Does 'welfare-to-work' work? A systematic review of the effectiveness of the UK's welfare-to-work programmes for people with a disability or chronic illness.

摘要

Welfare to work programmes directed at increasing the employment chances of people with a disability or a chronic illness are a controversial aspect of welfare reform in countries such as the UK. There has been considerable public debate about their effectiveness and appropriateness. What evidence is there about the effects of these programmes on employment outcomes? This paper adapts the methodology of systematic review to inform the evidence-base for welfare to work as it applies to people with a disability or a chronic illness in the UK. Quantitative and qualitative studies of welfare to work programmes directed at people with a disability or a chronic illness were identified using electronic databases, hand searches of the relevant literature, searches of the world wide web, citation follow-up, and contacts with authors. 5399 abstracts were identified and 17 studies were included and critically appraised. Three of the included studies were qualitative, two used mixed-methods and twelve were quantitative. The results suggested that welfare to work programmes increase the uptake of employment among people with a disability or a chronic illness. However, as the majority of the studies were retrospective and only three were controlled, it was difficult to determine if the evidence of increased employment was due to the effectiveness of the welfare to work interventions themselves or attributable to more general upward labour market trends. This indicates that there is a need for more robust research on the employment effects of welfare to work to provide a stronger evidence-base for future welfare policy.