Views & Reviews Personal View

Doctors are key to welfare reform

BMJ 2010; 341 doi: (Published 27 October 2010) Cite this as: BMJ 2010;341:c6029
  1. Clare Bambra, professor of public health policy, Wolfson Research Institute, Durham University
  1. clare.bambra{at}

The UK government’s comprehensive spending review has set out plans for unprecedented cuts to public sector funding. A particular focus has been on the Department for Work and Pensions’ budget and the £192bn (€215bn; $300bn) paid each year in welfare benefits.

Most attention has focused on incapacity related benefits (Incapacity Benefit, Disability Living Allowance, and Employment and Support Allowance), which account for £12.5bn of the welfare bill. The coalition government intends to move all the current 2.6 million recipients of incapacity related benefits onto other benefits (such as Jobseeker’s Allowance or Employment and Support Allowance). This will be done by using private sector agencies to reassess the health and fitness of all recipients over the next four years.

Those deemed “fit for work” will be transferred immediately to the lower paying Jobseeker’s Allowance (box). Those deemed to be too “incapacitated” for work will be placed on the Employment and Support Allowance, with a “support” premium and no conditions. Those considered “sick but able to work” will be placed on Employment and Support Allowance with a “work related activity” premium. Failure to engage in compulsory “work related activity” would result in loss of this premium and placement on the basic rate of the Employment and Support Allowance.

Weekly benefit rates in 2010

  • UK poverty line: £115

  • Incapacity Benefit: £91.40

  • Employment and Support Allowance (with support premium): £96.85

  • Employment …

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