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Failed by the system

24 June 2010
Failed by the system

Why the Employment and Support Allowance isn’t working for people living with cancer

Executive summary

Employment and Support Allowance (ESA) was introduced in October 2008, replacing incapacity and income support for people off work long-term due to ill health or disability.  The benefit was designed to actively encourage the more ‘job ready’ claimants to move off benefits and return to work.  At the time, the government made assurances that the very sick or disabled – including chemotherapy patients and terminally ill people – would be protected and hence would not be required to attend medical assessments or work-focused interviews.  Certain safeguards were included to protect these people.  However, these safeguards are not working.  Poor knowledge of the ESA rules within Jobcentres, poor systems and poor understanding of cancer and its effects, mean many vulnerable people with cancer are getting a poor deal. Macmillan Cancer Support and Citizens Advice have worked together to collate evidence demonstrating the key problems people with cancer are experiencing accessing ESA.  Since May 2009, the Macmillan Benefits Helpline has received 661 calls about ESA and Citizens Advice bureaux have dealt with more than 85,000 enquiries about ESA since April 2008, gradually building up to the launch of the new benefit in October 2008.  Between January and October 2009, Citizens Advice bureaux received 61,254 enquiries about the benefit.  

Our advisers have identified three key ways in which the new ESA system is failing people with cancer:

  • terminally ill patients are not being fast tracked into the ESA support group and are being required to undergo the work capability assessment or attend work-focused interviews
  • cancer patients receiving chemotherapy are being asked to attend a work capability assessment or work-focused interviews
  • the work capability assessment, which is used to determine if someone is eligible for ESA and should be taking part in work-related activity, is not sensitive to the problems faced by people with cancer.

This report looks at these issues in more detail. Citizens Advice is also publishing a series of working papers on ESA, the first of which covers the administration of the claiming process for ESA, including claiming by telephone, poor advice and delays in the process.  Subsequent papers will focus on the work capability assessment, decision-making and appeals and the use of sanctions in ESA.

Failed by the system [PDF 380 kb]