The importance of welfare advice for people with disabilities or health conditions at times of benefit reform

22 May 2018

Advice services are a vital support system for people who have health conditions or disabilities, especially in times of welfare reform, research from the University of Bath, supported by NIHR CLAHRC West has shown. This advice is often provided by charities to people who wouldn’t be able to afford to access legal advice. But advice services often face funding cuts, in the context of austerity.

The research, published in Public Management Review, highlights how vital advice services are for people trying to navigate the disability benefit system, and follows on from a wider study on the impact of advice services. The new paper focuses on the experiences of 22 people who were seeking advice on health and disability benefits.

There have been substantial reforms in the welfare benefit system for people who are either too ill or disabled to work, or need financial support for daily activities. Some of these reforms are controversial, and the House of Commons Work and Pensions Committee published a critical report on assessments for Employment Support Allowance (ESA) and Personal Independence Payments (PIP).

After a recent court judgement, the Government announced that everyone receiving PIP will have their claim reviewed, which could cost £3.7bn by 2023. People with illnesses and disabilities are at the sharp end of these contested welfare reforms. Yet the United Nations in 2016 found that information and advice about benefits for people with disabilities was limited, not accessible or non-existent.

The research shows how an advice services charity was a source of solidarity, advocacy and empowerment for clients caught up in the personal consequences of welfare reform. Advice led to increases in people’s income in at least 82 per cent of cases, often from situations of severe poverty where people with illnesses or disabilities did not have enough money for rent, food and bills.

At least six clients were able to manage their debt problems more successfully and homelessness was prevented in at least four cases. Three clients who had sought advice about disability benefit appeals said that they would have needed in-patient psychiatric care or would have been at serious risk of self-harm or suicide without advice and support. Advice ‘was a godsend’, ‘I don’t want to think about what would have happened… (without support). Advisors (often volunteers) could contest injustices of benefit assessment decisions and advocate for clients’ rights, reinstating people’s basic income.

The paper sets these personal stories in the wider context of health and disability welfare reforms. The aim of welfare reform has been to reduce state welfare bills, but the Government is yet to generate value for money in its contracted-out health and disability assessments. The costs of benefit assessments, conducted by private companies, have risen, yet these welfare reforms have not met their aims.

The paper also provides a new framework to extend social impact measurement methods beyond economic approaches. Social return on investment is a popular way to measure social impact, but it puts a financial value on all social outcomes. This paper provides a broader framework, based on realism and complexity theories, to account for wider social impacts and evidence public values that are difficult to put a price on, such as tackling social inequalities and promoting social justice.

Who was involved in this study?

The research on which the paper is based was conducted at the University of Bath, working in partnership with the Bath and North-East Somerset Citizens Advice Bureau (CAB-BANES), and funded by the Big Lottery Fund (South West Forum Proving Our Value). The research paper was supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West).

Read the full research paper

Farr, M. and Cressey, P. (2018) ‘The social impact of advice during disability welfare reform: from social return on investment to evidencing public value through realism and complexity’. Public Management Review. doi: 10.1080/14719037.2018.1473474

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