Earlier this month, theNew Statesman publisheda long and fascinating article by its newly installed editor, Tom McTague, about the prime minister. Much of it was an account of a dogged hunt for something that never really materialised: some idea of what Keir Starmer believes in. The closest McTague got was an answer to a question about ideals Starmer thinks of as sacrosanct. “Human dignity,” he said. “The dignity of the individual. And the respect that goes with it.”
Successful politicians are often distinguished by their ability to hold completely contradictory beliefs, and Starmer is clearly no exception. After months of outrage and protest – and whispers about ministerial resignations, given more credence by the return to the backbenches of theLabour whip Vicky Foxcroft– he and his government are seemingly more committed than ever to reforms to disability and sickness benefits that will soon come to a vote in the House of Commons. The people these changes will tip into an everyday nightmare are already terrified. Quite where a belief in human dignity fits into all this is a question that answers itself.
A huge part of the government’s plans centres on the tightening of eligibility for the part of personal independence payments (or Pip) known as the daily living component. Assessments are based on acumulative score, which adds together ratings for “descriptors” of living activities based on a scale from zero to eight. They include such bald representations of abilities as “can prepare and cook a simple meal” and “needs physical help to be able to manage toilet needs”. In thenew system, people will have to score at least one rating of four to qualify for the daily living component, which will rule out thousands who experience complicated but very real issues – autism and learning disabilities, for example, tend to be manifested in lots of twos and threes – and threaten to tip their lives into financial freefall.
Asummaryfrom Citizens Advice speaks volumes: “Someone who needs assistance to cut up food, wash their hair and body below the waist, use the toilet and dress/undress their lower body wouldn’t receive Pip under the new rules.” These changes are grim enough, but there are more: chiefly, thehacking backof the so-called health element of universal credit. The Pip reforms will have knock-on effects for people’s eligibility for this benefit: many who are refused one are likely to be denied the other. The rate for new claimants whose applications are granted will be cut from £97 a week to £50, and then frozen for four years. The entitlement age is also being raised,from 18 to 22.
And so, as the government insists that “those who can work should work”, this cruelty charter goes on. Reduced Pip entitlements look set to affect whether lots of people’s family members are entitled to carer’s allowance, which is now £83.30 a week. After rumblings about partial retreats, the only clear change to what was originally floated is an increase in the transition period from people forced off Pip from four to13 weeks. The arrival point, needless to say, will remain the same: huge losses of income for hundreds of thousands of households – some of whom, according to the Joseph Rowntree Foundation, will be as much as£12,000 a year worse off.
Amid predictions of a big parliamentary revolt and wild speculation that the vote could even be pulled, it is worth thinking about how Labour’s collective belief in the dignity of labour regularly curdles into two toxic ways of thinking. One is a belief that paid employment is the only reliable gauge of people’s esteem; the other is a queasiness about disability that sometimes lurks just below the surface. There is also an apparently desperate need to counter any suggestion that Labour ministers are liberal fainthearts. In March, the justice secretary, Shabana Mahmood, offered acurt explanationof why the government was set on its plan: “This is the Labour party. The clue is in the name. We believe in work.”
Such banal obstinacy gets in the way of any deep understanding of the issues swirling around this story. Since the pandemic, the number of Pip awards hasmore than doubled. Much of this is to do with an epidemic of anxiety and depression, not least among the young. That shines light on something politicians rarely talk about, which also includes the kind of long-term health conditions that blur into disability: the fact that millions of people were damaged by both Covid-19 and the lockdowns it triggered. Research by theNew Economics Foundationalso suggests that although many disabled people usually claim no benefits at all, the cost of living crisis pushed them into applying for Pip, and therefore shoved up the benefits bill. These, needless to say, are all complex stories that demand careful answers; what the government is proposing, by contrast, amounts to the insane idea that you can immiserate people out of their problems.
Meanwhile, a very convenient theory is gaining ground. Over the past six months, we have heard more and more about the alleged modern scourge of “overdiagnosis”. Words of sympathy and support for such ideas have come from – among others –Nigel Farage, Kemi Badenoch and theheath secretary, Wes Streeting. And this school of thought now has a set text:The Age of Diagnosisby the consultant neurologist Suzanne O’Sullivan, which has receivedrave reviews, and become one of this year’s most fashionable books.
It presents as a measured and nuanced exploration of everything from Lyme disease to attention deficit hyperactivity disorder, but it can easily be read as an elegant justification for taking some people’s claims of disability and illness with a pinch of salt. She insists, for example, that “a psychosomatic explanation for people with long Covid has not featured nearly enough in public discourse”. This point is surrounded by caveats and qualifications, and reminders that illness triggered in the mind can be just as debilitating as ailments with physical causes. But her book makes it far too easy for bad actors to strip those nuances away, and lean into a cruelly dismissive attitude that perfectly suits culture warriors, and politicians who want to hack back public spending.
A lot of what she has to say about human psychology, moreover, reflects themisplaced ideathat particular conditions sit on a simple continuum that goes from severe to mild, and it might be in everyone’s interests to tell those on the “mild” end that the labels they claim are doing them more harm than good. As O’Sullivan sees it, diagnoses of autism (which she describes as a “brain disorder”) “might become a self-fulfilling prophecy as some will take the diagnosis to mean they can’t do certain things, so won’t even try”. There is a strong whiff here of the crass logic the government wants to apply to the benefits system, and the same implied message: buck up, be resilient, get back to work.
People are scared. For many, the prospect of disabled people being so impoverished is part of what made last week’s vote for assisted dying more than a little unsettling. Changes to special needs education will materialise in the autumn, and there have been whispers and briefings about the restriction of disabled children and young people’s most basic legal rights. It all seems to confirm that whatever a progressive approach to disability and human difference looks like, Starmer and his people are speeding off in the opposite direction. The idea that the people at the top believe in “the dignity of the individual”, in other words, is looking more threadbare by the day.
John Harris is a Guardian columnist