End of the 'sick note': Rishi Sunak to stop GPs signing people off work in welfare scheme overhaul

19 April 2024, 01:09 | Updated: 19 April 2024, 08:23

Rishi Sunak is to call for an end to the "sick note culture".
Rishi Sunak is to call for an end to the "sick note culture". Picture: Alamy

By Emma Soteriou

Rishi Sunak has called for an end to 'sick note culture' as part of an overhaul to the benefits system.

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The PM is set to warn against "over-medicalising the everyday challenges and worries of life" in a speech on welfare reform on Friday.

It will comes as Mr Sunak unveils his vision for a "new welfare settlement for Britain" - pledging not to dismiss or downplay illness but to call for a "more ambitious" approach to helping people back to work.

He is expected to say the focus must shift to what work people might be able to do, amid concerns that some are being unnecessarily written off as sick and "parked on welfare".

Mr Sunak will add that there is a "growing body of evidence that good work can actually improve mental and physical health".

Last month, Work and Pensions Secretary Mel Stride faced criticism for saying there is "a real risk" that "the normal ups and downs of human life" are being labelled as medical conditions.

The Government's plans for getting specialist work and health professionals to issue fit notes will often mean "a different configuration of existing resources," the Work and Pensions Secretary said.

Asked whether these staff are ready to go, Mel Stride told Nick Ferrari at Breakfast on LBC: "We are absolutely staffing up. In many cases it means actually just having a different configuration of existing resources."

He added: "We have already gone out to the various health boards around the country and we have 15 of the 42 in England who in the autumn will be participating in something called WorkWell, which is the name for what I described earlier of bringing together the medical assistance but also that critical work-based advice and support as well."

Mr Stride said a call for evidence launched on Friday will help determine "exactly what the model is and exactly how it will work," but broadly, a GP would send a patient with a bad back to WorkWell, where an advisor may contact their workplace to make adjustments such as relocating their office to the ground floor.

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'Enough is enough, is my message on this' says Mel Stride

Speaking on Friday, Mr Sunak will say: “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.”

GPs will lose the power to hand out sick notes
GPs will lose the power to hand out sick notes. Picture: Alamy

As part of the reform, Mr Sunak is expected to announce a review of the fit note system, suggesting specialist work and health professionals should be charged with responsibility for issuing them instead of GPs.

It comes after recent NHS data showed almost 11 million fit notes were issued last year, with many being repeat fit notes "issued without any advice, resulting in a missed opportunity to help people get the appropriate support they may need to remain in work".

Mr Sunak is expected to refer to challenges presented since the pandemic, with the government saying a "significant number of working aged people have become inactive due to long term sickness which has in large part been driven by mental health conditions".

He is expected to say: “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.”

Since 2020, the number of people out of work due to long-term sickness has risen significantly, reaching 2.7 million people in January 2024.

A large proportion of those report suffering from depression, bad nerves or anxiety, although most of those report these as secondary conditions rather than the main one keeping them out of work.

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