Prime Minister’s New Plan to Reform Welfare and Tackle Britain’s “sick note culture”


Prime Minister’s New Plan to Reform Welfare and Tackle Britain’s “sick note culture”

In a major speech today, the Prime Minister unveiled a package of welfare reform measures aimed at addressing the unprecedented rise in economic inactivity and ensuring that our benefits system is better targeted at those who need it most.

Ending Britain’s “Sick Note Culture”

The Prime Minister’s new plan for welfare aims to end Britain’s “sick note culture”, which has led to a significant increase in people being unnecessarily written off work and parked on welfare. This comes amid concerns that the fit note system has allowed millions of people to be written off work and into welfare without receiving the right support and treatment they might need to help them stay in work.

Data recently published by the NHS shows that almost 11 million fit notes were issued last year, with an overwhelming 94% of those signed “not fit for work”. A large proportion of these are repeat fit notes which are issued without any advice, resulting in a missed opportunity to help people get the appropriate support they may need to remain in work.

Review of the Fit Note System

To address this, the Prime Minister announced a review of the fit note system to stop people being written off as “not fit for work” by default. Instead, the aim is to design a new system where each fit note conversation focuses on what people can do with the right support in place, rather than what they can’t do.

As part of this, the government will consider shifting the responsibility for issuing the fit note away from already stretched GPs, towards specialist work and health professionals who have the dedicated time and expertise to provide an objective assessment of someone’s ability to work and the tailored support they may need.

A call for evidence will be published later today to seek responses from a diverse range of perspectives, including those with lived experiences, healthcare professionals, and employers, both on how the current process works and how it can better support people with health conditions to start, stay, and succeed in work.

The Prime Minister said: 

“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.  

“Building on the pilots we’ve already started we’re going to design a new system where people have easy and rapid access to specialised work and health support to help them back to work from the very first Fit Note conversation.  

“We’re also going to test shifting the responsibility for assessment from GPs and giving it to specialist work and health professionals who have the dedicated time to provide an objective assessment of someone’s ability to work and the tailored support they need to do so.”  

The Current State of Economic Inactivity

Latest figures from the Office for National Statistics suggest there are currently 2.8 million people who are ‘economically inactive’ due to long-term sickness, a near-record high. Of those inactive due to long-term sickness at the start of last year, 53% reported that they had depression, bad nerves, or anxiety.

This is also driving an unsustainable increase in welfare spending as more people claiming disability benefits are now assessed as having anxiety or depression as their main condition. Since the pandemic, total spending on working-age disability and ill-health benefits increased by almost two-thirds from £42.3 billion to £69 billion, and we now spend more on these benefits than our core schools’ budget or on policing.

The fit note process is often the first step to someone falling out of work and acts as a gateway towards some ill health and disability benefit assessments. There is also clear evidence that the longer someone is out of work, the lower the likelihood that they return to work – further exacerbating the rise in inactivity.

Ambitious Plans for the Future

The Prime Minister made the case that we need to be more ambitious about how we help people, particularly with mental health conditions, back into work and ensure they are not left behind on the benefits system.

The Prime Minister also said: 

“We should see it as a sign of progress that people can talk openly about mental health conditions in a way that only a few years ago would’ve been unthinkable, and I will never dismiss or downplay the illnesses people have. 

“But just as it would be wrong to dismiss this growing trend, so it would be wrong merely to sit back and accept it because it’s too hard; or too controversial; or for fear of causing offence. Doing so, would let down many of the people our welfare system was designed to help. 

“Because if you believe as I do, that work gives you the chance not just to earn but to contribute, to belong, to overcome feelings of loneliness and social isolation and if you believe, as I do, the growing body of evidence that good work can actually improve mental and physical health…

“…then it becomes clear: 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.”  

Today’s fit note review builds on the significant steps we’ve taken so far to break down barriers to work and tackle inactivity. This includes through our £2.5 billion Back to Work Plan which is already helping over a million people, including those with mental health conditions, break down barriers to work by expanding access to mental health services and putting an additional 384,000 people through NHS Talking Therapies.

The new WorkWell pilot is also being rolled out and will support almost 60,000 long-term sick or disabled people to start, stay, and succeed in work once it has gone live in approximately 15 areas across England.

The WorkWell services provide a single, joined-up assessment and gateway to a range of support, helping people to overcome barriers to work and build a healthier, more inclusive society.

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