Shifting the goalposts: a longitudinal mixed-methods study of the health of long-term incapacity benefit recipients during a period of substantial change to the UK social security system

The UK social security safety net for those who are out of work due to ill health or disability has experienced significant change, most notably the abolition of Incapacity Benefit (IB) and the introduction of Employment and Support Allowance (ESA). These changes have been underpinned by the assumption that many recipients are not sufficiently sick or disabled to ‘deserve’ welfare benefits – claims that have been made in the absence of empirical data on the health of recipients. Employing a unique longitudinal and mixed-methods approach, this paper explores the health of a cohort of 229 long-term IB recipients in the North East of England over an eighteen-month period, during a time of significant changes to the UK welfare state. In-depth interviews with twenty-five of the survey cohort are also presented to illustrate the lived experiences of recipients. Contributing to debates surrounding the conceptualisation of work-readiness for sick and disabled people, findings indicate IB recipients had significantly worse health than the general population, with little change in their health state over the eighteen-month study period. Qualitative data reinforced the constancy of ill health for IB recipients. Finally, the paper discusses the implications for social policy, noting how the changing nature of administrative definitions and redefinitions of illness and capacity to work can impact upon the lives of sick and disabled people.