Lucy Delap
Home / Policy Papers / Stigma, trust and the history of UK disability policy

Executive Summary

• The numbers of people who are physically impaired, neurodivergent, chronically sick or experiencing mental distress have increased to around one in four of the UK population. Government ministers have announced an independent review in 2025 into possible over-diagnosis.

• For those of working age in the UK, there is a substantial employment gap of 27.8% between disabled and non-disabled people. The ‘disability pay gap’ has increased in recent years, to around 17.2%.

• Historically, policy responsibility for disabled people has been divided between different departments and was a low priority for much of the twentieth century. There were few reliable estimates of the numbers living with impairment before the 1970s.

• The exception to this was the bold policies embraced during the wider social upheaval of World War Two. 1944 saw a statutory quota enacted, requiring all employers of 20 or more to employ disabled people at 3% of their workforce, alongside a new national Register of Disabled Persons.

• The quota, however, brought little meaningful integration. It was unenforced, with nugatory fines that were almost never imposed. Why was it such a failure?

• Policymakers strongly believed that attitudes towards disabled people were benign and sympathetic. As a result, education and moral appeals to employers were prioritised rather than quota compliance. This underestimated the stigma and discrimination associated with impairment.

• Failing to understand stigma was a significant oversight. Attempts to draw disabled people into paid work through the quota failed when most people living with impairments opted not to register as disabled. Many understood that disclosing their disabled status would not help them in the labour market.

• The UK state has a history of creating and amplifying disability stigma. Politicians have regularly stoked public fears of disabled people, through talk of shirkers and scroungers. Lower-level officials have casually and harmfully judged, ignored and discriminated against disabled people.

• Today’s policymakers are living with the legacy of such histories. They are not trusted by disabled people, and are unlikely to be until they address the exclusions and harms associated with decades of poorly-resourced services, neglect and discrimination. Interventions ‘on their behalf’ will not work until disabled people feel ownership and inclusion, and can see that policies work in their interests.

Introduction

The UK government elected in 2024 promised to champion the rights of disabled people and work closely with them, ‘so that their views and voices are at the heart of everything we do’. Yet with a highly contested attempt to reduce eligibility for the non-means tested Personal Independence Payment (PIP) as well as cuts to disability-related elements of Universal Credit, its efforts have floundered. With substantially higher poverty and unemployment rates than the non-disabled population, disabled people’s organisations have argued that austerity is continuing, and continuing to fall on those least able to afford it.

The low rate of paid employment amongst disabled people is a central concern amongst policymakers. Around 55% of disabled people are in work, though numbers are much lower for those affected by some conditions. Only around 5% of individuals with Down Syndrome, for example, are in paid work and many of their jobs are very part time. Where disabled, neurodivergent and chronically sick people are in work their jobs often pay less, with a pay gap of 17.2% in 2024. This gap has been slowly increasing over the last decade, testimony to the UK’s polarising pay structures and ineffective tribunal system to contest discrimination. Disabled workers are disproportionately stuck in low-paying, part-time work, and also report high levels of harassment and bullying at work. For a government committed to supporting working people and making work pay, doing something positive to support better outcomes seems a compelling prospect. Yet it will be hard to regain the trust of the disabled community. The history of the employment of deaf and disabled people has important insights to offer in understanding why, and why it matters.

Tinkering and window-dressing

Since the nineteenth century, the British state began to take some responsibility for supporting disabled people’s needs, initially through asylum and educational provision. As part of the administrative changes of World War One, pension and employment support were tentatively developed but after fears over rising expenditure the Geddes Axe cuts to spending were imposed to ‘balance the books’. In addition, responsibility for disabled people’s needs has been split across different levels of government and different ministries. There was insufficient joined-up thinking between ministries of labour, pensions, health and education in the early to mid-twentieth century, and between local and central authorities. Disabled people found the system bewildering, and lacked support as they transitioned into and out of education or work, or as their condition changed. Moreover, it was often not the state but the voluntary sector that provided core services and mobility aids. Despite rhetoric of returning heroes, for example, the casualties of World War One prompted only meagre state pensions and a voluntary employment scheme. Employers were known to cut wages to reflect disablement pension payments, and with the rise of mass unemployment, public sympathy for disabled veterans was quickly eroded.

Across Whitehall, the Northern Irish devolved authorities and local government, the needs of disabled people were seen as lacking in policy urgency. Only the relatively well-organised blind community managed to get specific legislation to address their needs. The 1920 Blind Persons Act provided for pensions, training and workshop employment, providing a policy template that other groups representing disabled people also claimed, but without success. Part of the problem was a lack of understanding of the scale of impairment. Government officials openly acknowledged that they had little sense of how many people lived with impairment or chronic sickness. The distinct needs of different medically-defined groups were often stressed, despite their common experiences of economic  and social marginalisation. In the 1940s, junior minister George Tomlinson, in charge of employment policy for disabled people, admitted that ‘it does not seem possible to make even a rough estimate’ of numbers. Until a survey of England, Wales and Scotland published in 1971, policymakers worked with guesstimates as to numbers of disabled people. Even after this date, changing definitions and reluctance to disclose from some of the disabled themselves made the scale of disability extremely unclear.

The Quota

The exception to the pattern of government inactivity on disabled people’s needs came during the wider reboot of social policy and transformation of the state’s relationship to its citizens during World War Two. This was a moment of optimism about inclusion, motivated by awareness of obligation towards the injured servicepeople who were returning from war service and by the huge upheaval to labour markets during war mobilisation. Many disabled people previously thought to be unemployable had been drawn into paid work as employers became less choosy. The 1944 Disabled Persons (Employment) Act imposed an obligation on employers of over 20 people to employ registered disabled people as 3% of their workforce. This was as much about productive capacity and national competitiveness as it was social justice. Minister for Labour Ernest Bevin noted that the Act would add ‘man-hours of production […] to the total national wealth’, and preserve ‘the virility of the nation and the productive capacity of every human being we have at our disposal.’

This was the first piece of legislation to use the language of disability in the United Kingdom, though those judged unemployable were described in the legislation of the late 1940s as ‘handicapped’. Disability was narrowly defined in relation to labour market potential, with a male breadwinner model in mind. This largely left disabled women out, alongside those judged unemployable. Though World War Two had proved that many previously economically inactive – including of course many women-  could contribute to offices, farms and factories when labour was urgently needed, there was still a tendency to exclude whole categories – such as people with epilepsy or speech impairments – from participation.

The 1944 Act awarded ‘green cards’ (blue in Northern Ireland) to those registered as disabled when they joined the Disabled Persons Register. During and shortly after the war, British citizens were habituated to wartime schemes of registration and labour management. Registering as disabled may not have seemed an imposition in this context, and many disabled people were hopeful that they would be fully incorporated into a reconstructed, postwar society. By 1949, nearly a million workers had registered, representing around 4% of the total UK working population.

Registration woes

The register was not, however, a reliable indication of impairment.  Some employers, fearful of additional costs, had urged existing workers to register for trivial conditions such as chilblains or upset stomachs, to avoid having to make new hires. In terms of numbers, 1949 was the highpoint of numbers registered. In subsequent decades, many became extremely reluctant to join the register and it only captured around 1.5% of the workforce by the mid-1970s.  Why were workers so reluctant? Registration could also be a fraught process. On the front-line, poorly trained Disability Resettlement Officers were quick to judge individuals as unemployable, or as only fit for sheltered work, typically in a very limited range of poorly-paid trades such as basket and mat making. Attempts to categorise and set boundaries around disabled people’s labour market activity added to their vulnerability and exclusion.

Registration brought no personal advantages – the quota operated at the population level, and individuals could not claim any employment entitlement from it. It was still perfectly legal for employers to deny registered disabled people work or promotion on the basis of their impairment. Indeed, registration was widely understood as concentrating prejudice and exclusion. Individuals reported that if they disclosed their disabled status, employers would immediately rule them out. It proved a better bet to stay quiet and attempt to pass as non-disabled if possible. Policymakers had assumed that ‘disability’ was a neutral category, and failed to take into account the stigma it attracted.

Moreover, during the decades after 1944, it became clear that the quota was not going to be enforced. By 1975, 60% of private sector employers and 27 of the 29 Whitehall departments failed to meet their quota. By 1988, there had only ever been five prosecutions for non-compliance, and the potential fine remained at £100. With very few disabled people on the register, employers could argue that it was impossible to fulfil the 3% expectation. But the non-enforcement was also because policymakers thought it unnecessary, assuming that only ignorance or inattentiveness lay behind the employment and pay gaps faced by disabled people. This attitude continued into the 1990s, despite campaigners having documented widespread discrimination. The Minister for Disabled People William Hague, responsible for the 1995 Disability Discrimination Act, claimed for example that ‘To a much greater extent than for women, or even ethnic minorities, the problems faced by disabled people in securing fair treatment in society are individualistic.’ Perhaps as a result, the Disability Discrimination Act was weaker than other equalities measures, lacking enforcement mechanisms and setting high bars of medical proof in relation to impairment.

Fixing disabled people

Rather than focus on discrimination, policymakers were prone to keep a narrow focus on disabled people themselves. This could be a useful source of funding for mobility aids, adaptation of workplaces and transport solutions. But emphasising assistive technologies and gadgets was also a means of avoiding scrutiny of tougher problems of social stigma and discrimination. This was not just a problem of employers or the general public. Stigma was also embedded in government, where officials often judged disabled people as lacking in work ethic or as burdens on welfare systems. Officials in charge of welfare benefits at the National Assistance Board, for example, termed them, ‘habitual refusers’.

Though much changed across the twentieth century, there are remarkable continuities in these sentiments. In 1935 the Daily Telegraph, for example, had declared hysteria and ‘chronic invalidism’ to be the cause of many seemingly physical impairments, and many of those working ‘for’ disabled people appear to have shared such beliefs. As the editor of the Cripples Journal put it in 1930, ‘Social services have become a national game in which sickness benefits and workmen’s insurance and doles can be wrangled with little effort.’ Such evidence suggests it was commonly believed that disabled people had a disinclination to work, or suffered from psychological complexes of inferiority that needed to be fixed.  

Though the UK government began to absorb and reflect new definitions of disability – as a matter of discrimination and exclusion – that emerged amongst activists in the 1970s and 1980s, medical definitions and judgemental rhetoric remained the norm. The Manpower Services Commission, in charge of disabled people’s employment in the 1970s, talked of ‘low motivation and personality problems’ amongst disabled people. This was periodically echoed and amplified by elected representatives. Prime Minister John Major questioned the numbers claiming invalidity benefits in 1993, echoing the more polemical efforts of right-wing Conservative MP and Daily Mail journalist Olga Maitland, who denounced the ‘fraud’ of disabled claimants. As David Turner has shown, this is an agenda with a long history, and a great deal of popular resonance. Even those with good claims for public sympathy were stigmatised. A former policeman, seriously injured in the 1970s Troubles, described in 1994 his reluctance to talk about his disability, for fear of giving ‘the impression that I was looking for something or that I was playing on my injuries.’

Austerity in the twenty-first century has had a similar tone. In 2014, welfare minister Lord Freud publicly speculated that some disabled people were ‘not worth the full wage’ and might instead be paid sub-minimum wages. Despite his later apology, the rhetoric continued with Rishi Sunak declaring a war on Britain’s ‘sick-note culture’ in 2024. There is little evidence that fraud is widespread; widespread errors in assessment, or disabled people refusing to participate in aggressively cost-cutting, hostile systems of benefits and employment services are far more costly, both personally and to the nation.  

Conclusions

The 2020s are a time of substantial change with regard to how paid employment is organised. The Covid 19 pandemic up-ended assumptions about how and where work should happen, and brought in radical new ideas that have promoted greater inclusion of disabled people in some countries. Not only France, Spain and Australia but also Canada and even USA have put UK to shame in the extent of the rise in disability employment out-running the rise in non-disabled employment, 2019-22. This was by a factor of 2 to 5 times  and over 12 times in USA. UK was the only one of these six countries in which the percentage rise in disabled employment was actually less than the rise in non-disabled (both being very small).

There have also been innovative pilots in four day working weeks, and new ways of supporting people through the benefit system through experiments with minimum incomes. Our economic life is capable of being reorganised. The 3% disability quota system, on the statute books from 1944 to 1995, was brought in during the policy space offered by the upheavals of World War Two. Periods of social change and fresh policy thinking represent an opportunity to go beyond the window-dressing and lack of vision typical of UK policymaking around disability for much of the twentieth and twenty-first century. After 14 years in opposition, the current Labour government were unwise to squander the opportunity for a reboot that their election represented, and must work hard to distinguish their agenda from that of their predecessors.

The quota was brought in with optimism in 1944, aiming to make work more accessible to disabled people, but its history offers a case-study of policy failure. Employers ignored or cynically manipulated it. Enforcement failure helped cement the idea that the problem lay with disabled people, not the workplaces that would not accommodate them. Overall, there has been a strong tendency for policy initiatives to be aimed at ‘fixing’ disabled, chronically sick and neurodiverse people, and having little to say about the elephant in the room – the enduring stigma associated with bodies and minds that are impaired or, simply different. Despite the Disabled Persons Register failing precisely because the widely stigmatised status of ‘disabled’ was not factored in, government has preferred to depict a broadly generous, benign policy and social environment. It would do better to acknowledge discrimination (including its own) and provide meaningful ways to contest it.

There has been a long twentieth century of unchallenged, casually reproduced stigma, and repeated episodes of it being fanned for political purposes. Until this ends, exclusion and employment gaps for disabled people will persist, and the Labour Party’s historic mission to root out poverty will fail.

Further reading

‘Cause and Cure of Hysteria’, Daily Telegraph, 1 May 1935, p. 11.
Helen Bolderson, ‘The Origins of the Disabled Persons Employment Quota and Its Symbolic Significance’. Journal of Social Policy (Cambridge, UK) 9, no. 2 (1980): 169–86.
Integrating the Disabled: Report of the Snowdon Working Party. National Fund for Research into Crippling Diseases, 1976.
Marie-Therese Fay and Marie Smyth, eds. Personal Accounts from Northern Ireland’s Troubles: Public Conflict, Private Loss. Pluto Press, 2000.
Gareth Millward. Sick Note: A History of the British Welfare State. Oxford University Press, 2022.
Michael Oliver and Colin Barnes. The New Politics of Disablement. Palgrave Macmillan, 2012.
Frances Ryan. Crippled: Austerity and the Demonization of Disabled People. Verso, 2019.
David Turner, ‘Fraudulent’ Disability in Historical Perspective, History & Policy, https://historyandpolicy.org/policy-papers/papers/fraudulent-disability-in-historical-perspective/
Frederick Watson, Civilization and the Cripple. J. Bale & Danielsson, 1930

About the author

Lucy Delap is Professor of Modern British and Gender History at the University of Cambridge and is a Fellow of Murray Edwards College. Her historical research has focused on histories of feminisms, gender, sexuality, labour, disability and religion, including The Feminist Avant-Garde (2007), Knowing Their Place: Domestic Service in Twentieth Century Britain (2011), and Feminisms: a global history (2020). She has published on disability history including ‘Slow Workers: Labelling and Labouring in Britain, c. 1909–1955’ Social History of Medicine 37, 1, (2024), pp. 160–182; and Grindery: Disability and Labour in Modern Britain (forthcoming).

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