The disability benefit system needs “fundamental change”, a minister leading a review has said as he insisted it must be made “financially sustainable”.
Sir Stephen Timms said people would have to “wait and see” what his team’s final report into personal independence payment (Pip) said this autumn when asked whether it might include cuts to the numbers of people claiming the benefit.
He warned that the “vital support” provided by Pip to help cover the extra costs of being disabled could be under threat if the costs of the system keep rising.
Pip is intended to help with everyday tasks and extra living costs if someone has a long-term physical or mental health condition or disability.
The latest official figures earlier this year showed the number of people in England and Wales claiming the main disability benefit passed four million for the first time – roughly doubling since 2019
Spending on Pip was around £15 billion in 2019/20, had risen to around £26 billion by 2024/25 and, by spring 2026, was forecast to rise to more than £41 billion by the end of the decade.
The number of claimants classed as having autistic spectrum disorders has more than doubled in six years, according to Press Association analysis, as has the number with mixed anxiety and depressive disorders, while the number with ADHD (attention deficit hyperactivity disorder) has almost quadrupled.
The Timms review was launched last year after ministers were forced to climb down on plans to reform disability benefits, including for those with mental health conditions, in the face of backbench Labour opposition.
Sir Stephen, speaking about his interim report published on Thursday, said his team wants to “come up with a better process”, adding that “for many people, Pip has become a barrier to participation, which is the opposite of what’s intended”.
He told BBC Radio Four’s Today programme: “Because people worry that if they do participate, DWP (Department for Work and Pensions) will come along and say, ‘So you can do things after all’, and take their benefit away.”
The review noted that while Pip “enables many people to stay in work” through covering extra costs of disability, research also “demonstrates that some people on Pip are scared to participate, either in physical activities or employment, as this could be seen as evidence that their functional ability has improved”.
Sir Stephen told Today the system “hasn’t kept up with our changing understanding of disability and ill health over the 13 years since it was first introduced, so we do think fundamental change is needed and we’ll be making our recommendations for change in the autumn”.
Asked if his team would come up with recommendations which would cut the number of people on Pip, Sir Stephen said: “Well, we’ll need to wait and see what our recommendations are.”
Explaining what he meant by the term “financially sustainable”, Sir Stephen said: “My view is the current level of spending is not a great concern.
“What would be a concern would be if it carried on going up forever more, and that we have to address, and we will be doing so.”
Conservative shadow work and pensions secretary Helen Whately has accused Labour of being “in denial about the seriousness of the situation with our welfare system and the fact that we have to make savings”.
Sir Stephen said his team’s terms of reference “do require us to stick within the currently projected envelope for spending on Pip”, but “don’t require us to make savings”.
He said: “Financial sustainability of the system is a concern. It’s a concern to our steering group. We want the vital support that Pip provides to be there for the long term, and it won’t be if it gets more and more expensive inexorably.”
The Timms report said Pip claimants often find the system to apply for the benefit “dehumanising”, “soul destroying” and “degrading”.
The review team said the recommendations will be “bold in nature and bold in recognition of the wider environment in which disabled people in the UK are living” as it concluded “while Pip is widely valued as a benefit, it is no longer fit for purpose”.
The team, which includes Sharon Brennan and Dr Clenton Farquharson, who have lived experience of disability, said feedback from almost 40,000 people and organisations had found more than 90% described negative experiences of the process of claiming the benefit.
Asked this week about the rise in claimants with conditions such as ADHD, Work and Pensions Secretary Pat McFadden said he had told the Timms review panel it must consider “whether the assessment process is today really fit for the range of conditions, and the rise in the reports of some conditions that have been reported compared to when it was conceived 13 years ago”.
He added that he had suggested the panellists should be “ambitious” in their recommendations, and that he is “pretty confident that that whole question of the assessment and different conditions will be quite central to their work”.
There were 4.01 million Pip claimants in April 2026, according to DWP data published in June, up 7% in a year and roughly double the number since comparable figures began seven years ago in January 2019, when the total was 2.05 million.
Of those, 1.56 million – or 39% – were listed as having psychiatric disorders, the highest proportion for any type of disability.
Some 258,539 claimants were classed as having autistic spectrum disorders, more than double the 103,414 in April 2020, according to PA analysis.
A further 435,330 claimants had mixed anxiety and depressive disorders, up from 214,119 in April 2020, while 100,207 had the hyperkinetic disorders ADHD or ADD, up from 28,740.
The second most common type of disability among claimants was general musculoskeletal diseases, which applied to 752,799 people, or 19% of the total.
The Timms report noted that numbers reporting mental health conditions and autism have “increased significantly” since 2009, covering the period pre-2013 before disability living allowance (DLA) was replaced by Pip.
It said in contrast to this rise, the number of people reporting the two main musculoskeletal conditions of back pain and arthritis had risen “only slowly”, likely to have been driven by an ageing society and broader demographic changes.
But the report said demographics “do not obviously explain the trends in the mental health and neurodevelopmental conditions”.
Teenagers and young adults continue to account for a growing proportion of those receiving Pip, with 16.6% of claimants in April aged 16-29, up from 14.3% in April 2020.
While there has been a similar rise for the 30-44 age group – which accounted for 20.9% in April, up from 18.7% in 2020 – there has been a fall in the proportion of claimants aged 45 to 59, at 28.9% of claimants in April, down from 36.0%.
The figure for 60 to 74-year-olds was 31.1%, broadly unchanged from 31.0% in 2020.
The Rethink Mental Illness charity agreed that “radical reform is needed”, but added this must “focus on building a fairer, more compassionate system, rather than resorting to harsher sanctions and conditionality that will hurt rather than help”.
Charlotte Gill, head of campaigns at the MS Society, said the review was a chance to “build a Pip system that acknowledges invisible and fluctuating symptoms, ends unnecessary reassessments, and works for everyone”.
Jon Sparkes, chief executive of learning disability charity Mencap, welcomed the fact the review team had listened to and worked with disability campaigners and said this approach “should continue so that future recommendations are practical, deliverable and do not harm disabled people”.
End-of-life charity Marie Curie called for an end to reassessments and an introduction of lifetime awards for people with terminal and progressive, life-limiting conditions which it said “would create a fairer, more compassionate system that treats people with dignity”.
The Carers Trust said there is a “complete lack of trust in the system, with many carers describing it as trying to ‘catch them, or the person they care for, out'”.
