Government proposes disability benefits overhaul in face of ‘spiralling’ caseload and costs

Disability charities label proposals 'dangerous' and 'reckless' as ministers float reforming personal independence payment (PIP) by replacing regular cash payments and restricting eligibility

Cubes spelling out the word 'benefits' with a final cube having 'Yes' on one face and 'No' on the other
Photo: Dzmitry/Adobe Stock

The government has proposed overhauling a key disability benefit in the face of its “spiralling” caseload and costs, in a move labelled “dangerous” and “reckless” by charities.

Its green paper on reforming personal independence payment (PIP) floats restricting access to the benefit and replacing regular cash payments with other types of provision.

The Department for Work and Pensions (DWP) proposals are premised on the idea that PIP does not account for the significant variations in additional costs that different disabled people face in their lives. They are also designed to contain projected increases in spending on the benefit over the coming years.

What is PIP?

  • It is a tax-free, non-means tested benefit for people aged 16-66 (at the point of claim) who have a long-term condition or disability, and is designed to cover the extra costs of disability. It was introduced in 2013 to replace disability living allowance (DLA) for people of working age.
  • People are awarded PIP based on a functional assessment by a health professional (working for an outsourced provider) who checks their ability to carry out certain daily living tasks (eg preparing food, washing and bathing) and mobility. This is based on a submitted form, with accompanying medical evidence, and a phone or video-based interview.
  • The health professional must assess that the person’s impairment has lasted for three months and will persist for at least a further nine months.
  • There is a fast-track claims process for people nearing the end of life.
  • Recipients receive either £72.65 or £108.55 per week for daily living and/or either £28.70 or £75.75 weekly for mobility.
  • Awards are for a fixed period or are ongoing, for which the person receives a light-touch review after 10 years.
  • DWP figures show that, from February 2019 to January 2024, half of new claims for PIP (excluding reassessment of previous DLA claimants) resulted in an award.

Increasing costs and caseloads

According to government data, the real-terms cost of PIP, in 2024-25 prices, rose by 26% from £15bn in 2019-20 to £18.9bn in 2022-23 (in 2024-25 prices), as the number of recipients grew from 2.2m to 2.8m (29%). However, it is projecting that PIP’s cost and caseload will increase more steeply over the subsequent three years, with the budget required rising by 45% to £27.4bn (in 2024-25 prices), and case numbers growing by 35%, to 3.8m, by 2025.26.

The government has particularly highlighted growth in the number of claims for people with mental health conditions, with the numbers being awarded PIP whose main disabling condition was mixed anxiety and depressive disorders rising from 2,200 per month in 2019 to 5,300 in 2023.

Sunak questions additional costs of mental health conditions

In a recent speech that trailed the green paper, prime minister Rishi Sunak questioned whether people with mental health conditions faced the same level of costs from their impairments as those with physical conditions.

Rishi Sunak

Rishi Sunak (credit: HM Government)

“Since 2019, the number of people claiming PIP citing anxiety or depression as their main condition, has doubled, with over 5,000 new awards on average every single month,” he said.

“But for all the challenges they face, it is not clear they have the same degree of increased living costs as those with physical conditions.”

Sunak added that the current PIP assessment approach “undermined” the system by asking people to “make subjective and unverifiable claims about their capability”.

He said the government wanted a “more objective and rigorous approach that focuses support on those with the greatest needs and extra costs”, which he said would involve “being more precise about the type and severity of mental health conditions that should be eligible for PIP”.

Proposed assessment and eligibility overhaul

This is reflected in the green paper’s ideas around overhauling PIP’s assessment and eligibility process.

While the current assessment is functional – based on people’s ability to carry out certain tasks and activities – the DWP is mooting switching to a system based entirely or partly on people’s conditions.

It is suggesting introducing a requirement for people to provide evidence of a formal diagnosis from a medical professional to access PIP, while people with specific conditions would be given access without an assessment.

As an alternative to replacing the assessment system, it is suggesting tightening eligibility under the existing system, in order to “focus support on people with the highest needs and significant ongoing extra costs”.

This could include increasing the qualifying period for which the person needs to have had the relevant impairment from the current three months, to screen out people who have shorter-term conditions.

Replacing cash payments

Another idea put forward to is replace the current system of giving recipients weekly cash payments that they can spend how they wish, in order to “better target” resources.

Options include providing vouchers, requiring people to account for their spending, restricting them to buying from an approved list or offering one-off grants for expenses such as adaptations or equipment.

It also suggested doing away with financially based support altogether for some disabled people “who have lower, or no extra costs” and “may have better outcomes from improved access to treatment and support than from a cash payment”.

In addition, the DWP proposed “aligning” the support delivered through PIP with that delivered by health, social care and other local authority services for disabled people, to provide “better joined up and streamlined support than the current system”.

The department said this could help minimise the number of assessments people underwent and suggested it could also involve devolving resources from PIP to local areas so they could choose how best to support people.

However, it also implied this could also involve cutting back overall provision for disabled people. It said that financial support may currently be “duplicated”, with the extra costs of disability being met by services or equipment, as well as through PIP, for some people.

Implications for social care

As well as the proposed alignment between care and support services and PIP, the proposals would have an impact on adult social care should they succeed in reducing the numbers receiving the benefit.

This could increase levels of unmet need among disabled people, thereby raising demand for adult social care, while it could also reduce the level of resource councils collect from charging people for care and support.

This is because councils include the daily living component of PIP as part of a person’s income when calculating charges, though they must also disregard a sum to cover a person’s “disability-related expenditure”, such as privately arranged care or specialist equipment.

‘Reckless’ proposals to replace cash with vouchers

The proposals have sparked anger among disabled people’s organisations and charities.

In reference to the idea of replacing cash payments with vouchers, Disability Rights UK said: “Being offered vouchers is more than an insult; it is dangerous. We all want the right support when needed, and vouchers will not improve our lives. Instead, they will shut us off from our communities, leaving thousands without access to crucial services and support.”

It said that disabled people were already facing significant, and deepening levels of poverty, adding: “The social security system should be an essential public service that ensures everyone has access to the right support when they need it. But after years of dire cuts and reforms, it has been torn apart.”

Disability charity Scope said it was “deeply concerned” about the proposals, adding: “It’s hard to have any faith that this consultation is about anything other than cutting the benefits bill, no matter the impact on people’s lives.”

‘A reckless assault on disabled people’

It said its research had found that households with at least one disabled member needed an extra £975 a month to have the same standard of living as non-disabled households, after taking account of benefits such as PIP.

The charity said the issues identified by the government in the green paper arose from “crumbling public services, poor quality jobs and increasing rates of poverty”, not benefit rates, and added: “We believe the government should end this reckless assault on disabled people and focus on how to fix the real underlying issues.”

From a mental health perspective, Mind chief executive Sarah Hughes said: “The PIP assessment is already an incredibly difficult process, and we are hearing from people living with mental health conditions that they are deeply concerned about the government’s proposed reforms. Taking away crucial financial support from people with mental health problems is not going fix anything, it will make things worse.”

Implementation dependent on election outcome

However, implementation of the green paper is dependent on the Conservatives winning the next election – due by January 2025 but expected to take place by November 2024 – which they are widely tipped to lose to the Labour Party.

Giving Labour’s response to the green paper in Parliament yesterday, shadow work and pensions minister Alison McGovern did not set out any plans on disability benefits but linked the increase in PIP caseloads to people not being able to get the NHS treatment they need, because of long waiting times. She said Labour would seek to tackle the issue by recruiting 8,500 more mental health staff .


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22 Responses to Government proposes disability benefits overhaul in face of ‘spiralling’ caseload and costs

  1. stevielad April 30, 2024 at 9:21 pm #

    this is typical Tory bullying,lets put those who are the weakest at the front of the queue to attack,let’s blame them for what we ourselves have caused through 14 years of austerity cuts and not enough taxes to cover their tax cuts for their rich cronies.anyone with any guts and i include the Labour party there daren’t have a go at the super rich for fear of widespread media attacks on them digging up the slightest bit of wrongdoing and persecuting them like they did with the fear of Jeremy Corbyn getting into power.i’m afraid we are turning into a dictatorship state from one of the most democratic ones and the use of immigrants is their way of divide n conquer yet again coming into a general electionand the racist poor can’t see it they are voting against themselves.

    • Nik May 24, 2024 at 1:58 am #

      I’m a little confused a society is based on how they look after the week an infirmed, latest is people that have been registered as disabled on PIP are to be retrained to be carers ..WHAT they need to be looked after by our society.

  2. Jay May 1, 2024 at 10:47 am #

    Firstly, I’m not on PIP. But, I’m absolutely disgusted at these proposals & the attack on the disabled. Apparently, mental health doesn’t matter anymore! If these proposals go ahead, there will be a lot of out of work taxi drivers as a lot of PIP recipients who can’t drive need taxi’s to get to appointments. Bus routes don’t get you to the street you need to get to, plus the bus stop may be a considerable distance from your home. Many disabilities (including lung/heart diseases) affect mobility. When my mother, who had to use a wheelchair, had Alzheimer’s & we had to get her to an appointment, we had to find a special taxi that had wheelchair provision & it cost us nearly £100, to get her there and back. The amount of PIP claims is due to NhS waiting lists, Covid lockdowns, cuts in local services & support & increase of cancer rates from 2 in 10 to now 1 in 2, which no one seems to be talking about.

    • Petal May 1, 2024 at 12:39 pm #

      I’m on pip and I’m shocked over what the government want to change I wish they could come and see how our health effects us .Were are the jobs and who will take people in constant pain i cant take pain relief as it courses stomach bleeds. My conditions have medical evidence,since lick down so many people have said they have mental health I blame the system in giving these people pip.The government should attack them not us who really have medical conditions I don’t drive so rely on taxis im worried sick the moment listening to the prime minister he needs to live in the real world and spend a day with us real disabled people

      • Sammy May 13, 2024 at 6:13 pm #

        Your comment about Giving people who have Mental health issues Pip …so you don’t think they are medical issues ? You don’t think we should get Pip ? I’ve had chronic Anxiety for 15 years….I was having 30 plus panic attacks daily! Agrophobic…etc etc ..Anxiety causes so many problems and has numerous symptoms! It’s a living hell if you have chronic Anxiety which I would not wish on anyone! …if I had the choice I would rather have certain physical illnesses than my Anxiety!…I also have Fybromyalga …out of the 2 I would rather have the second …I suffer from clinical depression caused by Anxiety …I had an amazing job earning £40 K plus! …I loved my job and would give anything to return ….so please do not dismiss Mental health as nothing and tell the government to attack us! Saying they are not real medical conditions…I pray you never suffer 1 panic attack ..I must of had thousands! …each one as frightening as the first …your comment is utterly selfish ….people take their lives due to mental health as its horrendous to live with! I’ve sat on the edge of a cliff because coping with it is just terrible…I was lucky as I got amazing help from beautiful people who understand the depths we suffer …you need to spend a day with a person suffering Anxiety and seeing a panic attack and how it affects you ….not only Anxiety …but Autism…AdHA ….the list goes on ….educate your self because and stop the ignorance…do you think I would say such things to you ? Saying attack people with your issues?

    • Helena Adedeji May 3, 2024 at 4:27 am #

      All taxis should cater for disabled my dad had to have a ramp and then his black cab could take a wheel chair no extra costs . I think who charges you this is exploiting your disability.

  3. Chrissy May 1, 2024 at 10:49 am #

    As usual the purposed reform of PIP not correctly thought out , I agree that the system is unfair lots of people haven’t appealed their assessments and have probably lost out what was due to them while others have screwed the system and it should be looked into correctly , but there is a lot of Genuine people who struggle everyday with their disabilities and health issues and who will suffer greatly if they lose their benefit they already in a world of struggle and pain low esteem without having the stress of all this added to their already difficult lives . I think it’s very unfair and cruel to add to their suffering .. typically it will be the most in need that will end up suffering the most , if their PiP is affected it then snowball to other lost benefits and they will end up in very bad place financially , this really do need to be handled correctly and fairly if people are to survive through this ..

  4. L jackson May 1, 2024 at 12:20 pm #

    I am 59. I have worked all my life the last 15 years of my working life as a children social worker. I recently have become unable to work due to severe arthritis in my back, hands, feet and both my hips. This has been an awful experience of pain, disablement, financial instability and a big loss of my physical independence . I now claim pip and universal credit. I have a 17yr old son in 6th form. I live in a tiny two bed house rented privately. Cost 825 a month. I can only get 500 towards housing benefit due to local authorities cap. I am trying to get social housing due to financial strains. But my local authority does not allow you to chose your social housing home or the area. Whereas two nearby local authorities have choose a home where you can put your interest in on a property shown on their site but you have to have lived in that local authority for 2yrs. The rents on social housing are significantly lower. I am stating all this because disability payments for anyone claiming are to help with your disability but lots of factors like housing means you rely on this payment to help. I don’t know if I will be one of the ones the government will be targeting or questioning as a sufferer of a physical disability . But I truely have to say it saddens me to think that anyone with genuine mental health issues and this covers so many different conditions, that they may be forced to work. And the government are also talking about forcing folk with varying mental health condition to attend therapy believing that they will then be able to work. people probably have been asking for therapy for years just to help them but there are hardly any facility or money to provide but now all of a sudden the government are stating they may be offering this as a package to force people to work. I would like the prime minister to actually experience the loss of physical independence and the pain and mental health conditions that affect a person’s day to living hugely. He is going to be rushing through an ill thought out set of rules and changes with total disregard. He has no idea at all what financial destitution is – or how it affects people. He has no care for consequences. He is a bully with no experience of what live is like for people struggling with disabilities dictatorship is what this government is showing. .

    • S B M May 22, 2024 at 9:33 pm #

      Hi there
      I’m so glad you stated this ! I’m a professional and have fibromyalgia and i totally understand your views and experiences as I too suffer with a condition that differs from day to day!!! For a very long time I never knew I had it.Your totally bang on right the prime minister is a bully and has no clue about poverty or disability. He is so well off himself he thinks get getting the vulnerable into work will solve everything…. The UK has no industry and some really poor jobs. If you work in a professional capacity the resources are strained and impact of heavy case loads / no staff it will definitely drive you round the bend !! The point I’m making is MH and any disabilities are not a joke it’s serious. So one should ask the prime minister or any future government that just leave the disabled alone.don’t remove there benefits from them. If they implement the voucher system that will be be most damaging for disabled people. Carers how suffered drastically and have been totally discredited for their hard work. They are those individuals who have saved millions and millions for the government and NHS… for mezily £80 … that’s like horrible and then to be targeted and insulted. The list goes on … I do worry about the future and who is going into 10 Downing Street because they are ready to dictate and ruin millions of people lives

  5. Holly May 1, 2024 at 1:39 pm #

    My daughter has had a suspected asd since being at school and it affects her quite badly. She has been waiting for three years for an assessment to receive a formal diagnosis and I have been told it will be at least another two years before she is seen due to the backlog. How on earth can people provide formal diagnoses for their pip claims when there are no services available to provide this. Are they going to provide backdated pip claims for FIVE years? I think not. Another attack against the vulnerable whilst they let our health and social care services become unfit for purpose.

  6. Donna May 1, 2024 at 7:57 pm #

    Another attack on the vulnerable people.
    Use genuine people that apply for personal independence payment, just filling out the forms is just one nightmare when you are seriously ill.
    Nevertheless the waiting for a decision.
    Yes I understand a proper formal diagnosis, but the waiting times just to wait for appointment is totally shocking.
    Nevertheless how many people don’t turn up for appointments which costs the NHS millions every year.
    Which these DNA appointments could of been given to the people in serious need.
    I’m a 55 year old woman in remission of tonsil cancer yes I’m in receipt of PIP,
    The sheer discomfort and unable to swallow food.
    Also suffer with Trismus nerve damage to my jaw.
    I will be unable to work again. So the thought of pip being taken from me is totally frightening.
    Upmost stressful at the least..

  7. Vee May 1, 2024 at 8:23 pm #

    The resolution to the fear this Green Paper has generated is simple enough. Under the Tories, this ill informed and light weight set of proposals will never be implemented after the next election.

    The Tories will not form a majority to push the measures through. What is Labour going to do regarding Sickness and Disability Policy when it forms the next Government? (Far more relevant) This is what counts for the future for millions of vulnerable people; not the current multi-diciplinary Clown show, made up of Tory Ministers who will be looking towards their own welfare needs, when they are booted from power in the coming months.

    • Phil May 2, 2024 at 12:25 am #

      Well said the Conservatives are robbing the poor to feed the rich

  8. Billy smith May 2, 2024 at 10:04 am #

    Vote every Tory out attacks on sick and disabled and mental health you can’t see but it effects people a great deal Tories must be booted out show them what we think of there policies

  9. caron May 3, 2024 at 9:40 am #

    they the gov should make your minds up we’ve the disabled have all ready gone through all this with being switched from DLA to pip and then having to reapply for it even though like some I had a life time award most doctors and GP ,s have not clue or idea on what I go through every minute of every day some days wks on end bed ridden I can just about potter from one blinking room to the next and that’s if I don’t pee my self trying to get to the loo after I’ve done that every few hrs I’m fit for well nowt I’m in pain tired lack of sleep chronic fatigued I can’t use my hands and shoulder to wheel a manual wheel chair I don’t have the energy in pain tired I have to rely on others every day and through the night times I’ve been healthy n fit and now I’m disabled I’ve been on both sides of the coin and I really wish I could get to work hold down a job with all these bosses that will tolerate us and our health ? I’m fit for. F all now only getting my self to the loo and even that takes me 20 mins ! You at DWP have no idea about disability ! Most doctors not got a clue either I have many complex health issues I’m depressed because of my health fact! You should have left it way it was DLA you’ve given out lift time awards then take it off ppl and yes I buy food bedding and keep a roof over my head with my pip all you will do is make again 1000,s top them selves yet again with you silly switch over from this to that all i want is to be left alone ! Enjoy what’s left of this miserable life and die ! I can’t even afford a holiday I’ve had one in 30 yrs ! You will have blood on your hands it’s discusting the way your treating disabled ppl !

  10. Scarlett Murray Dimbleby May 3, 2024 at 1:09 pm #

    I am on pip and suffer permanently with mobility due to spine conditions that gradually get worse older I get after a accident when I was a late teen . And siezures .my husband is now my full time carer .and this threat from government is starting to scare me alot as there is alot I can’t do no more what happens to my care if I am forced to find work by government

  11. Bunny May 3, 2024 at 4:00 pm #

    I’ve been ill for eleven years. I was diagnosed with heart failure two years ago. I became suicidally depressed because everybody was ignoring me as I could not comply with “popping here” and “popping there”, I couldn’t even get to my own front door or lift my legs up even slightly, let alone “”pop” up anywhere. No car, no mobility, no wheelchair, no money, no family, anemic, couldn’t eat, no energy, constantly feeling ill and in agony, NO HELP from anybody but my husband who is mostly at work trying to keep us fed and warm.

    I get basic daily and enhanced mobility. Even then, the decision maker twisted my evidence to not award me the full daily living component. I only just got enough points for the basic rate. Quite how they can accept you are immobile but insinuate you are not really that unwell on a daily basis, I’d like to know.

    It has helped but I’m sicker than ever now, unable to enjoy (not the right word but, you know) the benefit of having it. I bought myself a wheelchair but can’t use it much because my husband is losing his health now from the stress of working and looking after me by himself and struggles to push it.

    Now this. Will the Tories get my vote? Will they F**K.

  12. S hills May 5, 2024 at 10:15 am #

    I’m now in a state of panic I have been surviving on lowest rate of pip since 2017 I was refused ESA .lost the appeal .I won’t claim UC because I can’t work and I cannot face the jobcentre anymore .yes I do suffer anxiety and depression but I also have arthritis and widespread pain and chronic fatigue I can’t get to see a doctor regularly to discuss more x-rays etc .I’m 61 now and I can’t take much more .I have my current pip until march 2026 but are they going to stop that before then ? It’s sad but I just need to get to retirement age which is 67.i

  13. Sharon May 6, 2024 at 7:39 pm #

    I have worked since I was 15 years old I never had children due to the fact I never had the motherly I have paid into the system for years.then 2 months before I was sixty I had to stop working because of several health issues I applied for pip twice and was turned down.then my health issues got worse so I applied again at the end of 2023 and had to go through the whole process again I eventually got it this year in 2024 and now the government want to take it away again.

  14. Lia May 8, 2024 at 3:14 pm #

    This PIP change is truly terrifying. I live rurally and although I am confined to the house due to Epilepsy and unable to work….I was refused the home care element of PIP. My Mobility PIP pays for all my shopping to be delivered, taxis to hospital, reimbursement fuel for neighbours support on longer journeys to specialists. None of this will be possible under a voucher scheme. Do I have to fill in a long form everytime I want reimbursement for a food delivery…..
    The cost of implementing such a scheme is way more than they will save. Recruitment of staff as usual will be contracted out so their will be new contractors fees… New staff on pay between basic £28,000 and managerial £41,000 not including their pensions, ironically up to 9 months full sick pay, holiday pay, maternity pay of up to 9 months, expenses, training. Then there is the cost of training already employed people in new schemes in all the job centres in the country, admin in central Government, Data and Budget monitors and the Treasury for payment. Then there is Senior officials time in passing the Bill and the consultation itself…MP’s time, House of Lords time, Consultants time and fees, expenses for meetings which will include meals and hotel stays. Then there is infrastructure.. new forms to be designed and approved by several people up the chain, redrafts, inline and paper copys, a new section of the website to be designed and updated, new laptops for new staff working from home, homeworkers expenses of broadband and phones, heating and electric, an extended department will be necessary to process all the new claims which will require new computers, new high tech security systems, new tables, chairs, meeting rooms. Dont forget the Royal Mail and postage of forms…this will be the same process but the paperwork going backwards and forwards will be at least 10 times more per month as individual letters, application and appeals forms are sent back and forth. Then there will be the waste of time of Medical Personnel like GP’s and Specialists providing evidence to back up every claim.

  15. Jane S May 9, 2024 at 8:52 pm #

    I find this whole proposal terrifying and unbelievable. My husband had a brain tumour which has left him with sight loss, severe mobility problems, dysphagia (can’t swallow) and many other issues. I have also had to stop working to be a full time carer. Not the life either of us imagined. These Tory people are living on a different planet and have no idea how a disability impacts your life. I could make a few suggestions for saving money, but quite honestly, I don’t think they would like any of them!


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