You can’t cut your way to health: Disability benefits and the politics of prevention in Wales

James Downs, Mental Health Campaigner

The UK Government is proposing sweeping changes to the disability benefits system, with a focus on reducing the number of claimants and cutting costs by £5bn.

Plans include tightening eligibility for Personal Independence Payment (PIP), especially for people with mental health conditions, and replacing cash payments with vouchers.

These proposals are being framed as necessary to protect the economy and tackle a so-called sick note culture, and have been compared by the Chancellor herself with cutting children’s pocket money.

But behind the headlines and political soundbites is a worrying shift: from recognising disability as a reality shaped by social conditions, to treating it as a personal failing or lifestyle choice.

This is particularly out of touch with the reality in places like Wales, where high levels of long-term illness are not a result of personal failure, but of deep-rooted inequalities

Disability Doesn’t Arise in a Vacuum

The government’s arguments for cutting disability benefits ignores the truth about what creates disability in the first place.

Disability doesn’t arise in a vacuum. It is shaped by the social conditions around us. Poor mental health support, unaffordable housing, food insecurity, in-work poverty, and racism all contribute to people becoming and remaining unwell.

Many of the conditions now leading people to claim disability or out of work benefits could have been prevented, or better managed, if support had been there early on.

This is made starkly clear in Wales, where rates of disability and long-term illness are higher than other parts of the UK as a result of overlapping inequalities: poverty, poor housing, industrial decline, environmental degradation, and under-resourced services.

We have more people living with chronic pain, more people struggling with mental illness, more communities left behind by Westminster’s economic priorities.

These structural factors mean that more people here need benefits. Not because we’re lazier or weaker, but because our public infrastructure has been allowed to decay.

And unlike health or education, welfare is not devolved. So while the Welsh Government carries responsibility for tackling health inequalities, it has little power over the benefits system that disabled people depend on.

Yet again, Wales has to pick up the pieces of decisions made elsewhere, with limited control over the policies doing the damage.

Falling Through The Net

In my own case, I waited more than 6 years to see an eating disorder specialist in Wales despite being diagnosed with severe anorexia.

I was legally disabled before I even met a clinician qualified to help.

I have a genetic condition which took more than 30 years to diagnose, for which there is no treatment.

Alongside me, I’ve seen people discharged from services too soon, or never picked up at all. I’ve met others whose physical symptoms were dismissed until they became permanently life-altering.

By the time we claim benefits, we’ve already fallen through every other net, and not for lack of trying.

We might be exhausted from struggling to be heard, from managing to survive without support, and from navigating a benefits system that’s high in blame and low in compassion – but we are not lazy. 

The narratives used by the media and politicians about those in reciept of disability benefits is especially alarming.

The idea that PIP is easy to get is laughable to anyone who has been through the process.

I’ve experienced assessments from people who have not understood my conditions, who have scored me 0 points for preparing and eating food when I have had a longstanding and life-threatening eating disorder.

I have had to appeal despite sending reams of medical evidence from multiple specialists, and being aware of my rights.

This leaves me worried about those who aren’t so self-confident, and people who don’t have anyone to support them through the process. 

I even ended up representing myself in a tribunal where a decision to stop my benefits was overturned unanimously, but I was only paid what I was owed several months later – coincidentally on the same day it became a news story and I spoke about my experiences on BBC Radio 4.

Whilst the DWP may have saved face, I had spent the intervening months trying to avoid eviction from my accommodation, and trying to keep my role as a volunteer for a mental health charity.

I became so unwell and suicidal that I was under the care of the crisis team and needed more medical intervention, making the whole exercise a false economy.

What’s The Benefit?

It is insulting to hear that my experiences are one of luxury, where I effortlessly depend on disability benefits whilst not contributing to society.

Benefits didn’t incentivise me to sit back and relax, nor have they kept me disabled. They help me to mitigate some of the consequences of the multiple disabilities I live with, and have given me a chance to build a life where I have dignity.

Without them, I would not have been able to live independently of my parents, and eventually go to university. I wouldn’t have been able to pay for therapy when the NHS refused my referrals. I wouldn’t be able to pay for the extra liquid supplements I need because of my genetic condition. I wouldn’t be able to contribute to society through volunteering, working when I can, and fighting for change. 

Asking The Right Questions

Cutting disability benefits is not a solution. It’s a deflection from the failure to act upstream, from the deep inequalities that breed illness, and from the government’s own role in making people sicker.

If the UK Government really wants to reduce the disability benefit bill, it needs to stop disabling people in the first place. Punishing those who bear the brunt of government inaction isn’t reform – it is cruelty, dressed up as efficiency. 

We need to stop pretending that rising numbers of claimants are a sign of fraud or dependency. They are, in fact, a warning. A signal that our society is not working for too many of us.

Instead of slashing support, we should be asking: how do we stop people becoming too ill to work in the first place? How do we build a society where disability isn’t met with suspicion, but with solidarity?

What’s gone wrong isn’t that people are claiming support. It’s that so many of us are becoming too unwell to live without it.

A Disability Confident Society

So what can we, here in Wales, do instead?

I think we need to find our voice in defending the disabled.

We must challenge the idea that the value of individual lives can be measured in economic productivity alone.

We must resist the narrative that sees disabled people as a burden rather than citizens with rights and dignity, who can contribute to society in all kinds of ways.

And we must demand the power to design systems that work for our communities, not just absorb the consequences of Westminster’s choices.

Building a truly disability confident society means investing in the conditions that allow disabled people to thrive, not just survive.

That means accessible services, early intervention, social security that supports rather than punishes, and work environments that adapt to people, rather than expecting people to adapt to rigid systems.

These aren’t just acts of compassion, they’re acts of economic sense. When disabled people are supported, we are more able to participate in education, employment, volunteering, family life, and community.

The cost of exclusion is far greater than the cost of inclusion.

A fairer, healthier Wales isn’t just good for disabled people, it’s good for everyone.

James Downs is a mental health campaigner, researcher, psychological therapist and expert by experience in eating disorders.

He lives in Cardiff and can be contacted at @jamesldowns on X and Instagram, or via his website: jamesdowns.co.uk