I'm sick of our disabling culture

My grandma was a ‘cripple’ by her own reckoning. On our regular trips to Wales we’d ask ‘are we nearly there yet?’ as all kids do. And my parents would joke, ‘She’s waving her sticks. Can’t you see her?’ My dad told me how she’d once rolled her three-wheeler onto its roof on a trip back to Birmingham, where we still lived. My grandparents had moved to a bungalow in Wales before I was born. (I always assumed they were Welsh and that bungalows were Welsh too.) She was a character. A battle axe. A hardy soul. On crutches, replacement knees and hips, a cupboard full of tablets and an intermittently whistling hearing aid.

She was of the Ian Dury school of disability. While today we worry that the words we use might cause offence, she would have had no time for such fads and regarded her predicament as a nuisance. It certainly wasn’t something she identified with or wanted to celebrate. Indeed, she was more intent on getting out of her bedroom, laden as it was with hoists, her painting equipment (she was a keen watercolourist) and a mechanical device she’d use to grab an out of reach newspaper. Even if grandma was a liability when she took to the road, you had to admire her spirit that pushed against the very notion of disability.

How attitudes have changed. Disability, while still very much with us (and no less of a nuisance), has risen up the political agenda. At the 16th Conference of States Parties to the UN Convention on the Rights of Persons with Disabilities (COSP16) this year, the UK’s Minister for Disabled People, Health and Work, Tom Pursglove MP, talked about the government’s plans for the social and economic inclusion of people with disabilities. My grandma would have found the language baffling - what a mouthful! - but, I think, would have nevertheless welcomed the sentiment.

So what is the government doing to include disabled people (or is it ‘people with disabilities’)? There is a Disability Action Plan, on which the government recently went out to consultation, and a National Disability Strategy. There is Access to Work, an employment support programme that provides disabled people with grants to pay for practical support to help them start work, stay in work or set up their own business. There has also been work in government around improving the lives of people with specific disabilities such as Downs Syndrome.

Earlier this year, it was announced that Sir Robert Buckland KC MP would lead an Autism Employment Review, supported by charity Autistica and the Department for Work and Pensions (DWP). The Review is interested in ‘supporting employers to recruit and retain autistic people and reap benefits of a neurodiverse workforce’. The intention is to boost their employment prospects and, we are told, grow the economy too. Shockingly, less than three in ten adults with autism are currently in work.

The Review aims to change this by asking businesses, employer organisations, specialist groups and people with autism to ‘help identify the barriers’ they face. Buckland rightly refers to the ‘huge potential’ of autistic people to contribute to the UK’s productivity. Pursglove is right to say that the low numbers in the workforce ‘is often down to the employers themselves not having the tools to support autistic people, or truly understanding the value of a neurodiverse workforce’.

While I don’t subscribe to the social model of disability - disabilities are real and often debilitating - I do think that we all, especially employers, have a duty to do what we can to accommodate the needs of people with autism and help them flourish. Dr James Cusack, Chief Executive of Autistica, wants to see the rate of employment of autistic people double by 2030. Who could argue against that? But there is, as the term Autism Spectrum Disorder suggests, a lot of differences in the abilities of autistic people. There is a world of difference between pushing a trolley at Tesco and working as a programmer for Google.

Back to the schemes. The Universal Support employment programme is all about reducing economic inactivity and growing the economy, by supporting those with mild to moderate mental or physical health conditions to get back into or remain in the workplace. This is not just about saving the money on benefits and getting disabled people doing their bit for the economy. As Secretary of State for Work and Pensions, Mel Stride MP, has put it, it will also help people with disabilities to ‘reap the benefits of fulfilling employment with the right help’ and ‘unlock people’s potential’.

A Work and Health Programme (WHP) targeted at people with disabilities, but also at the long-term unemployed and others who need support to (re-) enter the workforce e.g., ex-armed forces, homeless, care leavers, refugees. And yet, all is not well. While over a quarter of a million have ‘started’ the programme since it was launched three years ago, by 2021 only ‘29% achieved a job outcome and 44% achieved first earnings from employment within 24 months’. Indeed, getting people with disabilities, and with other health conditions, into the workplace is proving to be a challenge all round.

In June 2023, 1.8 million people were on ‘Universal Credit health’, compared with 1.4 million in 2022. This is paid to claimants of Universal Credit with a health condition or disability that impacts their ability to work. Those claiming this health-related benefit have risen from a quarter to 29%, in the past year, of those claiming Universal Credit. There is also a regional bias with those living in the North-East (35%), North-West (32%) and South-West (32%) having the highest proportion of claimants, and London having the lowest (23%). It’s almost as if the country needs levelling up. Either that, or people living in the North of the country, or in the coastal communities of the South West, are constitutionally predisposed to sickness and disability.

In July 2023, there were 3.1 million people claiming Personal Independence Payments (PIP), a benefit that, according to the Department for Work and Pensions, ‘helps with some of the extra costs caused by long-term disability, ill-health or where they are approaching the end of their life due to a progressive disease’. It is estimated by the Office for Budget Responsibility, that as many as one in eight adults of working age will be claiming a disability benefit by 2027, at a projected cost of £77 billion a year.

An increase in claimants and long-term sickness in recent years - made worse over the period of lockdown - means ‘two and a half million or thereabouts’ are declaring themselves unable to work, according to Stride. Indeed, the government has made clear its intent to clamp down on what it might once have regarded as the ‘work shy’ shirking their responsibility to earn a living. (Though it wouldn’t say such a thing. Even the Tories are politically correct these days.) Disability charities, like Scope and Sense, have rightly raised concerns that the government’s plans to reduce these numbers, may punish those who are genuinely unable to work.

And yet, I am persuaded that the government’s general approach is the right one. Stride points to the opportunities presented by flexible arrangements, reasonable adjustments and home working; of more understanding about mental health, and a greater willingness to accommodate ‘neurodiversity’ in the workplace. Of course, not all workplaces are like this. But there are surely more opportunities for the sick and disabled to enter, or return to, the world of work than there were in my grandma’s day? As the minister says:

Many people on disability benefits say they want to work, and with modern working practices could manage their condition effectively while working. Instead, they are stuck on benefits with no help to prepare for work.

Quite. So why are the numbers of those officially too ill or disabled to work continuing to rise so alarmingly? With such a historically high proportion of the population ‘off sick’ how do we grow the economy on which they have become so apparently dependent? Perhaps the continued lack of opportunity - or ‘life chances’ as we must now call them - unevenly distributed amongst those living in the most run down and hopeless parts of the country, mean that some effectively disable themselves out of desperation.

Or perhaps it's worse than that, and a wider cultural malaise is doing the disabling. According to research by the Policy Institute at King’s College London, nearly a fifth of Brits don’t think work is all that important. That’s the highest proportion recorded of the 24 countries included in the annual World Values Survey. Not only that, we don’t think hard work is worth the bother, and are unlikely to describe those who don’t work as lazy. Professor Bobby Duffy, director of the Policy Institute, observes ‘the feeling that welfare benefits were too generous and that people getting benefits didn’t deserve them peaked in the mid-2010s’.

This isn’t as generous and kindly as it sounds. While some can’t work, or face obstacles that make it hard for them to do so, the laziness taboo is rather important. If we all put up our feet and stopped working - as more of us are doing - the economy grinds to a halt (if possible, more so than it already has), and the social order falls apart. So wouldn’t it be a good thing to take a dim view of those who don’t do their fair share? Isn’t it an insult to our fellow citizens to expect them to support us just because we don’t want to work?

There are other drivers, no doubt. There is arguably a sex-based explanation, particularly for the younger generation of ‘toxic’ males? Gus Carter, writing for The Spectator, worries ‘boys are so browbeaten by activist adults that they are turning into purposeless young men’. It is true that older cohorts of workers were particularly less likely to return to work post-lockdown. But if attitudes to work are so negative - and the research suggests younger people are even more work-phobic than the rest of us - is it really all that surprising if more of us decide to adopt what sociologists call the ‘sick role’, rather than go against the grain and find a not necessarily rewarding job?

As so often is the case, those that face the greatest difficulties in life are the ones most likely to push against them. Perhaps we’ve all become too passive and lazy, but there’s nothing to be gained from doing nothing. If we are to make the case for getting more sick and disabled people into work, we need to find a way of renewing the work ethic and rediscovering the sense of purpose that many (not just young men) seem to lack. There’s no point blaming anybody for this. We all need to get in our three-wheelers and drive.

Image: Dietmar Rabich