Disability Sign

The Benefits of Devolution?

Published: 23 June 2015

Scotland's much-vaunted belief that it is fairer than the rest of the UK is under the spotlight, says Kirstein Rummery, as new powers reopen old questions about the best way to support disabled people. 

With the devolution of further powers under the forthcoming Scotland Bill, there is an opportunity to create a devolved system of welfare that is fair, universal, simple and sustainable. Scotland has long maintained that it is different and fairer to the rest of the UK when comes to its approach to welfare and care; now it has the means to prove it.

Extensive international research suggests that disability benefits should meet three interrelated criteria to be truly effective. Firstly, benefits should form a holistic package, which is joined up from the perspective of the user. They should be run according to a ‘social model’ of disability that is personalised and flexible – and administered by the service user themselves. Finally, eligibility should be based on simple criteria that are open to challenge by service users with access to well-supported advocacy services. 
The present complexity of benefits makes no sense, either from the perspective of principle or administration. Payments for disability are intended to meet the costs of impairments and illness, rather than compensate for lost earnings. So why separate out benefits for the over and under 65s? Or industrial injuries from other kinds of impairment? The costs to disabled people are the same regardless of age or the reason for injury. 
Given that Scotland now has control over a combined benefits bill of £2.6 billion, as well as control over health and social care spending (the Self-Directed Support costs in 2013 were around £80 million from an overall budget for social care of around £4.2 billion) this gives substantial scope for service redesign. 
The Bill offers opportunities for the Scottish government to work towards such a ‘gold standard’ of provision. To take one approach, Scotland could;
  • Take the existing benefits and combine them with the Self-Directed Support and adult social care budgets to fund a single, user-controlled benefit with three tiers of payment - derived from the World Health Organisation’s Instrumental Activities of Daily Living Scale - using three broad categories – mild, moderate and severe.
  • Users could then chose to take this as a weekly direct payment – to spend on services, support, personal care, informal care, aids etc. – and be assisted by user-run advocacy services both to apply for and manage the payment, or chose to have the payment managed for them by social services departments. 
  • This could be combined with an increase in benefits for informal carers so that users can put together the right package of support from state, community and family provision to reflect their own needs.
Admittedly, the initial setup costs for such an approach would be high but, over time, it would lead to considerable cost savings from the reduced administration of a simpler service and a reduction in need for directly provided care services. In addition, higher levels of independence from more personalised user-controlled services would mean more disabled people and informal carers able to work and pay taxes and a reduction in need for pricey high-level care services.
However, there are substantial barriers in achieving universal, fairer support for disabled people. The Scotland Bill currently devolves the benefits rather the function (i.e. a requirement to provide support to people with disabilities but leaving the details up to the Scottish Government). 
Furthermore, creating and running such a system would involve significant participation from disabled and older people, carers, local authorities, the social work and allied professions, the third sector, and employers. Conversely, the savings needed to make the system work would come from simplifying current provision and removing some of the statutory workforce needed to run it – this could lead to tensions between unions and disability rights organisations. 
Finally, and perhaps most problematically, for such an approach to reach its transformative potential, Scotland would also have to have full control over taxation and employment law to provide flexible working and leave for carers and disabled people, ending the benefits trap that makes it unfeasible for so many disabled people and carers to undertake part-time flexible work. 


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