‘Pathways to Work’ Green Paper
A rapid health impact assessment of changes to the welfare system
- The Pathways to Work Green Paper sets out wide-ranging reforms to the welfare system including significant changes to health and disability benefits. The government has published an equalities impact assessment and an assessment of the financial impact of the proposals. However, a health impact assessment has not been published.
- Our paper provides a rapid health impact assessment (HIA) of the government’s welfare reforms. It uses a systematic and defined framework to assess and set out the expected health impacts on those directly affected by the changes living in England and Wales.
- The Health Foundation has submitted its HIA of the government’s welfare reforms to the Work and Pensions Select Committee. Our related blog puts our assessment and its implications in context.
Spend on disability and health-related benefits has grown steadily over the past decade, with a substantial increase in the number of people claiming since the pandemic. On current trends, more than 1 in 10 working-age people could be receiving disability and health-related benefits by 2028/29, with spend exceeding £60bn per year. The reasons behind this rise are not fully understood but contributors include worsening working-age health, welfare system structures and processes and the cost-of-living crisis.
This HIA considers the health impacts of welfare reforms on people living in England and Wales who are directly impacted by the changes, given devolved responsibility for health and disability benefits in Northern Ireland and (partially) in Scotland. The paper makes an objective assessment of the health impact of the reforms. It does not seek to make explicit recommendations about mitigating actions.
The reforms will change entitlement to benefits and therefore result in direct financial loss for some families (a single adult, married or cohabiting couple and any dependent children) and gain for others. Income is a significant determinant of health outcomes and therefore there will be health implications of these changes.
This assessment does not represent the Health Foundation’s full response to the Green Paper. We will publish this before the consultation period ends on 30 June 2025.