The Faculty of Public Health is deeply concerned about the risk of growing poverty and health inequity, following the UK Government’s announcement of £4.8 billion cut to disability and health-related benefits. This is the biggest cut in a generation and comes at a time of rising poverty. People from low-to-middle income households with a disabled person will be the most affected. These changes are likely to diminish living standards, worsen inequalities and increase child poverty, undermining the government’s aim to tackle this critical issue.
A range of welfare reforms are proposed in the Spring Statement and the “Pathways to Work” Green Paper to reduce disability and health-related benefits and encourage people into work, and to ensure fiscal rules are met in a tough economic situation. The cuts primarily arise from restricting eligibility for Personal Independence Payment (PIP), a non-means-tested benefit which provides financial support to people who need assistance with the basics of everyday living, or with mobility; and reducing and freezing the health-focused element of Universal Credit.
We do welcome other changes proposed, such as the increase in the standard allowance for Universal Credit (but note that the rate will remain below that needed to cover essentials). Proposals to support people with a health condition or disability into work are also welcome, as the evidence suggests that good-quality work, in decent conditions, can improve health and wellbeing. However, these proposals do not address how the availability or quality of work might be improved in the current “gig” economy; nor is it easy to see how they will meet the immediate needs of people who have lost disability benefits.
Over 3 million families are expected to be worse off by 2029-30 as a result of these changes. The estimated average loss, of £1,720 per household per year, hides significant variation. Around 800,000 people stand to lose the “daily living” component of PIP, which amounts to nearly £4,000 a year. PIP is also a gateway to other support, such as carers’ allowances, so its loss will have a profound impact. As a result of these changes, it is estimated that an additional 250,000 people will fall into relative poverty by 2029-30, including at least 50,000 children.
This compounds an existing picture of widespread poverty in the UK, with around 14.3 million people (21% of the population, including 30% of all children) living in relative poverty in 2022-23. The latest DWP statistics show that the poorest 10% of households in the UK experienced the biggest falls in income in 2024, with growing numbers of children living in poverty. Disabled people face higher rates of poverty than the general population, driven by the additional costs of disability and barriers to work. The prevalence of benefit receipt varies substantially by area, so these changes also risk widening regional socioeconomic and health inequalities.
Evidence shows that people die too early across the UK and live additional years in ill-health due to poverty and deprivation. Children living in poverty experience impacts on educational, cognitive and behavioural development, with acute and chronic health effects across the life course. This makes benefit reform a pressing public health concern. The Faculty is concerned that the proposed changes will increase hardship for many families in already-precarious living situations, facing food, energy and housing insecurity. This will be exacerbated by the raft of rising household bills and the freeze in housing benefit contributing to the unaffordability of rents in the private rental sector. The changes will jeopardise policy commitments to reduce inequalities in healthy life expectancy and seems likely to undermine the forthcoming Child Poverty Strategy.
The cuts will also affect mental health inequalities in the middle of a national mental health crisis, especially among younger people, who will face restrictions in access to Universal Credit. Mental health conditions are a leading cause of sickness absence and account for nearly 40% of all Personal Independent Payments. It is not helpful to attribute the rise in prevalence of mental health conditions to “overdiagnosis”. We concur with the Mental Health Foundation response that we “should be looking at its root causes and how we tackle them, preventing people from developing poor mental health.” Charity helplines have reported a surge in calls from people worried about the impacts of the government announcement on their financial wellbeing and their physical and mental health [19].
We note that these proposals also carry significant implications for the health and social care system. These range from plans to increase the daily rate of PIP assessments, to a greater need for health and social care support among people who lose the “daily living” component of PIP or carer’s allowance. It is not clear how already-stretched health and social care services will be able to create the capacity to meet these anticipated additional demands.
We would support a robust evaluation of the economic and health impact of the welfare changes and employability programmes. In their current form, it seems unlikely that they are capable of leading to fairer or healthier outcomes, with the cost of these changes likely to be borne by people who already face serious socioeconomic disadvantage and coping with ill-health.
