Reforms to tighten up access to ill health benefits and end the current “sick note culture” have been unveiled by Prime Minister Rishi Sunak today.
In a speech, he said hundreds of thousands of benefit claimants with “less severe health conditions” will be encouraged to work under proposed changes to the work capability assessment (WCA).
The reforms, which are proposed for the next parliament, will look at shifting responsibility for signing off ‘fit notes’ away from GPs to specialist work and health professionals.
“It may not be reasonable to ask GPs, who are very busy at the moment, to assess whether their own patients are fit for work,” Sunak said. “It too often puts them in an impossible situation where they know that refusal to sign somebody off will harm that precious relationship with that patient.”
Mental health and the way personal independence payments (PIP) work came under close scrutiny. Sunak said that since 2019, the number of claimants that cite anxiety or depression as their main condition has doubled, with more than 5,000 new awards on average every month.
He said: “But for all the challenges they face, it’s not clear they [people with mental ill health] have the same degree of increased living costs as those with physical conditions. And the whole system is undermined by the way people are asked to make subjective and unverifiable claims about their capability.”
Sunak said he will publish a consultation on how to shift these assessments “to a more objective and rigorous approach” that focuses support on those with the greatest needs and extra costs.
“We will do that by being more precise about the type and severity of mental health conditions that should be eligible for PIP, we’ll consider linking that assessment more closely to a person’s actual condition and requiring greater medical evidence to substantiate the claim, all of which will make the system fairer and harder to exploit.”
In his speech, Sunak said: “We must be more ambitious in assessing people’s potential for work. Right now the gateway to ill health benefits is writing too many off, leaving them on the wrong type of support and with no expectation of trying to find a job with all the advantages that that brings.”
However, Karl Bennett, wellbeing director of Vivup and chair of EAPA, said “It’s incredibly insulting to assume that people are visiting their GP to be signed off with mental health issues, and that this is taking time away from GPs doing other work.
“The issue is not having the capacity to issue ‘fit notes’, it’s having the resources available within the NHS to support those people when they are at their most vulnerable.”
Bennett said it takes courage to ask for help if you are struggling with mental health issues, adding that visiting a GP may be a last resort for some. “Investment is needed to support people, rather than increase access to fit notes.”
He added: “When will the government recognise that support is available through employee assistance programme (EAP) services? EAPs offer everything that is needed to support people to remain at work, or return to work quickly. All employees should have access to the services offered by an EAP, while employers should have funding made available to them to ensure they are not choosing between their employees’ mental health and paying a fair wage.”
Steve Herbert, HR and benefits industry consultant and trainer, said Sunak’s comments “won’t have entered the public consciousness” yet as other world issues and political scandals are consuming the media oxygen. “That said, if the Conservatives return to this theme repeatedly in the run up to the general election, then this will eventually become a talking point for employers and employees too,” he added.
“In that situation there will certainly be a case for employers with more sophisticated wellbeing support to take the initiative and highlight to their workers that they are not reliant on the state for support, and that they can also bypass the logjams of NHS waiting lists etc. That could – and should – become a good case for recruitment and retention.”
However, Herbert said: “The case is harder for smaller employers with less robust offerings to make, but it might encourage them to upgrade their offering to combat the appeal of the large employers if the employment market remains challenging.”
He recommended that the government reconsider its fit for work proposals, which he described as an “occupational health ‘light’ approach”.
“The original proposals placed a requirement on the family doctor to refer their patient to a state-funded occupational health service if there appeared to be the prospect of a lengthy absence from work. Early interventions make a big difference to illness duration, so this would have helped the sickness absence numbers – not least after the pandemic.
“Failing that, then greater support for group income protection providers to develop further their early intervention services would be the next logical step. These have a proven track record of success, and perhaps some form of government support can help democratise such services beyond existing GIP populations.”
