Institutionalising activation for sickness and disability benefit claimants in the active UK and Danish welfare states
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The last 15 years have seen governments in a number of mature welfare states attempting to reintegrate people out of work for reasons of sickness and disability into employment, principally through changes to the value and conditions of incapacity benefits and the provision of active labour market programmes. Whilst the academic interest in these changes has been considerable, this thesis begins by arguing that these studies hitherto have been satisfied to categorise these emerging regimes according to a familiar Work-first v Human Capital Development activation typology (for example, Peck & Theodore, 2001), or a variation upon that, according to the presence or absence of different activation services. They largely do not apply the insights that the broader activation literature has provided in recent years, particularly those on the governance of activation. Instead, this thesis proposes that it is better to examine recent changes through the lens of institutionalisation: how well-embedded employment-related support for sick and disabled claimants has become in the structure and functioning of welfare-to-work regimes for sick and disabled benefit claimants. Though not a concept much used in academic analysis of Active Labour Market Policy (ALMP), a case is made for the value of looking at, firstly, how well activating sick and disabled claimants becomes a national government labour market policy priority and secondly, how well the organisation and governance of active labour market programmes for this group support this, in additional to analyses of the services themselves. Working from what is already known about the factors that can influence a workless benefit claimant's access to employment support, the contention of such a framework is that the successful embedding of an activation strategy for sick and disabled claimants into national Labour Market Policy (LMP) is a function of the interaction of a range of factors. Crucial here is the distinction between ALMP for these claimants, and for other activation target groups – there is good evidence to believe that the changes made to activation governance to promote active work-search for the unemployed may, however unintentionally, militate against a comprehensive system of support for 'non-employed' jobseekers considered to be further from the labour market, claimants of incapacity benefits included. Alongside this framework, a case is made for being much clearer and more precise in describing what measures apply to which parts of the incapacity benefit claimant pool. In most countries, this is a very diverse population with several distinct sub-sets with different levels of distance from the labour market, ranging from those with very severe disabilities or health conditions; others with multiple employment barriers not all stemming directly from their condition (outdated skills, for example), and those whose employability is high, their disability or health condition notwithstanding. As a small number of studies have pointed out (Evans, 2001, for example), activation regimes – defined in this study as the set of services that are provided to help nonemployed sick and disabled benefit claimants back to work; and how these are organised; delivered; targeted and financed – 'sort and select' claimants, applying different types or more or less intensive support for different categorisations of claimants. An activation regime for the claimant group can thus be very inclusive or rather narrow, depending on the extent to which these sub-pools are catered for. To demonstrate the value of this framework in reaching a more accurate understanding of the nature of these emerging regimes relative to extant approaches, a cross-national comparison of activation of sick and disabled claimants in Denmark and the United Kingdom is offered. Whilst they are considered to be very nearly diametrically opposed in a number of key ways – their approaches to activation; benefit generosity and broader welfare regime contexts – when looked at using the institutionalisation framework, they emerge as more similar than expected. Regardless of their quite different starting points, they experience many of the same challenges in creating a system in which the employment activation of the full extent of the claimant group is a priority and where a sick or disabled benefit claimant's right to back-to-work support is secure.