The welfare state has broken the link between family and care - it needs reform now - Miriam Cates

First there was the successful visit to The White House in Washington DC, where Starmer was widely credited for representing British interests in a statesmanlike way, overcoming any fall-out from his previous public criticism of US President Donald Trump.

Then came the efforts to coordinate support from European leaders for the beleaguered President Zelenskyy of Ukraine, an initiative which, whether successful or not, has certainly increased Britain’s standing on the continent. Domestically, the decision to scrap NHS England has caught both allies and enemies by surprise. But the most controversial reform—and the one that Starmer may find the most politically difficult to achieve—is the planned cuts to disability benefits.

Over the last few years, the number of British people claiming sickness and incapacity benefits has ballooned. A staggering 4.4 million individuals are now in receipt of some sort of disability payments. Between September and November 2024, an additional 175,789 people—that’s almost 2,000 new claimants every day—were judged to be too sick to work and were placed on the highest rate of Universal Credit.

Excluding the state pension, the total cost of welfare has reached £126 billion a year. That’s an annual cost of nearly £3500 to each and every British taxpayer. With eye-watering UK national debt of £2.7 trillion, and clear imperatives to spend more money on defence, it’s clear that the soaring cost of disability benefits must be addressed.

Of course, there are many people whose physical health problems or disabilities are severe enough that they can’t—and may never be able to—work. In a compassionate society, it is right that we support and provide for these people, although as I discuss below, we should not assume that the State is the best entity to provide that support. But one of the principal causes of the growth in incapacity benefits claims over the last few years has not been a rise in physical health conditions; instead a growing proportion of claims are for mental health problems, such as anxiety and depression and ADHD.

And the most significant—and concerning—increase has been amongst the young. The number of young people aged 16 to 24 with “limited capacity for work-related activity” has risen by 249 per cent from 46,000 to 160,000 since the pandemic. There are now nearly one million young adults not in education, training or employment.

Many people will welcome recent campaigns that have focused on reducing the stigma around discussing mental health. But it is difficult to argue that a young adult suffering from depression or anxiety should be treated the same—i.e. signed off work and given benefits with no requirement to look for employment—as someone with a serious disability or terminal illness.

Not only is the cost to the taxpayer unmanageable, but this approach is also deeply unhelpful to the claimants themselves. The last thing young adults with mental and emotional struggles need is to be paid to stay at home with all the time in the world to contemplate their own misery.

Going out to work, having a purpose and a routine, working alongside others and taking responsibility, are all activities that are well known to have positive benefits for mental health and self-esteem. It has been a huge mistake to pursue “parity” between mental and physical ill health; while we must think carefully about how to provide appropriate support for those with mental ill health, it is clear that having a job should be seen as part of the solution, not the problem. No politician—on left or right—should have qualms about reforming the current system.

And not all claimants are genuine. TikTok and Facebook abound with videos coaching people in what to say to medical professionals and how to complete social security forms in order to qualify for benefits on the grounds of mental health. Mental health symptoms are largely reported rather than observed.

You can’t fake a broken leg or heart disease—x-rays or blood tests will show you up. Yet if someone tells their doctor that they feel too anxious to work, or describes a carefully rehearsed catalogue of ADHD symptoms, it is much more difficult for a health professional to disprove the claim. Let’s be clear, pretending you’re sick in order to receive benefits is fraud.

Those of us who work hard to pay our own way, to feed our own families and provide for our own children feel rightly angry when our taxes get higher and higher to fund the living costs of those who sit at home when they could be working.

There are strong ethical arguments for removing incapacity payments and reinstating work requirements for most mental health claims. However, as much as I support reform of disability benefits and hope that Starmer can successfully face down potential rebels on his back benches to achieve this, we do need a wider conversation about the role of the welfare state.

Before the modern welfare state, it was widely understood that the responsibility to provide for those who were too young, sick or old to work, lay not with the state but with the family and community. Parents were responsible for providing for their own children.

Healthy able-bodied adults were responsible for caring for their own relatives, or when sickness, disability or old-age hit prevented them from working. Individuals were not seen as atomized units of either economic activity or inactivity, but rather as members of families or households, small communities that included those who worked, those who couldn’t, and those who cared for the young, the old and the sick.

In contrast, the role of the State was to deliver those things that families and communities cannot—to maintain the armed forces, to create infrastructure, to enforce law and order and determine foreign policy. A century ago, the idea that the Government should be expected to provide for individuals would have seemed absurd.

The original welfare state was meant to be a safety net for those who lost their jobs or needed emergency healthcare. But welfarism has metamorphosed into a culture that expects the taxpayer to support those who are ill, out of work, and elderly rather than the family.

This change has had profound and expensive consequences. We have removed the link between duty and personal responsibility, and provision.

In a pre-welfare society, if you were too lazy to go to work and yet expect your family to support you, your loved ones would very quickly kick you out of the house and force you to pay your way. Similarly, there is no incentive to fake sickness or incapacity if it is those that you love and live with who have to carry the burden.

Reliance on the faceless taxpayer incentivizes fraudulent claims, encourages a culture of dependence and weakens the family and the community. Why look after your own when the state will do it for you? Why not claim as many benefits as you can when the source of your cash is not your family, but the State?

Ultimately the welfare state has broken the link between family and care. Before the welfare state, there was a strong incentive to get married and have children—how else would you be cared for and fed in your old age? Yet now that we have socialized the cost of sickness and old age (everyone gets a pension and social care, regardless of whether they have children), and privatized the cost of raising a family, having children has become a financial expense rather than a benefit.

It should be no surprise that Britain’s marriage rate and birth rate are now the lowest on record, with frightening consequences for the future of the economy.

Labour’s attempts to reduce the benefits bill should be applauded. But we need total reform of our welfare system, shifting the focus away from worklessness and instead supporting families to care for their own.

Ultimately, this is the compassionate thing to do—strong family relationships and taking responsibility for yourself and your loved ones are the keys to a fulfilling life.