Introduction

Returning one million Incapacity Benefit (IB) recipients to work by 2015 is high on the UK government's disability reform agenda. Several interventions have been piloted in the Pathways to Work initiative and have proven moderately successful at returning new IB claimants to work. However, we know little about how they are experienced by long-term IB recipients.

This chapter presents evidence of the problems faced by long-term IB recipients and the limited effectiveness of current interventions to support their return to work. We undertook qualitative interviews with 12 long-term IB recipients who had used return-to-work interventions provided by a council in southern England. This council was among the first to provide a service targeted specifically at long-term IB recipients, but it had limited success. Our interviews reveal the damage to self and social identity that often accompanies life on IB; the non-linear process of repairing this damage; the obstacles that impede return to work; and the limitations of ‘off-the-shelf ‘ interventions.

The chapter supports the conclusion that long-term IB recipients require bespoke and holistic rehabilitation to repair the damage to their self and social identity. Government policy emphasises the need for personalised care, but the mechanism for delivering rehabilitation may militate against this approach.

In 2008, the UK government replaced IB, paid to working-age people who are considered to be incapable of paid employment for medical reasons, with a new Employment Support Allowance (ESA) (DWP, 2008). The reform reflects a policy debate about inappropriate uptake of IB, which led the government to set a target of one million IB recipients returned to work by 2015 (DWP, 2008, p 6). This might be addressed by reducing the inflow of recipients, or by increasing the outflow of long-term recipients off benefit and back into work. This chapter concerns the latter and more challenging approach.

We present evidence from a qualitative study of a programme designed to return long-term IB recipients to work. Our aim is not to present an evaluation, but to provide a rich account of the experiences of long-term IB recipients who chose to participate in the programme, in order to deepen our understanding of the nature of the problems they face and derive recommendations for policy initiatives that more adequately address their needs.