The missing million

With a third of unemployed disabled people keen to return to work, the government needs to find a long-term strategy for reintegration

When most people think of a disabled person they think of a person using a wheelchair or a guide dog, someone with a visible physical impairment. You don't see that many people using wheelchairs or guide dogs, so you presume there aren't many disabled people. In fact nearly one in five people of working age is disabled and you can't tell by looking at most of these seven million people. If this sounds implausible, take a look at the cabinet; at least three ministers are disabled but you can probably only tell that one is (apart from David Blunkett the others are Gordon Brown, who is partially sighted and Jack Straw, who is hearing impaired.)

One of the great challenges that the prevalence of disability presents for public policy is that less than half of all disabled people are employed. Three million people are claiming incapacity benefits, more than the combined number of lone parents and unemployed people claiming out-of-work benefits. While numbers of the latter two groups have decreased in recent years, the number of people claiming incapacity benefits has increased. And this is not because disabled people can't work - just under 3.5 million disabled people do work and well over one million of those claiming incapacity benefits say they want to work. Given the importance that being employed has in reducing poverty and exclusion, this situation is not good for disabled people and not good for the economy and society.

Recently we have seen significant improvements in the civil rights of disabled people, most notably through the Disability Discrimination Act and the creation of the disability rights commission; however, only incremental changes to the welfare and employment policy for disabled people have been forthcoming.

It's as if successive governments have felt trepidation in tackling this issue. This is evident in the government's most recent green paper on the subject, Pathways to Work. Its proposed policy reforms have been widely welcomed but most are pilot schemes and represent more of the small-scale changes, focusing on the individual, that we have seen before. Recently published research by the Institute for Public Policy Research argues that while the government's efforts are steering policy in the right direction, they are inadequate to meet the scale of this challenge.

After several years of steady economic improvement, generally falling unemployment rates, advances in civil rights and some positive policy reform, unemployment amongst disabled people remains high. The development of a successful new policy framework will depend on finding out why.

We already have some answers. For a start, more and more people are defining themselves as disabled. The Labour Force Survey recorded an increase of 700,000 in the number of working-age people reporting a current long-term health problem or disability between 1998 and 2001. This may be because we now recognise more forms of illness, especially in relation to mental health. A decade ago, musculo-skeletal or cardiovascular conditions were the most commonly cited reasons for not being able to work due to disability. Now mental health, often linked with workplace stress, dominates. People with mental or behavioural impairments now account for more than a third of claims. The incidence of disability increases with age and in our ageing population it seems likely that we will see disability continue to rise.

Disability is not a permanent, unchanging state and people may need to move in and out of work at different times depending on their condition; however, the benefit system does not have the flexibility to respond to this dynamic process.

The UK lags far behind comparable countries in the retention and rehabilitation of workers following the onset of disability. Most disability occurs while a person is of working age (less than 20% of disabled people were born with a disability). When a worker becomes disabled they have a one-in-six chance that they will lose their job. Once people do fall out of employment, it is difficult for them to return.

With so many issues to address, the government has little chance of meeting its target to significantly increase the employment rate of disabled people, or meeting its poverty pledges, without a more ambitious, longer-term strategy for change. A new public policy framework is required to transform the expectations of individuals, employers, the government and non-governmental organisations in the way disabled people are supported to stay in or enter work.

Individuals should expect to work, if they can, when they become disabled. They should expect to be supported at work and receive proactive rehabilitation interventions. Employers should expect to deliver policies such as flexible working patterns and make necessary reasonable adjustments to accommodate the needs of disabled employees (as they are required to do by law). This will lead to real business benefits through the retention of people who have become disabled and improved staff morale. Health services should expect to deliver a return to work as a treatment outcome wherever possible. The government should expect Jobcentre Plus to focus on ensuring it can deliver effective welfare-to-work options for disabled people, rather than imposing more conditions on benefit receipt which people may struggle to meet.

The success of the government's welfare-to-work strategy has so far eluded the missing million disabled people who want to work. It's time to award them the kind of priority we award other unemployed groups.

· Kate Stanley is a research fellow at the Institute for Public Policy Research