Britain's new welfare system emphasises self reliance

BMJ 1998; 316 doi: (Published 04 April 1998) Cite this as: BMJ 1998;316:1037

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  1. John Warden
  1. London

    The outline of a new welfare system for Britain, placing more emphasis on self reliance, was announced by the Labour government last week. It recognises that the system put in place after the second world war has created a dependency culture that is damaging to society and cannot be sustained financially.

    The reforms, to be implemented over 10 to 20 years, are to be based on the twin pillars of work and security—work for those who can, security for those who cannot. The government says in a green paper that it wants to spend more on health and on helping severely disabled people, while spending less on “social and economic failure” by cutting unemployment, rooting out fraud, and encouraging greater self provision.

    The approach, with strong echoes of Thatcherism, was well received, though implementing it without internal dissent will test the government's resolve. The plan is for care with coercion. Disabled people, for example, are offered a disability commission to protect their rights, and a pledge that disability benefits will not be means tested. But to target help at the right people there are to be “new gateways,” which may provide less easy access for two thirds of current claimants. The implication is that there will be stricter medical policing of these gateways.

    The government estimates that “hundreds of thousands” of disabled people want the chance to work, and they will be helped by relaxing the benefit rules that currently prevent them from doing so. Incapacity benefit for people who are both sick and unemployed will in future be subject to a stricter test of people's ability to return to some form of work. In addition, large scale fraud is to be eliminated and the child support agency reformed. The savings will allow more help for severely disabled people. The aim is to have a welfare system delivered more through high quality services, including health, than on social security payments.

    A New Contract for Welfare, from the Stationery Office, price £11.50.

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