Rishi Sunak has vowed to tackle Britain’s “sick-note culture” as he announced an overhaul of the benefits system in a plan he attempted to frame as “a moral mission”. 

Foremost amongst Sunak’s solutions to tackle the rapidly rising rates of economic inactivity is a government plan to strip GPs of their right to issue sick notes. Speaking at the Centre for Social Justice, the PM insisted that doctors are too readily writing people off as unfit for work.

“We have wiped out decades of progress,” said the PM, as he noted the huge rise in long-term sickness since the pandemic. The number of people in Britain off work with long-term sickness currently stands at a record high of 2.8 million, with almost a third of working age adults now economically inactive. Sickness benefits for people of working age cost £49 billion last year and this figure is projected to rise by another £20 billion before the end of the decade.

Another pattern the PM labelled both “tragic” and “an enormous waste and loss of human potential” is that the increase in those claiming sickness benefits is disproportionately concentrated in the young. 

“It is 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,” said the PM. Yet he went on to cite the fact that over 50 per cent of the long-term sick are not working due to mental health problems as evidence that we are “over-medicalising common anxieties”. 

Unsurprisingly, the comments have caused a backlash, with mental health charity Mind accusing the Prime Minister of “continuing a trend in recent ­rhetoric which conjures up the image of a ‘mental health culture’ that has ‘gone too far’”. 

“I know people will probably accuse me of lacking compassion,” the PM himself conceded. But work, he insisted, “is a source of dignity, purpose, hope,” and “it contributes to a sense of belonging and self-worth.”

The PM acknowledged that some are simply too unwell to work. Others, he insisted, with milder mental health illnesses and less severe mobility issues, for instance, could be encouraged back to work “if their employers made reasonable adjustments.” He did not specify what form these adjustments would take beyond offering employees the option of working from home. 

Aside from helping the sick to get back to work, he vowed to crack down on those lodging claims in bad faith. A new fraud bill, soon to be announced in full soon, “will treat benefit fraud like tax fraud”, giving the DWP similar powers to HMRC to punish benefit “fraudsters”.

Why do we need to crackdown on those “exploiting the compassion of British people”?  Because, said Sunak, “when people see others gaming the system that their taxes pay for, it erodes support for the whole welfare system”.

The government is planning to launch a consultation on toughening up the eligibility criteria for PIP, formerly known as Disability Living Allowance, by demanding “greater medical evidence” about the type and severity of mental health conditions. According to the PM, this will also mean changing who is responsible for issuing “fit notes”.

A “fit note” certifies a patient is sick, confirming a valid reason for staying off work and eligibility for sick pay.

“We are 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,” said the PM.

Will reallocating this task make any difference? 

While the suggestion that GPs are incapable of making “objective” assessments might cause some offence, overstretched doctors may well be all too happy to shift the responsibility for handling sick notes onto another trained professional.

But we are lacking details on who exactly these “specialist work and health professionals” would be – how they would be recruited, how they would be trained and the accompanying price tag.

And how would they assess patients differently? The severity of a mental illness is not an easy thing to quantify.

Sunak’s speech has shone a light today on the scale of sick-note Britain – a trend anyone, of any political persuasion, can agree is deeply worrying. 

He has made a convincing case for why we need to help individuals get back to work. But details on how exactly he will exercise his plan are still lacking.

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