Between 1979 and 1997, the numbers on incapacity benefit rose from 700,000 to 2.4 million, since then the number of new claimants has halved and the totals have been falling.
This government is aiming to get up to 1 million off the headline figure over the next ten years.
A lot of people are rightly concerned about the effect this might have on the 40% of claimants who are registered as mentally ill. The government are treading very carefully on this issue. No current claimants will have their benefit cut, and it is going to be 'carrot' rather than 'stick' that is used to get people into work. This is only right.
Nobody believes that all those on incapacity benefit are totally incapable of work and for those who are mentally ill, the best way to help them is probably to get them back into the workplace.
But the bigger question is why are there so many people on incapacity benefit in the first place?
The main answer to this is that it was initially used by the Tories to massage down the unemployment figures. The next point to make is that because the benefit rises the longer you are on it, it becomes increasingly difficult to escape the benefit trap. Your job prospects diminish and your benefit increases, making it too risky for most to get a job because once signed off, it is a bureaucratic nightmare to get back on if the job goes wrong.
Although it was initially a Tory way of massaging the unemployment figures, it is now more about the stresses of our society. There are now more claimants in the job rich south east than the deprived north.
If we really want to reduce the numbers on IB, we are going to have to tackle the causes of mental illness.
In my opinion the main causes are isolation (more breakdown in relationships, more people living alone), inequality (the UK is one of the most unequal societies in the EU), poor diet and lack of exercise.
Our individualist society places more demands on us than ever before, to improve our status both at work and in our social life. We have to accept that the state has a responsibility to help those who are left behind.
So first we need measures to improve community; I like Cameron's ideas on 4 months community service for school leavers (but why not extend it to everyone). We also need more local democracy. The reason the Tories decimated local democracy in the eighties was because local councils were too left wing. But these left wing councils provided useful support to communities.
Next we need to tackle inequality and this means redistribution. The most efficient way to do this (and get rid of the poverty trap and bureaucracy) is a citizen's income.
Poor diet can be tackled by better education and better labelling of products, maybe even an extra tax on salt and sugar in our foods to stop these being cheap ingredients to overuse.
Finally we need to tackle the exercise gap. Gyms and sports clubs can be too expensive, which is why we need more local authority funding, but more than that, the biggest impact on obesity has probably been the way the car dominates areas and restricts opportunities for walking and cycling by making the roads too dangerous, the distances too forbidding (surburban sprawl and out of town stores are difficult to reach) and the pollution too damaging.
We need to build at higher density for public transport to be more effective, and we need proper off road cycle paths next to every main road. I would even go as far as to make local public transport completely free to encourage people to leave their cars. We need more congestion charging and we need more eco-taxes on fuel.
It may seem I have gone completely off topic, but when it comes to health - housing, inequality, transport and the environment are closely linked. A long term consensus is needed in all these areas if we are truly to do something about the number of IB claimants.