In regard to welfare reform my focus has always been on the DPB for the reasons that 1/ children are being disadvantaged, sometimes very badly 2/ this benefit is at the heart of inter-generational dependence and 3/ it has the greatest potential for reform and improved lives in the process.
While I am very familiar with the history, statistics, reasons for being on and other aspects of
sickness and invalid benefits I have spent far less time talking about them. But a lot of time thinking about them. Their reform is absolutely essential but much more fraught, in terms of
hardship and politics. Sometimes I wonder if they aren't being handled by the wrong bureaucracy. That is, shouldn't they be part of the health system? If they were, perhaps more focus would go on getting people better, more rigorous diagnosis and attention to trends.
As it stands well people are lumped together with unwell people and are all seen under the same roof by the same people. People with no expertise in matters physical or psychological. If the money for sickness and invalid benefits was coming out of DHB funding you can bet that the focus on why more and more people are going on them would sharpen up pretty fast.
Which leads me to a further thought. Money is very tight in Health. It is also capped, whereas MSD funding is not. Does Health tacitly sign people over to the responsibility and cost of MSD because there isn't money available for whatever it would take to get them functioning?
This must be right to a degree. That is why various governments have tried programmes like Pathways to Health, bumping beneficiaries up public waiting lists in the Counties Manakau system I recall.
Some individuals may have been helped by these initiatives but overall the trend upwards continues. The percentage of working age New Zealanders reliant on one of these benefits continues to climb.
Suggestion: The existing funding pool for sickness and invalid benefits could be transferred over to the relevant DHB and thereafter managed but capped. Money saved by reducing the caseload (the current levels are artificial) and used elsewhere in the health system or invested in resources to further assist beneficiaries back to good health. Mental health exponents will tell you how badly under-funded their area is. This would give them a chance to up their funding and treat people to the best of their capacity which is surely what health professionals want to do.