Mentally ill, sick and disabled people are being used as a “political football” to make the government seem tough rather than addressing the causes of the UK’s growing long-term sickness problem, campaigners have warned, as ministers unveiled tentative proposals to cut disability benefits. Potentially thousands of people claiming personal independence payment (Pip) could lose the benefit – currently worth between £29 and £184 a week – under changes designed to tighten eligibility and, where possible, replace monthly cash payments with one-off vouchers or access to specialist support. Ministers suggested claimants receiving Pip for what they called “milder mental health conditions” should lose eligibility under the proposals, with the prime minister, Rishi Sunak, saying the “unsustainable” growth in take-up of Pip was a result of the benefit system “medicalising the everyday challenges and anxieties of life”. Although the green paper published on Monday evening did not set out how many people might lose eligibility or how much money reforms would save, the government insisted it would halt rapidly rising spending on disability benefits, while supporting genuine claimants and thwarting people trying to “game the system”. The proposals were criticised by campaigners and clinicians for ramping up “benefit scrounger” rhetoric while disregarding how difficult it is to claim Pip and ignoring underlying drivers of ill-health, from rising poverty to inadequate NHS services. Families in poverty were likely to be hardest hit by attempts to cut eligibility for Pip payments because of their heavy reliance on the benefit to pay for food and energy, charities warned. Pip accounts for a third of total household income for the poorest families. Although trailed as a “benefits crackdown” the green paper itself is more provisional, framing its proposals as the start of a “conversation” with disabled people and other stakeholders and rather than hard plans. Its proposals are unlikely to implemented before the next general election. It is uncertain whether a Labour government would embrace the proposals in their current form – although it is unlikely to be able to ignore the rising costs of Pip. It is currently £22bn, up from £16bn in 2020-21, and predicted to rise to £28bn in five years’ time, according to the Department for Work and Pensions. The Labour leader, Keir Starmer, said: “They designed it [the Pip system] and put it in place and now 14 years later they say it’s not working, so there’s an element of farce to it. But obviously we’ll look at the details when they come.” Alison McGovern, Labour’s acting shadow work and pensions secretary, said the party wanted to see a system that allowed disabled people to live independently and enable as many as possible to work. “This green paper is not a plan it’s an exam that the secretary of state is hoping he will never have to sit,” she said. Ministers said the reforms were designed to check rapidly growing Pip spending – driven by increasing numbers of claimants, many of them with mental health issues. Seven years ago there were an average of 15,000 new claims a month – this has now grown to 30,000. There were 3.3m Pip claimants in England and Wales in January this year, up by nearly a million in the last three years. Scotland is in the process of replacing Pip with adult disability payment, and so is unlikely to be affected by reforms resulting from the green paper. Pip is a non-means tested benefit intended to help recipients cope with the extra daily living costs of being chronically ill or disabled. It was introduced in 2014, as a replacement for disability living allowance but has failed to cut expenditure and has been dogged by controversy, not least over its complex assessment process. The new approaches to Pip – outlined in a green paper on Monday evening – include “moving away” from fixed monthly cash payments to what ministers call “tailored support” such as vouchers, one-off grants, and improved support access to mental health support. “We would like to understand whether some people receiving Pip who have lower, or no extra costs, may have better outcomes from improved access to treatment and support than from a cash payment,” the green paper states. Iain Porter, senior policy adviser at the Joseph Rowntree Foundation said: “This [the green paper] is clearly an opportunity for the government to sound tough, but it is on the backs of people who are already facing huge challenges financially as well as with their health. “People in this position should not be used as a political football. Even if there is no prospect of these changes coming in ahead of the general election, this rhetoric leaves many facing an uncertain future compounded by misinformation and stigma.” Dr Lade Smith, president of the Royal College of Psychiatrists, said: “If government is committed to addressing this crisis, it must tackle the causes of mental illness and ensure people have timely access to the care and treatment they need.” Anela Anwar, chief executive of anti-poverty organisation Z2K, said: “It’s clear these proposals have been dreamt up with no serious input from people with lived or learned experience of the reality of disability benefits.” Andrew Molodynski, mental health lead at the British Medical Association, said: “The government would be better placed properly funding the critical health and social services that keep people healthy, and tackling the record levels of poverty this country is facing.”