An Historian

historical stuff by Gareth Millward


Measuring Disability: Same Old Problems

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In the early 1990s, the Department of Social Security decided that disability benefits needed to be reformed. It changed the rules for Invalidity Benefit and created a new Incapacity Benefit.

Rather than going on a GP’s diagnosis of a disabled person’s medical condition, a new test measured people’s functional limitations. Claimants gained “points” for what they could not do. So, being unable to walk 50m unaided gained 15 points. Longer distances gained fewer points.

The different “descriptors” – such as walking, carrying objects, concentrating on tasks and so on – were added together. If the claimant got 15 points they could claim the benefit.

Broadly, this is how Employment and Support Allowance works today. The test is incredibly controversial. The BMA recently voted to have the test banned following heavy pressure from disabled people and their representative organisations. Disabled people will be protesting at the Paralympics about these policies.

In the early 1990s, a group of experts came together to trial these tests. Some disabled people were asked to try these tests on themselves and with their organisations to see how it might work in practice.

This is how they reacted in 1994 when the government tried to use this as proof of their acceptance of the new rules.

Some of us have been unable to complete the exercises and have indicated our reasons why to the department. Those of us who have undertaken the tasks have found that the exercises themselves have reinforced the potential difficulties we perceive as inevitable in a measurement of incapacity such as this. In particular we are concerned about the arbitrariness of scoring according to mechanical functions without reference to other factors such as age or employment history. The concentration on functions to the exclusion of all else is contrary to the whole person approach which so many of us advocate.

We know the Department hopes to ensure the test is not a snapshot of a condition frozen in time, but we fear the worst. And we have made these views known. Therefore it really will not be acceptable in panellists [sic] concerns about the various aspects of the test are not acknowledged in the final report of the consultation. […] We seek your assurance that there will be opportunity to address our concerns.

Letter in the University of Essex, Peter Townsend Collection, Disability Alliance files, 76.13

Written by Marilyn Howard, Disability Alliance to Viscount Astor, Parliamentary Under Secretary of State for Social Security, 6 May 1994.

Also signed by
Pauline Thompson, The Disablement Income Group [DIG]
Bert Massie, the Royal Association for Disability and Rehabilitation [RADAR]
Brian McGinnis, MENCAP
Andy Barrick, RNIB [Royal National Institute for the Blind]
Stuart Etherington, RNID [Royal National Institute for the Deaf]
Howard John, Wales Council for the Disabled
Frances Hasler, Greater London Association of Disabled People [GLAD]
Alison Cobb, MIND
Richard Wood, British Council of Organisations of Disabled People [BCODP]

These are precisely the criticisms leveled at the current tests.

It is also worth mentioning that these named organisations were far from the most radical. At the time, disabled people were chaining themselves to buses in protest at the lack of protection for disabled people. DIG, for instance, helped run a discretionary fund for disabled people alongside the government called the Independent Living Fund.

That such problems were foreseen in 1994 should say a lot about the situation today. These criticisms have still not been fully addressed. A reformed version of the test will be used for a new disability benefit – the Personal Independence Payment – in the next couple of years.

I wonder if we will still be talking about this in 2020?

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2 thoughts on “Measuring Disability: Same Old Problems”

    1. Yes, thanks, Andy. We must remember, of course, that private and outside medical testing in the benefits system is not a new thing, nor has it only been a “problem” for the last couple of years.

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