Welfare reforms generating fear among carers IF you were to conduct a straw poll of the single issue which most concerns third sector organisations in the short-term future, there is likely to be a two-word response - welfare reform. Benefit changes proposed by the coalition government have united the sector through a mixture of fear and despair about the impact they are likely to have on the people they support. Our organisation, the Health and Social Care Alliance Scotland (the ALLIANCE), is only too aware that many disabled people and people who live with long-term conditions in Scotland already live in poverty or close to the poverty line. Around 60 per cent of their households in Scotland have an annual income of just £15,000 or lower, and many live in social isolation, because they are unable to take part in community activities and find it hard to maintain friendships and relationships. Income poverty and debt are already significant features of the lives of these people, and further loss of income could lead to worsening or additional health conditions. Concerns abound that migration from Disability Living Allowance to Personal Independence Payment will have negative consequences on the health of people going through the process. All applicants must complete a face-to-face assessment to establish individual need, as well as regular reviews of their requirement for this support. However, the criteria developed to make this decision remain far too unrepresentative of the social impact of disability, most notably the introduction of a 20-metre limit for moving around to distinguish between people of restricted mobility and people with limited mobility. While the coalition government's central argument for welfare reform focuses on the importance of encouraging employment, in its own right an admirable objective, without a longer term sustained strategy it risks exacerbating inequality and poverty. A third of employers say they deliberately exclude people with a history of long-term sickness or incapacity when recruiting staff - and removing support, such as Disability Living Allowance which often helps disabled people to work, is a backward step. As these changes take hold, our focus moves to supporting people to mitigate the most severe effects. To do that requires a dual approach - taking short-term solutions to halt the more severe impact of changes alongside a longer-term strategy on welfare in Scotland. No one group or sector is solely responsible for delivering this strategy - but lessening the impact is in all of our interests. Approaches to supporting the rights, health and quality of life for disabled people and people who live with long term conditions going through the benefits process are becoming more important, and more pressing, than ever. We must now turn our attention to supporting people through the process and enabling better access to local services. And one element of our approach to mitigate the most severe impact of welfare cuts must be to ensure local advocacy is available. Independent advocacy is available to about one million people in Scotland - but was only accessed by 25,000 people between 2011 and 2012. For people who have sensory impairments, for example, only specialised advocacy support can help to support them through the new benefits process - and yet there are only 42 qualified interpreters in Scotland. Another element of this must be to ensure that local sources of support and information are more readily available and accessible. Research within health and social care has highlighted that people identify a wide range of resources as being important to their health and overall wellbeing, from services offered by health, social care and the third sector to access to parks, walks, lunch clubs, local activities and cafes. Information on local sources of support is often difficult to find, being dispersed across multiple paper and online directories, or known only by word of mouth. Those living with long-term conditions and disabilities may have additional challenges in accessing this information. Programmes of work are currently underway within the ALLIANCE to address access to information and sources of support. A Local Information System for Scotland (ALISS) uses technology to join up information and help make it more findable and maintainable. The Improving Links in Primary Care and the Link Worker programmes are exploring ways to strengthen local connections and aims to find out if a "link worker" can benefit people who have difficulty accessing local resources. Welfare reform presents Scotland with a complex range of challenges, some of which threaten to undermine the progress made by disabled people and people who live with long-term conditions over the last 30 years. We must be strong in our approach to support people through the system and mitigate its worst excesses. • Andrew Strong is policy and information officer of the ALLIANCE (alliance-scotland.org.uk), and Jane Ankori is ALISS Programme Director (www.aliss.org)