Disability benefits and social care for older people – case study

As far back as 2009 MiSoC provided written evidence to the 2009 Work & Pensions Select Committee inquiry, and was part of the academic panel of the 2010-11 Dilnot Commission and ongoing discussions with the commission. MiSoC’s Professor Ruth Hancock and Professor Mike Brewer spoke at the 2011 Public Debate on Disability benefits, social care and welfare reform.

Our written evidence to the 2010 Health Select committee inquiry into social care (Report, vol II, pp.172-178), which provided the Committee’s only rigorous academic evidence on the distributional pattern of disability benefits and which questioned the basis of the suggestion in the Green Paper on Social Care of withdrawing disability benefits. The Committee’s report, explicitly quoting from our work (Report, vol I, paras 310-324), calls for a better evidential basis for policy design in relation to disability benefits (Report, vol I, recommendations 34 and 35). The subsequent White Paper backtracked on that proposal, although it remains on the policy agenda.

The Head of Public Policy at Age UK has stated that: “we believe that their report, and your submission to them, influenced the then Government’s decision not to reform Attendance Allowance or integrate it with means-tested care support… It is our impression that the research has had an influence on the way the Department for Work and Pensions views the financial position of disabled older people in receipt of Attendance Allowance (AA) or Disability Living Allowance (DLA).”

The subsequent change of government led to the establishment of the Commission on Funding Care and Support (CFSC), whose report recommended retaining non means-tested disability benefits for older people. Before its report was funded we presented our research at a high-profile seminar organised by the Strategic Society Centre, which was attended by representatives from the CFSC, relevant government departments (HM Treasury, Department of Health, Department for Work and Pensions), Age UK and other third sector organisations, local authorities, the private insurance sector and academics. Papers and briefings published by the Strategic Society Centre and Age UK have quoted heavily from our work, and have continued to do so.

In October 2012, Professor Ruth Hancock and Professor Steve Pudney discussed MiSoC research on social care and disability benefits with the No 10 Policy Unit. In January 2013, MiSoC contributed to the Royal Statistical Society conference “Statistics for Adult Social Care”, itself partly a response to the Dilnot Commission on Funding Care of Support, which highlighted the limitations of data available for social care policy-making. Professor Ruth Hancock co-organised and chaired the conference, Professor Steve Pudney was an invited speaker.

A public policy change based on an incorrect premise has been avoided

The 2012 Welfare Reform Act has replaced DLA with Personal Independence Payment for new claimants, which differs from DLA in detail but remains a non means-tested benefit for disabled people. AA is still in place. For the foreseeable future older people in the UK therefore retain access to non means-tested cash disability benefits to help them meet the costs that disability brings. As of 2012, they reach some 2.44 million people aged 65+ in Great Britain. These are the immediate beneficiaries of the decision to retain these benefits. Some of them would have lost as much as £77.45 per week (April 2012 rates) had AA and DLA been withdrawn completely. Perhaps more importantly, a public policy change based on an incorrect premise has been avoided.

The relevant research concerns the extent to which in England disability benefits (DBs) for older people (mainly Attendance Allowance (AA)), and subsidised social care (SC) for older people, are each received by those in most financial and disability-related need. Suggestions have been made for integrating the two systems in part on the assumption that DBs are less well targeted than SC. MiSoC’s research (undertaken by Stephen Pudney and Ruth Hancock) since 2014 then has been enhanced in three ways: analysis of targeting of SC in addition to DBs; the use of novel measures to compare poverty levels for disabled and non-disabled older people taking account of our own new estimates of the personal costs that older disabled people face as a result of their disabilities; an analysis of the overlap in receipt of the two forms of state support. The research has shown that each system targets public support on those with high disability and financial needs, but the overlap between receipt of each source of support is relatively small and considerable numbers of older people with high need receive support from neither source. Combining the two sources into a single system therefore risks increasing the numbers who fall through the (single) net.

“The presentation of research on a much-neglected subject was hugely influential” Lord Lipsey

In December 2015, in the latest proposal for more integration of the DB and ScSsystems, the Government announced it was considering giving more responsibility to local authorities, to support older people with care needs – including people who, currently, would be supported through AA. The MiSoC research was used in a report by the Strategic Society Centre, launched at a seminar at the House of Lords in June 2016. The report urged caution over the government’s proposal. The event was chaired by Lord Lipsey who said afterwards “This was an occasion on which the presentation of research on a much-neglected subject was hugely influential. The evidence presented which suggested that, contrary to my assumptions, attendance allowance was quite progressive changed my perspective on the issue.”

Neil Coyle MP who was present at the event tabled 7 related written Parliamentary Questions over the period 11th- 14th July (HoC references 42359, 42490, 42360, 42364, 42361, 42362, 42363). In July 2016, the Department for Communities and Local Government (DCLG) launched a consultation on the Government’s plans to allow local government to retain 100% of the business rates that they raise locally. It sought views on a range of functions and responsibilities that could be funded locally from retained business rates. This included AA. In August 2016, the Joseph Rowntree Foundation published a report that MiSoC’s Pudney and Hancock wrote for their anti-poverty strategy. Twelve responses to the business rates consultation quoted this report and the SSC report which drew on the contents of our previous research and draft versions of our report for JRF.

The organisations which quoted our work in their responses include Age UK, Carers UK, the Associated Retirement Community Operators, the King’s Fund, Independent Age, the National Association of Welfare Rights Advisers and smaller specialist organisations such as the Motor Neurone Disease Association. Both our JRF report and the SSC report were quoted extensively in a House of Commons Library briefing on the background to the consultation and to its final conclusion.

The business rates consultation closed on 26 September 2016. In January 2017 the Communities and Local Government Secretary Sajid Javid announced that devolution of Attendance Allowance would not be going ahead.

More recently, MiSoC submitted written evidence to a current Health and Housing, Communities and Local Government Inquiry into Social Care, drawing on their latest research on the disability benefits and social care for older people, which is forthcoming in Fiscal Studies.