Children, poverty and disability
The Government has made an ambitious and public commitment to eradicating child poverty within a target of 20 years and has put (at least some of) its money where its mouth is, with a range of policy initiatives and increases in benefits. Some of the changes represent improvements for all parents – parental leave, above average increases in child benefit [footnote 1] – others are targeted at low-income families – working families’ tax credit, [footnote 2] allowances for children within income support [footnote 3] and schemes such as Sure Start.

So far, so good, but will these improvements reach all children at risk of poverty? What about disabled children or children in families where a parent is long-term sick or disabled? Lorna Reith looks at what action the Government is taking to address their needs.

Disabled children
Lower parental incomes
Poverty and ill health
Babies
Disability-related extra costs
What has the Government done?
Children with a chronically sick or disabled parent
Child dependants' additions
What has the Government done?

Disabled children
Surprisingly, the Government has no up to date information on disabled children in the UK. In terms of numbers the Government still relies on the figure of 360,000 cited in a 1989 OPCS report. [footnote 4] There is no information on trends, whether the numbers are falling, for example, as a result of a reduction in road traffic accidents; or increasing, as more severely disabled babies survive into child and adulthood. Nor is there information on the severity of disability experienced by these children or the income of their parents.

In fact, all the evidence indicates that disabled children are at particular risk of poverty because their parents have lower incomes while having to meet the extra costs of disability.

Lower parental incomes
Results from the General Household Survey 1994 showed that parents with disabled children had a lower socio-economic profile than other families. They were poorer, less likely to own their home and more likely to be on income support. An earlier study carried out by OPCS in 1989 [footnote 5] found that parents of disabled children were less likely to work, and when they did, their earnings were lower, than for parents as a whole. Given the practical difficulties of looking after a disabled child it is unlikely that this has changed much since 1989. It is rare to find both parents in work if the family has a disabled child. Many parents prefer to stay at home and care for their child themselves believing that this is better for the child. Others find it impossible to find suitable, affordable childcare – few nurseries are accessible and even fewer childminders live in homes accessible to a child in a wheelchair. The one-to-one care required by a child with severe behavioural problems also means that childcare can be prohibitively expensive. Parents who are employed can find that caring for their child limits the amount of overtime they can do, making it impossible to bring their earnings up to a decent level.

In addition, there is a higher proportion of lone parents among families with a disabled child. Such parents face the same difficulties as other lone parents in combining work with raising children but face huge additional problems. The cost of childcare, not wanting to leave their child with a stranger, lack of accessible childcare places, all combine to make it very unlikely that a lone parent with a disabled child will be able to work.

It is while children are young that the often complex business of making a diagnosis and deciding on a treatment programme takes place. Parents with younger disabled children have to contend with seemingly endless hospital appointments – all during the working day and involving costly journeys. Whilst the need for regular trips to hospital reduces for many families as the child gets older, for some children it will remain a permanent part of their life. The expectation by the health service that there is always a parent available makes it extremely difficult for both parents, and virtually impossible for lone parents, to work.

Poverty and ill health
There is a well-established link between poverty and ill health. Poor families are more likely to have children with chronic health problems such as asthma and children from poor families are more likely to suffer accidents in the street and in the home. Children in the poorest families are twice as likely to die by age 15 as children in the highest social class. [footnote 6]

Not only are families with a disabled child likely to be poor because their earning capacity is limited. Families which are already poor are more likely to have chronically sick or disabled children.

Babies
An average of 1,400 babies are born each year weighing below 1,000 grammes, and a further 14,000 weigh between 1,000 and 2,000grammes. Such low birthweight babies invariably have serious health problems and most will go on to be disabled as children. The mothers of these children are overwhelmingly poor, often very young, and are very unlikely to be able to combine employment with caring for a vulnerable and sick infant. This group is also likely to be ill-informed about the help, financial or otherwise, that is available.

Disability-related extra costs
Work done for the Joseph Rowntree Foundation on the cost of childhood disability [footnote 7] estimated that it costs on average (at 1997 prices) £125,000 to bring up a severely disabled child from birth to age 17 as against £37,394 for a non-disabled child. In annual terms that is £7,355 as against £2,100. The actual extra costs will vary from child to child but is likely to include some, if not all, of the following:

• Transport – extra trips to hospital, the need for a car if the child cannot be taken on public transport.
• Clothes and shoes – specially made clothing or shoes, extra wear and tear, for example because the child crawls everywhere.
• Bedding, laundry and hot water – as a result of incontinence or need for frequent washing.
• Food – special diets or wastage if the child throws food around.
• Damage and breakages in the home if the child has severe behavioural problems.
• Special toys (£80 for a velcro building set, £40 for giant finger dominoes).

Yet take up of disability living allowance (DLA) is low at between 40 per cent and 60 per cent, [footnote 8] and poor families with disabled children have the greatest access problems. A report, Reaching its Target? Disability living allowance for children, [footnote 9] concluded ‘socially disadvantaged families are less likely to apply for DLA, less likely to be successful and less likely to receive an award at the higher rate’. Parents of children receiving DLA are likely to be eligible for invalid care allowance but few claim as they do not perceive the benefit as being available for parents.

What has the Government done?
Disabled children clearly benefit from increases in benefits for children generally, they also benefit from the various community-based programmes like Sure Start and the new Children’s Fund.

More specifically, last October saw the introduction of a disabled child tax credit worth an extra £30.00 per week (from April 2001) for working parents, paid through working families’ tax credit (WFTC) or disabled person’s tax credit (DPTC). In addition, for parents with a severely disabled child (defined as in receipt of DLA care component at the highest rate), there is an additional £11.05 per week. These are significant extra weekly amounts and are of enormous benefit to many working parents of disabled children.

Following pressure from disability and children’s groups the Government has now made a public commitment to relaxing the definition of eligible childcare for access to the childcare tax credit within WFTC/DPTC. Currently the childcare tax credit is only payable for care with registered providers outside the child’s home. This excludes the many parents with a disabled child who cannot find accessible, appropriate childcare outside their home or those for whom it is in the child’s best interests to be cared for in their own home.

One of the (few) positive elements in the Welfare Reform and Pensions Act 1999 was the extension of DLA higher rate mobility component to disabled three and four-year-olds. This very welcome change came into effect in April and is worth an extra £37.40 per week. It is expected to benefit some 8,000 children.

In April parents on income support saw the disabled child premium go up to £30 per week (up by 35 per cent) and the carer’s premium increase to £24.40 per week. Those with a child getting higher rate DLA care now get an additional £11.05 a week.

These various additions, combined with the Government’s promotion of family friendly employment practices and the introduction of more generous parental leave, will begin to make a significant impact on the poverty faced by families with disabled children.

Despite this progress there remain some serious shortcomings. Firstly, the absence of up to date statistics on the disabled child population, numbers, ages, trends and levels of extra costs, make it extremely difficult (arguably impossible) to measure success in any meaningful way.

Secondly, there are no proposals to promote take-up of DLA, yet this is crucial in raising the income of families with a disabled child – accessing DLA could be worth an additional £159.40 a week for a family on income support. [footnote 10] A huge impact on child poverty could be achieved if the Government were to launch a campaign, together with local authorities and voluntary organisations, to increase take-up of disability and carers’ benefits among families with disabled children.

One further step the Government could take would be to target financial help to those families with low birthweight babies. An automatic extra payment for the infant’s first year, coupled with well timed and targeted information about DLA, would be a relatively inexpensive and well targeted programme.

Children with a chronically sick or disabled parent
According to Poverty and Social Exclusion in Britain, [footnote 11] a major, comprehensive survey of deprivation and exclusion, homes with a chronically sick or disabled person were among those with the highest deprivation rates.

The Acheson report [footnote 12] on ill health and poverty found that class differences were significant, with unskilled men and women experiencing much higher levels of serious illness and disability than people in professional occupations.

Sixty per cent of disabled adults in families with children have an income below half the general population mean, after adjusting for extra costs. [footnote 13] Although this includes families where the disabled parent is in work, in the majority of cases the disabled parent is in receipt of an earnings replacement benefit.

There are 653,000 [footnote 14] children living in households where a parent is in receipt of incapacity benefit (IB), severe disablement allowance (SDA) or income support with a disability premium. Although not all such families will be poor there is evidence of poverty among this group which becomes clear when we examine the characteristics of households on incapacity benefits.

A small proportion of people will be on IB for a relatively short period of time and then return to employment – though often at a lower salary than before. [footnote 15] However, most will be on benefit for long periods of time. This will be particularly the case for those on SDA, given the greater degree of severity of disability needed to qualify.

Those on IB could be assumed to be better off as this is the contributory benefit and is paid at a higher level than SDA. Yet the basic level of benefit is only £69.75 per week or £3,627 a year. During the passage of the Welfare Reform and Pensions Act 1999 the Government made much of the numbers of people on IB who also have occupational pensions to top up the basic level of benefit. But do they? In fact only 38 per cent of those on IB also get an occupational pension (compared to 86 per cent of men in the general population) and the amounts of pension are generally low. Thirty-nine per cent have an occupational pension of less than £50 per week and 80 per cent have one worth less than £130 per week. [footnote 16] In practice, IB is very much targeted on former manual and semi-skilled workers who experienced lower pay and conditions when in work and are less likely to have decent additional pensions.

From April those people forced to give up work because of ill health or disability who are lucky enough to have a pension (of over £85 per week) will find their benefit reduced as a result. Families having to adjust to a parent’s disability or chronic ill health will also have to cope with a sharp reduction in household income.

As people on IB are generally those who became sick or disabled while in employment they may also have small amounts of savings – just enough to deprive them of income support even if their weekly income is below income support levels. As IB does not give access to free prescriptions or free school meals some families will find that their actual disposable income falls below IS levels as a result.

Child dependants' additions
On top of the basic rate of IB and SDA, child dependants’ additions are payable for those with children. These are worth £11.35 per week (except for oldest child for whom it is £9.70). These amounts did not go up last year or this year. In fact the child dependants’ additions have only been increased by the princely sum of 35p a week since 1994.

What has the Government done?
There has been a raft of measures designed to assist disabled people back into work, DPTC, the New Deal for disabled people, and changes to benefit rules to offer more security for those making the transition into work. There has also been a welcome emphasis on job retention with the recognition that providing help before someone comes out of the workforce, following the onset of ill health or disability, is more cost effective than trying to help them re-enter the labour market after a period out of work.

Severely disabled people (those getting DLA higher rate care) have benefited from the introduction of an enhanced disability premium, worth an additional £11.05 per week to those on means-tested benefits. The very welcome increases in carers’ benefits also help raise household income in many families.

But, although the savings limits for pensioners on income support went up significantly in April this was not extended to disabled people. Those forced to stop work early because of ill health or disability continue to be penalised if they have savings above £3,000 – an extraordinarily low limit for a family with children.

However, with the exception of those severely disabled people entitled to the new enhanced premium, the incomes of those not able to work have not been addressed by the Government. It is hard to see how the children of disabled/chronically sick parents are to be lifted out of poverty without substantial increases in their parents’ incomes. The decision to keep the child dependants’ additions at such a pathetically low level threatens to undermine the Government’s efforts to eradicate child poverty. Either these additions have to be raised to a realistic level or the proposed new integrated child credit must include provision for the children of disabled/chronically sick parents.

Lorna Reith is Chief Executive of Disability Alliance

Footnotes
1. 26 per cent real increase in the rate of child benefit for the first child since 1997 [back to text]
2. 300,000 more families getting working families' tax credit (WFTC) than its predecssor family credit (FC); those on WFTC receiving on average £30 more than on FC [back to text]
3. Couples on income support with two children under 11 now almost £30 a week better off in real terms than in 1997 [back to text]
4. Bone and Meltzer, The Prevalence of Disability Among Children, OPCS surveys of disabililty in Great Britain Report 3, 1989 [back to text]
5. Smyth and Robus, The Financial Circumstances of Families with Disabled Children Living in Private Households, OPCS surveys of disability in Great Britain Report 5, 1989 [back to text]
6. H Roberts (Barnardo's), What Works in Reducing Inequalities in Child Health, Joseph Rowntree Foundation, December 2000 [back to text]
7. Dobson and Middleton, Paying to Care: the cost of child disabiltiy, Joseph Rowntree Foundation, 1998 [back to text]
8. Craig and Greenslade, First Findings from the Disability Follow-up to the Family Resources Survey, DSS, March 1998; figures quoted are for 16-24-year-olds as no figures on children are available [back to text]
9. Roberts and Lawton, Social Policy Research Unit, University of York, 1998 [back to text]
10. DLA highest rate care and mobility, carer premium,disabled child premium and enhanced disability premium [back to text]
11. Poverty and Social Exclusion in Britain, Joseph Rowntree Foundation, 2000 [back to text]
12. The Independent Inquiry into Inequalities in Health, September 1998 (the Acheson report) [back to text]
13. Burchardt, Enduring Economic Exclusion: disabled people, income and work, Joseph Rowntree Foundation, October 2000 [back to text]
14. Client Group Analysis: families with children on key benefits, DSS Statistics, May 2000 [back to text]
15. See note 14 [back to text]
16. House of Lords, Hansard, 9 June 1999, col 170WA [back to text]

Poverty 109, Summer 2001