The interim report from the Milburn review into young people and work has slammed what the author regards as the failure to link personal independence payment (PIP) to work or to functional improvements. Milburn also claims the benefits system offers perverse incentives to avoid work and that too much money is spent on benefits and not enough on supporting young claimants into work.
The Young people and work: interim report published last week is the “discovery phase” of the review, which looks at the problems that Milburn considers young people face. The “solution phase” of the review will be come out in the Autumn, at a similar time to the Timms review, and will set out how Milburn thinks these problems can be solved.
Amongst the many welfare-related issues the report claims young people aged 16-25 face are:
- PIP claimants are not asked about work.
- PIP doesn’t aim to improve employment prospects or functional capacity.
- There is no monitoring of PIP outcomes.
- Too much money is spent on benefits and not enough is spent on employment support
- There are not enough requirements attached to PIP or the limited capability for work-related activity (LCWRA) group in universal credit (UC).
- There are too few UC reassessments.
- There are not enough face-to-face assessments for PIP and UC.
- UC offers a perverse incentive to avoid seeking work.
- Too few claimants in the LCWRA group ever move into work.
- Autism, ADHD, anxiety and depression fluctuate and should not automatically trigger a verdict of unable to work.
We have extracted some of the major themes from chapter six of the report “A welfare state not designed for participation” below.
PIP claimants are not asked about, or supported to, work
Milburn criticises the fact that “At no point in a young person’s application or journey on PIP are they asked about, or supported to, work. This is not an accident of delivery. It is how PIP is designed.”
Until now, PIP has been seen as a benefit to help with the additional costs of disability rather than as a tool to help people move into work. Milburn’s criticism seeks to fundamentally redefine the purpose of PIP, at least for younger claimants.
PIP doesn’t aim to improve functional capacity or labour market participation
Milburn argues that “The way PIP works means that the considerable and growing resources devoted to it are not targeted on helping improve the functional capacity of disabled young people, and thereby enhancing their labour market or wider participation prospects.”
He complains that there is “no consistent provision of practical support” with issues like:
“daily living,
occupational therapy,
vocational rehabilitation,
mental health social work,
specialised coaching,
workplace assistance or
links to the networks that would enable participation.”
Again, targeting PIP on improving functional capacity and labour market participation would be a major change in the role of the benefit. It is not clear whether this support would be provided in addition to PIP – which would increase costs to the state -or whether Milburn has in mind replacing some of the cash value of PIP with services instead
There is no monitoring of PIP outcomes
Milburn says that “as PIP is not designed to consider participation outcomes, the participation status of claimants is not routinely captured, monitored or published.” Milburn’s own analysis suggests that “The employment prospects of a young person claiming PIP get 21% worse over six years, whereas for everyone else they get 31% better.”
However, until now PIP outcomes have not been monitored because the only outcome expected was that it would help deal with the additional costs of disability.
Poor return on investment
Milburn complains that “The state spends approximately £8 billion a year on PIP and Universal Credit for young people. For that investment, claimants are getting worse outcomes with every passing year.”
The concept of PIP as an investment for which there should be a return, either for the individual or for the state, is one that Milburn revisits throughout his examination of welfare benefits for young people.
There are not enough “requirements” attached to PIP and UC health
Milburn complains that when you include PIP, “less than half of spending for young people across disability, incapacity and unemployment support has any participation support or requirements attached to it. Over time, that situation has become worse not better.”
Introducing “requirements” for PIP or LCWRA would be a major change to the way UC health and PIP currently work. If requirements were attached to PIP, it would also raise the question of how those requirements would be enforced, something Milburn may need to address in the solution phase of his report.
Autism, ADHD, anxiety and depression fluctuate and should not automatically trigger a verdict of unable to work
The report claims “Today, nearly half of PIP claims among young people are for Autism and ADHD, compared to less than one in ten for all PIP claimants… The combined share of anxiety or depression, autism and ADHD reported as the primary condition for 16 to 24-year-olds claiming PIP has risen from 49% in January 2020 to 64% by January 2026”
The report goes on to insist that “These conditions often fluctuate. Research has consistently shown that even severe mental illness is not always a lifelong or even chronic condition. Many people with severe mental illness have a reduction of both symptoms and associated secondary impairments over time, with a range of interventions, including supported employment, being effective in supporting recovery. A young person with anxiety or depression may be unable to attend an interview on Tuesday and be capable of working on Thursday. ADHD does not present the same way every day. Autistic young people can thrive in the right environment and collapse in the wrong one.”
At the moment, the world of work is not designed for people whose conditions are as unpredictable as Milburn suggests here. This is much more an issue about employment rights – and the lack of supported employment - rather than benefits. It seems unlikely that reducing claimants’ benefits, or their protection from loss of those benefits, without first dramatically altering employment laws, would be in the interest of young claimants. But that seems to be what Milburn goes on to advocate when he argues that:
“a diagnosis of a neurodevelopmental condition or anxiety and depression should not automatically trigger a verdict that a young person is unable to work. These are not conditions that lend themselves to a binary judgement of able to, or not able to, undertake certain activities.”
This is aside from the fact that the claim that such conditions “automatically trigger a verdict that a young person is unable to work” is entirely inaccurate.
Too few in LCWRA group move into work
The report highlights that “Movement into work collapses for those on the UC Health Journey. For young people who are in the LCWRA group, only 1 in 100 move into work each month, compared to around 1 in 10 for those in the intensive work search group.”
Many readers would argue that comparing the work outcomes of these two groups is in itself a pointless exercise: one group have been found unable to work, the other have not.
Fit notes fail to encourage participation
Milburn believes that fit notes “fail to encourage participation”. The report claims that “93% of fit notes reported individuals were not fit for work; very few identify the barriers that need removing to enable people to participate in the labour market or other opportunities to learn or train.”
Previous attempts to get GPs to include suggestions for reasonable adjustments on fit notes appear to have failed dismally.
But with the DWP currently trialling schemes in which GPs do not issue fit notes at all, but refer claimants directly to agencies employing unqualifiued work and health coaches, the solution to this concern may already be on the horizon.
Not enough engagement with work coaches before WCA
The report argues that “A key opportunity to engage young people before they become long-term inactive is when they have identified themselves as having a health condition and are waiting for a Work Capability Assessment.”
Many wait three months for an assessment but receive only the equivalent of 1 to 2 minutes of work coach time a month, Milburn says.
As above, referring under 25s directly to agencies employing work and health coaches and requiring regular engagement prior to a WCA would deal with this issue.
However, it should be noted that this is when young people would be most at risk of serious harm from medically unqualified coaches, who may require them to do things that a subsequent WCA would find that they are unable to do safely.
Reassessments are too infrequent
The report complains that not only does the WCA “effectively treats current incapacity as static in a way that does not match the reality of many young people’s fluctuating or changing conditions” but that “Worse still, processes to reassess claimants’ conditions have been progressively weakened since the pandemic.”
Milburn argues that reassessments used to account for a third of all those moving off health benefits but, following Covid there is now a 2 million backlog.
There is unquestionably an issue with a failure to reassess claimants whose conditions have deteriorated, but for those whose conditions are unlikely to alter, they are a source of needless distress. However, the decision by the DWP not to apply the new PIP extension regime to under 25s suggests the DWP agree with Milburn, that young people should be subject to a different benefits assessment regime.
Too few face-to-face assessments
The report also notes the decline in the proportion of face-to-face assessments which they authors say “produces different and generally tighter outcomes than remote assessment”. It argues that the reduction has led to “a weakening of the system’s ability to understand the young people it is supposed to serve and to enable them into work”
The DWP have already announced targets to increase the proportion of face-to-face assessments for both PIP and the WCA.
Not enough conditionality
Milburn seems to be unhappy about the lack of conditionality for claimants with LCWRA. The report comments, without apparent disapproval, on the job seeking regime for young people found fit for work and the fact that “If they miss this appointment, they can be sanctioned up to 100% of their benefit payment.”
He contrasts this with the LCWRA regime where “many young people on the health journey have no regular, personalised engagement.”
We will have to wait for Milburn’s final report to see how he proposes to tackle this issue.
UC offers a perverse incentive to avoid seeking work
Milburn claims that additional support in UC for claimants with more serious conditions is structured “in ways that can drive young people into passive inactivity rather than into them actively seeking work.”
He goes on to argue that “For a young person with a health condition who is unemployed and potentially seeking work, taking a pathway to inactivity can offer higher income, less hassle and lower risk. This is a perverse incentive that is the polar opposite of what a participation-first welfare system should be providing.”
As we will see below, the term “perverse incentive” is one also favoured by Rachel Reeves when justifying cuts to benefits.
Too much is spent on benefits and not enough on employment support
The report states “Benefit spend on young people for PIP alone is expected to rise to £6.5 billion by 2031/32. If spend on DWP employment support remains at the levels currently being funded through the Youth Guarantee, we estimate that by 2030/31, for every £1 that DWP spend on employment support for young people, around £10 will be spent on welfare support for young people. This is not a spread of investment that prioritises participation. It is an investment choice that prioritises income transfers.”
Because this is the “discovery phase” Milburn does not set out how he would rebalance this “spread of investment”.
But the language he uses very closely echoes the justification for cuts to UC health payments for new claimants introduced in April, where some of the money saved is being invested in employment programmes instead.
This is from the 6 April 2026 DWP press release when the UC cuts came into force:
“Incentives that discourage work and trap people on benefits to be removed via legislation coming into force today… Comes alongside employment support package of £3.5 billion… tackling perverse incentives by introducing a lower Universal Credit health element… Anyone affected by the changes to Universal Credit will be entitled to voluntary employment support,”
Young people should not be treated in the same way as older workers
Milburn argues that young people should not be treated the same as older workers:
“An older worker who develops a disability in mid-career has decades of experience behind them. Established habits, routines, professional identity, financial reserves and networks. Their relationship with the labour market is disrupted but not absent. Income replacement during a period of ill health is appropriate and proportionate. The system was designed for this person.”
But young people, Milburn says, have none of these advantages: “They are not returning to something. They are trying to reach something for the first time. The critical need is support to make the first transition into work. Yet the system makes no such distinction.”
We suspect that many older workers, after decades of low paid, insecure, work would be surprised to learn that they have financial reserves and networks to fall back on. But Milburn is clearly making a justification here for offering different, and potentially less generous or more onerous, welfare terms to young disabled people
No encouragement of part-time work
There are some positive findings in the report. Milburn argues that “While the system permits part time work, it does not provide effective encouragement of it. For a young person who has never worked, who has spent months at home, who is managing anxiety that makes leaving the house difficult, the idea of moving straight from inactivity to a full-time job is terrifying. What they need is an intermediate step. A few hours volunteering. A supported work taster.”
Few readers would disagree with this.
Right to try not enough
Milburn also says that while the Right to Try is a positive step, it is “not a full guarantee that a claimant’s wider position cannot be revisited if other evidence suggests a relevant change in circumstances.”
Again, whilst many may not consider that the Right to Try even constitutes step in the right direction, few would argue that it stops very far short of a full guarantee. Much more needs doing in this regard.
Few grounds for optimism
Milburn says that the state must provide a financial safety net for people with disabilities “who may have extra costs or never be able to work”.
And he has won widespread praise for not supporting the tabloid obsession with blaming young people themselves for their health conditions or levels of unemployment.
Many commentators have taken this lack of blame as evidence that Milburn has no intention of recommending harsh changes to welfare benefits for under 25s. We hope that they are right, but the contents of chapter six of the interim report give few grounds for optimism.
