Disability, Work and Starmer’s Cruel Cuts

This blog is about the UK government’s proposed cuts to disability benefits such as PIP (Personal Independence Payment). If implemented, these cuts will impact negatively upon many thousands of people who are already experiencing significant mental distress. The blog challenges some of the arguments being used to justify these cuts.

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We begin in rural Surrey, 1976. The sun is low in the sky, soon to ignite the banks of grey cloud that loom above the horizon. Cattle are gathering at their barn, birds are flocking to roost, and in a far-off field a young man wipes sweat from his brow. It is Keir Starmer, the 14-year-old son of a humble toolmaker, who has been toiling all day to clear the field of stones.

Nearly 50 years later, Starmer – now Prime Minister – explained to the Daily Mail how this, his first job,  taught him “the pride of earning some money, the feeling of independence and achievement that comes with earning a living. That’s what I mean when I talk about the dignity of work.”

Morals and Motives

Starmer spoke to the Mail about the dignity of work in November 2024. He used the same phrase talking to his own MP’s in March 2025. Both times, he was not merely reminiscing: he was building an argument for cuts to disability benefits. Starmer’s professed belief in the dignity of work is part of a moral argument for benefit cuts. For Starmer work is good for you, and cutting benefits supposedly ‘encourages’ ill and disabled people to work.

Other moral arguments are of course possible. Starmer could argue that his government has a moral duty to support and protect vulnerable people with disabilities. He could argue that, since social inequality is both bad for health and corrosive of communities, it would be immoral to entrench it further. Starmer could commit his government to reforming the tax system and developing wealth taxes. These would both reduce inequality and generate more than sufficient income to pay for disability benefits.

Yet we can’t, in fact, explain Starmer’s choice to cut disability benefits on the sole basis of his personal moral commitments – whatever their nature. Evidence suggests that we frequently over-estimate the extent to which ‘inner’ qualities of that kind influence choices. Far more than insight into Starmer’s character, as David Smail might have said, we need outsight of his circumstances. Specifically, we must consider the flows of power in the stock, bond and money markets; in corporate headquarters, government departments, and media newsrooms; and in the many UK institutions that wield influence while simultaneously striving for invisibility.

In orienting toward those powers, the Starmer government created a trap for itself. The Chancellor, Rachel Reeves, pledged to retain, rather than update, the fiscal rules that regulate how the economy should be run. These rules, inherited from the Conservatives, require government borrowing to be matched by income. Reeves also promised not to raise income tax, VAT or national insurance. Simultaneously, though, she committed to reduce NHS waiting times, invest in public services, and stimulate economic growth.

These incompatible commitments reflect two opposing tendencies in the field of power that enmeshes the government. On the one hand, they reflect commitments made during the election campaign, often informed by opinion polling. On the other, they reflect the Starmer government’s alignment with neoliberal ideology

Neoliberalism emphasises competition and markets in all spheres of human life. It promotes unfettered capitalism and consumer choice, alongside privatisation and cost-cutting in education, welfare, health and social care, and public administration. Under neoliberalism, workers are expected to be flexible, adaptable and compliant, just as work becomes more precarious, demanding and exploitative. Neoliberalism is the unacknowledged ideology that has been shared by every UK government since Thatcher in the 1980s. This is why, when asked to identify her greatest achievement, Thatcher said “Tony Blair and New Labour.”

Far more than Starmer’s personal morality, it is his government’s neoliberalism that motivates its reluctance to implement tax reforms, introduce wealth taxes, or alter the fiscal rules. And it is neoliberalism, far more than belief in the dignity of work, that is driving the government’s choice to cut disability benefits.

Costs and Benefits

While the reasons for cutting disability benefits are ideological more than moral, the justification is mostly financial. Quoting figures from the Office for Budget Responsibility (OBR), the BBC reported that by 2030 “total spending on health and disability benefits” is projected to rise by £36bn to £100.7bn. This includes spending on PIP, the government’s primary target for budget cuts. The BBC says PIP’s cost is expected to go from £18bn now to £34bn in 2030: an increase of £16bn.

The government claim that these increases are unsustainable. But in presenting their evidence, both the BBC and the government ignore the OBR’s warning that projections of this kind must be evaluated in their appropriate context: the share of UK national spending they represent. Otherwise “interpreting changes [in costs] .. is difficult, particularly over long time periods.” This is because spending rises over time anyway due to population growth, inflation and (less reliably) economic growth.

In addition, economic forecasts are typically somewhat volatile, partly because new economic performance data is published monthly. The figures quoted in this blog reflect data that were available in mid-March 2025. Subsequent forecasts will undoubtedly change some of the details, though the overall picture seems likely to remain largely unchanged.

The OBR also cautions that its predictions rely upon assumptions that could prove incorrect; in this case, that applications for PIP will continue to rise, and that GDP will grow at a modest rate. Simultaneously, they rely upon survey data the results of which vary significantly depending upon the methodology. A former OBR insider said recently that “The OBR forecast embodies all sorts of adjustments, judgments – it’s pretty flaky. People who do the forecasts understand the uncertainty.”

Looking more closely at the projected increases, the OBR calculate separate forecasts for incapacity benefits and disability benefits. The annual cost of incapacity benefits (including Universal Credit and Employment and Support Allowance) is predicted to increase until 2030. Nevertheless, the OBR say that “our forecast for incapacity benefits spending as a share of GDP stabilises after 2024-25”. So the cost will increase in cash terms, but as a percentage of UK national income spending on incapacity is predicted not to increase at all.

Separately, the OBR forecast that total spending on disability benefits (including PIP) will rise from 1.4% of GDP in 2023, to 1.8% in 2029: an increase of 0.4%. While this looks less dramatic than the same increase expressed in £bn, even fractional percentages of GDP represent huge amounts in ££’s. Recall that for PIP alone the projected increase is said to be £16bn. To gauge the impact of an additional £16bn of government spending, we can compare it with other elements of government finance:

• Total GDP for the UK in 2024 was £2848bn. As a percentage of this, the increased cost of PIP would be around half of one per cent (0.56%).
• HS2 – High Speed 2 – is the new railway line that will reduce the travel time from London to Birmingham by all of 30 minutes. On current estimates, it will be completed in 2033 at a total cost of £66bn.
• Construction of Hinckley Point C nuclear power plant in Suffolk was contracted to the French energy company EDF. Work began in 2016 at an estimated cost of £18bn. It is now estimated to be completed by 2031 and to cost around £43bn.
• The UK’s defence budget for 2024-5 was £56.9bn, but will rise sharply in the near future. A group of eminent economists have proposed that the government could change the fiscal rules to exclude this spending, as Germany is planning. They believe this would not trigger an adverse reaction from investors who would accept it as a measured response to the changed geopolitical situation. This would make nearly £60bn available for public spending and investment this year, and more in years to come.
• A handful of Labour politicians (Diane Abbott, Richard Burgon) have suggested imposing a wealth tax on the super-rich rather than cutting disability benefits. A levy of 2% on assets over £10mn would be payable by just 0.04% of the UK population, yet is estimated to generate £24bn
• The UK Tax Justice Network have developed a package of 10 tax reforms. None are based on entrepreneurial activity or individual income, so should not inhibit investment or growth. They estimate that implementing these reforms would generate an additional £60bn each year.

These comparisons show that £16bn, while a huge amount of money, is not exceptional when placed in the context of government finances overall. The question remains: what is driving the increasing cost of disability in the UK?

Sickness and Health

The increase in PIP applications consists disproportionately of people who have been experiencing mental distress. According to the OBR, in 2019-20 poor mental health generated 28% of successful PIP applications, but by 2023-4 this had risen to 38% .

Labour figures have been questioning the legitimacy of this. During an interview in January this year, former Labour prime minister Tony Blair said “..we’re spending vastly more on mental health now than we did a few years ago, and it’s hard to see what the objective reasons for that are”. In February, Work and Pensions Secretary Liz Kendall said that some people on benefits “are taking the mickey”. And in March, Health and Social Care Secretary Wes Streeting agreed with an interviewer that “there is an ‘overdiagnosis’ of some mental health conditions”.

Contributors to ‘Mad In The UK’ frequently reject psychiatric diagnosis. Psychiatry’s zealots sometimes respond with claims that these critics are promoting right-wing agendas. In failing to acknowledge the many differences between (say) Streeting’s ideologically-loaded assertion and evidence-based critiques, zealots imply that critiquing psychiatric diagnosis is always indicative of right-wing sympathies. They seem oblivious of right-wing advocacy of psychiatry, of diagnosis being used as a tool of social control, and of psychiatry’s history as an arm of the repressive capitalist state.

In fact, not only is it possible to reject diagnosis while critiquing these politicians’ claims: leaving diagnosis behind actually facilitates critique. Amongst other reasons, this is because critics can engage with the reality these claims misrepresent without needing to invoke invisible diseases lurking stealthily inside the person (so stealthily, in fact, that they can’t be seen and leave no traces: no biomarkers.)

These diseases – depression, anxiety disorder and so on – are believed by psychiatry to mediate responses to circumstances. This biases psychiatry toward the person’s (presumed) inner dynamics, and so deflects it from sustained examination of the actual circumstances that create distress. It means that psychiatric accounts tend to be tainted by both individualism and reductionism. Critics simply don’t need to invoke these invisible diseases. As James Davies put it: “If you are feeling down, inordinately sad, and have lost all interest in things, you aren’t suffering the ‘symptoms of major depression’. You are rather feeling down, inordinately sad, and have lost all interest in things”.

With this in mind, consider Tony Blair’s claim that “it’s hard to see .. objective reasons” why the numbers of people with mental health difficulties have increased in recent years – a claim so ill-informed that it is frankly astonishing. Blair appears insensitive to the hopelessness and despair created by enduring social inequality, rampant environmental destruction and accelerating climate change, and oblivious to the psychological impacts of insecure jobs, low wages, unaffordable housing, decaying public services and high levels of debt.

Blair also seems unable to comprehend that young adults, who now constitute a significant proportion of PIP claimants, have matured into a hostile world of restricted opportunities and commodified selves, a world where hope of anything better has been systematically crushed. Many endured the Covid lockdowns at important developmental periods, and the consolations of social media to which most of them turned were double edged. Social media’s psychological cost includes its novel capacity for 24/7 adverse social comparisons that can scale rapidly and unpredictably, whilst simultaneously preserving indefinitely every gaffe or faux pas. This is a unique combination that seems almost deliberately designed to foster misery and anxiety.

Nevertheless, some people will inevitably suspect that these politicians have a point. Perceptions of benefit claimants, disabled or not, have been shaped by years of propaganda about profligate welfare spending, by speeches pitting ’strivers’ against ‘skivers’, and by politicians blithely implying that many benefit claimants are cheats.

This makes it essential to ask whether there is evidence of a real deterioration in overall emotional wellbeing that is, in turn, driving the increases in disability benefit claims. A recent study by right wing think-tank, the Institute of Fiscal Studies (IFS), was focused specifically upon this question. On reviewing the relevant literature, the study found:

“.. compelling evidence that mental health has worsened since the pandemic: more people are reporting mental health conditions in a range of surveys, a growing share of disability benefit claims are for mental health, there has been an increase in ‘deaths of despair’, and more people are in contact with NHS mental health services. While none of these pieces of evidence is dispositive, they all point in the same direction, suggesting that deterioration in mental health is playing some role in the rising number of people claiming health-related benefits.”

So despite the insinuations of politicians, the evidence suggests that the additional £16bn projected for PIP simply reflects a real increase in need.

Dignity and Despair

The bucolic setting of 14 year-old Starmer’s first job, invoked to illustrate the dignity of work, bears little relation to the reality of employment today. A more representative description appears in a research paper analysing the impact of ‘smart’ armbands upon warehouse work:

“..workers gathered products from 87 aisles of three-story shelves with the incentive to free up time spent writing on a clipboard, and they wear armbands that track goods. The band allocates jobs to the wearer, forecasts a completion time and quantifies movements among the area’s 9.6miles of shelving and 111 loading bays. A 2.8 inch display gives analytical feedback, verifying the order or otherwise ‘nudging a worker whose order is short’ … If workers meet targets, they are awarded a 100% score, rising to 200% if they work twice as fast. A worker reported, ‘the guys who made the scores were sweating buckets and throwing stuff all over the place’ .. Warehouse workers were at risk of being penalised if they do not record toilet breaks on devices..”

Alternately, here is a description of another contemporary workplace, drawn from TV documentary series “The Call Centre”. The company CEO, Nev, is interacting with trainees:

“..speaking to a room of new workers, Nev explains that ‘happy people sell, miserable bastards don’t. Isn’t that right?! Happy people sing don’t they?! It lifts your spirits. You don’t sing sat on your arse, you sing standing up to project your voice’. The projector lights up with a karaoke style display and Nev signals to start: ‘Ok – Mr Brightside, the Killers, C sharp! Here we go – on your feet!’. The trainees look embarrassed – both in front of the camera and at the prospect of singing – while Nev pushes on: ‘Now we go for this – no messing!’. And in a mixture of different tones, abilities and levels of commitment, the music starts playing and the whole room begin to sing .. Nev’s despotic management style is illustrated as he claims: ‘I would sack somebody for not singing – I have sacked somebody – two people – for not singing.”

Despite being more-or-less arbitrarily chosen, these examples illustrate aspects of modern work that are probably more general: incentivised competition against colleagues to gain meagre bonuses; authoritarian regimes of compulsory enthusiasm; maybe even arbitrary dismissal for not exuding sufficient happiness.

They also illustrate just how thoroughly modern work is bound up with digital, communication and information technologies. Research shows that the introduction of these technologies frequently leads to job losses; intensifies work; or drives down pay due to de-skilling. Simultaneously, studies illustrate how workers are increasingly subject to real-time covert electronic monitoring: of driving destinations, times and distances; of active computer use; of time on phone calls, away from the desk, visiting the bathroom, and so on.

When contrasted with these realities of modern employment, Starmer’s choice of casual physical labour from half a century ago seems like nothing less than a calculated attempt to manipulate sentiment. In a manner reminiscent of the 1970s TV advertisement for Hovis, Starmer’s vignette appears designed to persuade: specifically, to persuade that work produces dignity.

Now imagine, instead, that Starmer’s first job was as an Amazon delivery driver: probably being tracked by GPS, but in any case on a tight schedule with no toilet breaks, and so forced to urinate in bottles simply to stay on time. Or imagine that Starmer had worked in one of the USA poultry factories where instead of toilet breaks workers are actually required to wear nappies. Such working conditions, increasingly common today, are more clearly productive of indignity, if not outright despair.

Work and Wellbeing

In relation to work, critical responses to the proposed cuts have mostly focused on their coercive character: people need to be helped and supported back into work, not coerced through financial desperation. While this is self-evidently true, it raises the bigger question of whether work is actually good for emotional wellbeing.

There is certainly extensive evidence that work can be bad for wellbeing. A number of empirical studies find that precarious employment causes mental health problems. Insecure employment is associated with increases in diagnoses of major depression, and with a range of anxiety disorder diagnoses. Similarly, there is evidence that higher job strain (high levels of workplace demands, combined with low job control) is associated with increases in both depression- and anxiety- related diagnoses. And one of the largest and most comprehensive reviews of this research concluded that specific aspects of employment are bad for workers, and in particular that “high job demands, low job control, high effort–reward imbalance, low relational justice, low procedural justice, role stress, bullying and low social support in the workplace are associated with a greater risk of developing common mental health problems”.

There have also been studies specifically designed to identify and assess any positive impacts of work. However, a review found only four relevant good quality studies, and on that basis concluded somewhat weakly that “work can be beneficial for an employee’s well-being, particularly if good-quality supervision is present and there are favourable workplace conditions.” By contrast, a report both commissioned and sponsored by the DWP came to the strikingly unequivocal conclusion that:

“There is a strong evidence base showing that work is generally good for physical and mental health and well-being. Worklessness is associated with poorer physical and mental health and well-being.”

There is also research on the impact of unemployment upon wellbeing. This research is difficult to interpret because being workless almost always means being poorer, too. Other frequent confounding factors include loss of status and prestige, conflict with the former employer, and deterioration and loss of friendship networks. With those cautions in mind, a large review found associations between unemployment and “mixed symptoms of distress, depression, anxiety, psychosomatic symptoms, subjective well-being, and self-esteem”. Finally, there is some research into the impacts of work on recovery from mental distress. A USA-developed program “Individual Placement and Support”, a form of supported employment for people with severe mental health problems, appears to have achieved positive results. Similarly, a review of longitudinal studies appeared generally positive, although the authors ability to draw meaningful conclusions was impeded by the heterogeneity and quality of the research.

For people in general, and still more for those who have been struggling with severe and enduring distress, whether work is good for you depends upon its character and its conditions. Some jobs can be beneficial, but others can actually be harmful. Certainly, any assumption that work is necessarily good for emotional wellbeing is powerfully contradicted by a substantial body of evidence.

Conclusion

The Starmer government’s arguments for disability benefit cuts are significantly flawed. At best they receive only ambiguous support from the research evidence. The ideological nature of the government’s choice to make cuts is highlighted by their reluctance to pursue other viable strategies. Implementing tax reforms, introducing a wealth tax or updating the fiscal rules would each generate sufficient income to cover the projected cost of PIP and other benefits. The decision to cut benefits is particularly cruel, given that even the IFS conclude that there has been a real, widespread deterioration in the emotional health of the UK population.

The remaining question, then, is what caused that deterioration? It appears that Covid was possibly a factor, since it is particularly since the pandemic that applications for health-related benefit claims have accelerated. Two speculative explanations have recently been proposed.

Former shadow chancellor John McDonnell suggests that the covid pandemic was largely coincidental, and that “The rise in young people claiming benefits for sickness and disability, especially related to mental health conditions, has to be understood in the context of this austerity generation coming on to the books”. Alternately, economist Richard Partington suggested that when the pandemic happened “the UK had a particular large health shock – perhaps linked to record NHS waiting lists and crumbling public services.” (to which we might add the accumulating effects of neoliberalism, the effects of loss of hope, of persistent social inequality…and so on).

This question seems likely to be the focus of extensive future research. For now, the priority of many will be to challenge these cruel and senseless cuts. This blog was written to encourage and support those challenges.

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Mad in the UK hosts blogs by a diverse group of writers. The opinions expressed are the writers’ own.