. I will therefore look forward to full details of the contract between ATOS - who carry out the medical assessments for DLA on behalf of DWP - and the DWP, along with all its financial information, performance information and details of targets etc.

10. Paragraphs 2.33 and 2.34 talk about the "penalties" that will be put in place for individuals who don't report changes in their circumstances. It's a shame the report didn't take the opportunity to note that the fraud rate for DLA is 0.5% - a rate significantly lower than Income Support (2.9% fraud rate), Incapacity Benefit (1%) and Jobseekers Allowance (2.8%). Indeed, it's lower than the office error rate for the DWP, which stands at 0.6% (data: ).

It's only fair to note that there are some good points in the reform paper:

1. Paragraph 2.18 talks about bringing the definition of those who could potentially get DLA into line with the legal definition of disability. This makes sense.

2. Maintaining DLA as a non means-tested, non-taxable, non-NI contributions dependent benefit is right, as is recognising its role as a passport to many other publicly-funded services.

3. Looking to align assessments across benefits, health and social care, and sharing information (with permission) across professionals about those assessments, could be a big win, for both individuals going through the process and to streamline administration (para 0.11). In its Right to Control work (on which I've written a series of posts) the government is developing an infrastructure that could enable this to happen.

4. Throughout this document, the government has finally and explicitly acknowledged that DLA is "not an income-replacement benefit for those who are out of work due to disability" (para 1.1). It's just a shame that the government did so much to encourage the perception of disability as an out-of-work benefit.

Overall, I'm afraid to say there is a lot for disabled people to be worried about in these proposals. There is no getting away from the fact the government has decided it wants to spend less on DLA and is justifying where it is going to draw the line to save the 20% they're looking for.

The most superficial of all the proposals is renaming what has become the potent "Disability Living Allowance" and replacing it with a "Personal Independence Payment", which has the unfortunate acronym PIP, which puts me in mind of Great Expectations.

The problem being, of course, that the government's reforms aren't something that disabled people can think of in terms of hope and promise. Instead, the reforms confirm the very Worst Apprehensions that we held over these reforms.

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Thanks for this. I haven't had time to read the document having been delayed by work but hope to catch up in the morning. There are a lot of warning bells going off in my head - I don't even know where to start with listing them... I'm uncomfortable with ATOS' role as well as the arbiters. But I guess I should read the entire document before passing too much judgement - maybe it'll help me get to sleep!

I would just like to thank you for providing such a thorough and well reasoned analysis of the new proposals to reform DLA.

I share your concerns about the possible consequences for many people who are dependent on this and and other benefits to fund their daily living and mobility needs.

Informative article, I have a couple of comments. Point 2 - accessing specialist support as a requirement of PIP sounds like an extension of the Independent Living initiative where disabled people can choose which support they have. My issue is to do that the claimant must have access to specialists in their particular condition. In mine that would be Sensory Loss Team, D/deaf charities with funding to help claim DLA. For the past 5 years the government has been trying to build a web of support with public, voluntary and private sector involvement. To ensure great service to DLA claimants all sectors have to tweak their thinking (and that's revolutionary).

DLA is being revisited as the government cannot sustain it financially. IMHO it is up to us to help form a system that works to help disabled people have the same access as everyone else, i.e., ongoing support instead of closing down cases and a job to suit them. We have an opportunity here to help form a system that makes the client's life easier and one the government can afford to pay for long-term.

We should also be looking at the structure of Tribunals. There are some excellent Disability Experts well-prepared and incisive. Can I suggest Doctors be replaced by Social Workers (e.g. SLT)as DLA is about impact on a life and not the medical circumstances of it.

Point 6 - the consultation document says that people over 65 and children will have their cases looked at after DLA has been sorted out so that's at least 2014. No point worrying in 2010.

Point 10 - I agree, all of my self-referrals were genuine and 99.9% of other referrals.
Pips are protected by apple fruit and skin. You have to do a lot of chomping before you reach the pips. Let’s take this opportunity to use the consultation document as our opportunity to continue to protect disabled people. The government has promised ‘unconditional support’ and although it is a soundbite, I think the intention is genuine.

socialworkuk / Frances - thanks for your comments. I'm afraid I do share your concerns.

Debbie - thanks for taking the time to comment. You're reading of point 2, and what it refers to from the consultation, is not quite what I was driving at. Requiring DLA recipients, as part of their DLA payment and when they have already gone through significantly more stringent testing to get it, is motivated partly by getting more support, but also ensuring that the DLA budget is not called upon and other budgets are. It's a superficial form of creamskimming.

Point 6: Given that it's been announced now, there is plenty of reason to worry now. If we take your point at face value, we'd not bother responding to the consultation since its effects won't come in to 2013/14. And, of course, by then the damage will be done.

I'm afraid virtually every single element of the consultation document contradicts the government's apparent intention to offer "unconditional support".

I think they can afford to be generous with the good bits because they know damn well then intend to make the application process deliberately difficult so that very few people will negotiate it successfully.

I'd like to know exactly how many disabled people were consulted too.

One potential disaster is the idea of taking other aids into account in assessing mobility. A Wheelchair offers improved mobility in some places, not others. Will the assessment take into account the steepness of the hills around the applicants home? the inclines at their holiday destination?
The question of the cost of these aids is also one that needs to be raised and the availability. In some council areas a wait of up to two years after assessment for the supply and fitting of aids is not exceptional. (Are these the ones the document refers to as being easily obtained?)
Why do I have the feeling that these proposals were written up by a physically active and quite well paid civil servant who wouldn't recognise a disabled person if they saw one? Thanks for the analysis the best summary I have seen

as a disabled per son in recipt of dla it looks like we are going to be a third class of people housing bennifit are going to charge per extra bedroom you have in your house .so someone like me who lives alone and in a 2 bedroomed property will have to pay for that so the goverment our getting disabled people from all sides by looking into our sickness benefit and DLA & housing benefit.alcaholics get DLA so they should be stopped first let the genuin disabled person get the benifit.

I filled up the form but it is a little complicated they haven't made it easy for people to respond to. It took me all day but was looking for clarification and some sites as yours have provided it. We must all stand together because many deserve the help and payments and many disabled such as learning disabilites are relying on us to be their voice.many thanks.

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