The Week

The Week, 13 January 2023

Charlotte Pickles

It’s been another week of wall-to-wall coverage of industrial action (actual strikes, balloting for strikes, negotiations to avert strikes) and NHS crisis.

On the latter, stats out this week have provided a (v small) glimmer of hope, showing a 200,000 decrease in the number of people on waitlists (from 7.21 million to 7.19 million) and an increase in activity (treatment volumes are up 5% of pre-pandemic levels). Though as my colleague and Reform’s resident health lead points out, the latest emergency care data is “shockingly bad” — less than 50% of people are being seen within the 4-hour target at A&E, and the average ambulance wait time for a category 2 incident (that includes heart attacks and strokes) is more than 1.5 hours (against a target of 18 mins). Do give Seb (@SebRees1) a follow for all the latest health insights!

Against this background of union pay demands and collapsing care, we had some striking polling from Redfield & Wilton this week: 43% of people say they would not be willing to pay more tax to provide more funding for the NHS (including 41% of 2019 Labour voters). The pollsters also found that 43% of people think the NHS tends to use its money “wastefully”, versus 37% who think the Service uses it “efficiently”.

Perhaps the most interesting story this week, however, was the suggestion that the Government is looking at how to “rewire” the benefits system, with a view to tackling the huge number of people dependent on sickness and disability benefits. By now, you’ll all be familiar with the surge in post-pandemic economic inactivity (i.e. people of working age who are not in work and not seeking work). Much of this is down to the over-50s exiting the labour market, but even before the pandemic we had over 2 million people in receipt of out-of-work incapacity-related benefits.

The last meaningful attempt to tackle this was in 2006 when Labour announced its intention to introduce Employment and Support Allowance. At the time then Secretary of State John Hutton said that “[r]adically changing incapacity benefit is critical to giving more opportunity to those trapped by the current system”. The expectation was that, within a decade, the caseload would be reduced by one million. In fact it barely changed, and it remains the case that you’re more likely to die or retire than move into work.

Back in 2016 Reform published a paper looking at why, and what further reform was needed. We’re delighted to see the Government has, 6 years later, recognised some of the same flaws in the design of the system that we did. To access ESA, and now the equivalent in UC, you must literally fail the Work Capability Assessment, and once you have done this, you’re all but written off (you’re not expected to undertake activities that might help you move into work, nor are you offered much help). If you attempt work — and 1 in 5 people on these benefits would like to work — you risk showing you do have some capability, so if that job doesn’t pan out, you might not be able to get back on the significantly higher sickness benefit. Or in other words, the system actively works against the very thing we want, more disabled people in work (good for them, good for the economy). A more radical reset of the system would be hugely welcome, and it’s great to see the new Work and Pensions Secretary suggesting we might get that.

Just for the record, the other idea floated via The Times, that over-50s who return to work could be exempt from income tax for 6 months, is ludicrous. Talk about perverse incentives (take a career break, then go back to work tax-free!). And the last thing the Conservatives need to be doing is further skewing public policy towards older generations.

Onto the reads...

First up, our friends at the Resolution Foundation released their fifth annual Living Standards Outlook. The cheery top line? “The past year was a disaster for UK living standards” and “the second year of this living standards disaster which lies ahead of us may be as bad as the first.” Most starkly, on current estimates, living standards won’t return to their pre-pandemic levels until 2027. This poor outlook is largely being driven by soaring energy prices and their knock-on impact on the cost of household essentials. That makes new solutions to the challenge, short of those already announced by the Government, hard to come by. But there are a few sensible recommendations here: ensuring those that are entitled to benefits claim them and investment in home insulation are good places to start.

In related news, Citizens Advice’s ‘Kept in the dark’ report lays bare further impacts of the cost-of-living and energy crisis on vulnerable households. As many as 600,000 people were forced onto a prepayment meter due to debt in 2022. Out of these, 130,000 households with people living with a disability or long-term health condition have been disconnected from their energy supply at least once a week because they cannot afford to top-up. The physical and mental impacts of this problem are severe as the case studies in this report expose — for example a woman reliant on an electricity-powered breathing machine being cut off because her prepayment meter ran out and she could not afford to top it up. An urgent area for action…

Next up, the Met Commissioner Mark Rowley gave a speech on Tuesday. As he points out, the “case for reform at the Met is already well made… A diagnosis of systemic failings has been laid bare”. Some of what he announced is long overdue: a leadership academy for senior officers is eminently sensible, while it’s pretty astounding that giving “every officer a mobile phone” is a new development in 2023! But his focus on data analytics was most interesting. For example, Professor Larry Sherman, founder of the Cambridge Centre for Evidence-Based Policing (and the new Met Chief Scientific Officer), has been asked to work with tech companies to examine how data analytics can be used to predict and disrupt serial violent predators. Of course tech and data has been a priority for policing for sometime, the proof will be in the delivery.