Rishi Sunak is considering withdrawing a major cash disability benefit from some people with mental health conditions, prompting claims he has launched a “full-on assault on disabled people”. The prime minister announced fresh curbs on disability benefits on Friday, saying he wanted to explore whether some cash payments to claimants with mental health conditions could be replaced by treatment or access to services. In a speech on welfare, Sunak said he was launching a consultation on the personal independence payment (Pip), a non-means-tested benefit paid to disabled people to help with the extra living costs caused by long-term disability or ill health. He said that in addition to reviewing payments to people with mental health conditions, the government would look at whether some other disabled people should get help with one-off costs rather than continuing payments. The announcement triggered an outcry from disability charities, which said the rates of people being signed off work and claiming benefits were being caused by crumbling public services, poor-quality jobs and high rates of poverty among disabled households. Mind, the mental health charity, said services for mental health conditions were “at breaking point”. There are 1.9 million people on a waiting list for mental health treatment in England, meaning the treatment they should be able to access through the NHS is not currently available to them. Sunak said Britain was proud to have a strong safety net of welfare payments to those who needed them, but he also said the country had a “sicknote culture” that needed to be tackled. He said “something has gone wrong” since the pandemic to increase the number of economically inactive people who are long-term sick, especially with mental health conditions. “Most worrying, the biggest proportion of long-term sickness came from young people … parked on welfare,” Sunak said. He said the country could not afford the “spiralling” disability welfare bill of £69bn, which was now more than the core schools budget, and claimed the Pip budget was forecast to increase by 50% in the next four years. Other measures he set out included: Shifting responsibility for issuing fit notes, formerly known as sicknotes, away from GPs to other “work and health professionals” in order to encourage more people to return to work. Confirming plans to legislate “in the next parliament” to close benefit claims for anyone who has been claiming for 12 months but is not complying with conditions on accepting available work. Asking more people on universal credit working part-time to look for more work by increasing the earnings threshold from £743 a month to £892 a month, so people paid below this amount have to seek extra hours. Confirming plans to tighten the work capability assessment to require more people with “less severe conditions” to seek some forms of employment. On the review of Pip, Sunak said it may be right to pay one-off costs for adaptations, but that the payments may not need to be ongoing. The prime minister said the government would look at whether more medical evidence about conditions should be provided, as some payments were made on the basis of “subjective and unverifiable claims”. He said some people with mental health conditions may be better served by treatment and access to therapies rather than cash payments. Sunak also warned about the “the risk of over-medicalising the everyday challenges and worries of life” when it came to paying benefits to people with mental health conditions. His comments were echoed by Mel Stride, the work and pensions secretary, who told Sky News on Friday: “If you go to the GP and say you are feeling a little bit depressed, and you’re signed off, in 94% of occasions, a box is ticked that says you’re not capable of work whatsoever. “What we want to do is change the system so that that individual will be referred to – the government is setting up something called Work Well – where they will get both the healthcare support they need, but also a work coach who will be involved to either help them stay in work if they are in employment, or to help them get into work if they’re not.” Ed Davey, the Liberal Democrat leader, said: “Millions of people are stuck on NHS waiting lists, unable to get a GP appointment or struggling to access mental health support. Rishi Sunak is attempting to blame the British people for his own government’s failures on the economy and the NHS and it simply won’t wash.” Matthew Pennycook, the shadow housing minister, said Sunak had been pursuing a “cheap headline” over his claims that Britain has a “sicknote culture”. “There has been a long-term rise for many, many years under this government in people who are on long-term sickness benefits, either because they can’t get the treatment they need through the NHS, which is on its knees after 14 years of Conservative government, or they are not getting the proper support to get back into work,” he said. Charities warned that the benefit curbs would make people’s problems worse. James Taylor, the director of strategy at the disability equality charity Scope, said the speech “feels like a full-on assault on disabled people”. “These proposals are dangerous and risk leaving disabled people destitute,” he said. “In a cost of living crisis, looking to slash disabled people’s income by hitting Pip is a horrific proposal. “Calls are pouring into our helpline from concerned disabled people. Life costs more for disabled people. Threatening to take away the low amount of income Pip provides to disabled people who face £950 a month extra costs isn’t going to solve the problem of economic inactivity … Much of the current record-levels of inactivity are because our public services are crumbling, the quality of jobs is poor and the rate of poverty amongst disabled households is growing.” Dr Sarah Hughes, the chief executive of Mind, said the mental health charity was “deeply disappointed that the prime minister’s speech today continues a trend in recent rhetoric which conjures up the image of a ‘mental health culture’ that has ‘gone too far’. “This is harmful, inaccurate and contrary to the reality for people up and down the country,” she said. “The truth is that mental health services are at breaking point following years of underinvestment, with many people getting increasingly unwell while they wait to receive support. Indeed the Care Quality Commission’s latest figures on community mental health services show that nearly half of people (44%) waiting for treatment found their mental health deteriorated in this time.” Iain Porter, a senior policy adviser at the Joseph Rowntree Foundation, said the prime minister had launched an “irresponsible war of words on people who already aren’t getting enough support, which the government would rather not talk about”. “Many people want to work, as the prime minister says, but have their hopes dashed by woeful health and wellbeing support and job centres unfit for purpose,” he said. The British Medical Association said the prime minister should focus on getting people access to the medical help they needed to get back to work rather than “pushing a hostile rhetoric on ‘sicknote culture’”. This article was amended on 19 April 2024. A previous version said the earnings threshold was increasing from £743 to £892 a “week”, rather than a month.