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Rishi Sunak will unveil a package of measures to crack down on welfare claimants and what he described as Britain’s “sick note culture” as he attempts to tackle a sharp rise in mental health conditions that have compounded labour shortages.
The prime minister will on Friday announce a review of the “fit note system” that doctors use to sign patients off from work. It will look at shifting responsibility for issuing them away from GPs and on to “specialist” work and health professionals.
More commonly referred to as “sick notes”, the number issued by GPs has increased significantly over the past few years, from 8.7mn in the 12 months to March 2021 to 11mn in the equivalent period to March 2023, according to NHS data.
Mental and behavioural disorders were the most common cause given by doctors for ordering patients to take time off work, appearing on 1mn notes. More than 60 per cent of all mental health diagnoses last year led to “fit notes” being issued for more than five weeks, while a quarter extended beyond 12 weeks.
A large proportion of the fit notes issued are repeat ones that are provided without any advice, according to the government, potentially resulting in a missed opportunity to help people get the appropriate support they may need to remain in work.
“We don’t just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do — not what you can’t,” Sunak will say.
“We need to be more ambitious about helping people back to work and more honest about the risk of over-medicalising the everyday challenges and worries of life.”
Policymakers have called for urgent action to tackle rising levels of ill health in the UK’s workforce as it has aggravated labour shortages, which are weighing on economic growth and driving up the welfare bill.
The UK is the only country in the G7 where economic inactivity — the share of working-age adults who are neither in a job nor looking for one — remains higher than it was before the coronavirus pandemic.
Ministers have been pursuing a carrot-and-stick approach to try and bring more people back into work, bolstering funding for mental health services and employment support for those with health conditions. They are also looking to cut eligibility for incapacity benefits whose recipients are not expected to job hunt.
Data released earlier this week showed the problem has, if anything, worsened, with the rate of economic inactivity rising to 22.2 per cent, the highest since 2015, in the three months to February.
The increase in worklessness over the past four years has been overwhelmingly driven by rising numbers of people in all age groups — but in particular the over-50s — suffering from long-term health conditions.
Ill health now accounts for 2.8mn — more than 30 per cent — of the inactive population of 9.4mn.
The Office for Budget Responsibility estimated last year that a rise in health-related economic inactivity has cost the government £16bn more annually since the start of the pandemic — a combination of extra welfare spending and foregone tax revenues.
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