PM to overhaul benefits system and tackle Britain's "sick note culture" in welfare reform speech
In a major speech today [Friday 19 April], the Prime Minister unveiled a package of welfare reform measures to tackle the unprecedented rise in economic inactivity and ensure our benefits system is better targeted at those who need it most.
- PM to announce plans to overhaul benefits system to ensure people who are fit to work aren鈥檛 left behind on benefits聽
- Fit note system to be reviewed after 11 million fit notes issued last year with 94% written off as unfit to work
- Comes amid unprecedented rise in inactivity due to long term sickness with latest figures showing almost a third of working age adults are inactive
The Prime Minister鈥檚 new plan for welfare will end Britain鈥檚 鈥渟ick note culture鈥�, which has resulted in a significant rise in people being unnecessarily written off work and parked on welfare.聽
It comes amid concerns that the fit note system has opened the floodgates for millions of people to be written off work and into welfare without getting the right support and treatment they might need to help them stay in work.
Data recently published by the NHS shows almost 11 million fit notes were issued last year, with an overwhelming 94% of those signed 鈥渘ot fit for work鈥�. A large proportion of these are repeat fit notes which are issued without any advice,聽resulting in a missed opportunity to help people get the appropriate support they may need to remain in work.
To address this, the Prime Minister announced a review of the fit note system to stop people being written off as 鈥渘ot fit for work鈥� by default and instead design a new system where each fit note conversation focuses聽on what people can do with the right support in place, rather than what they can鈥檛 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聽an objective assessment of someone鈥檚 ability to work and the tailored support they may need. 聽聽
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聽can better support people with health conditions to start, stay, and succeed in work.
The Prime Minister said:聽
鈥淲e don鈥檛 just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do 鈥� not what you can鈥檛.聽聽
鈥淏uilding on the pilots we鈥檝e already started we鈥檙e 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聽Fit Note conversation.聽聽
鈥淲e鈥檙e 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鈥檚聽ability to work and the tailored support they need to do so.鈥澛犅�
Setting out his vision for a 鈥渘ew welfare settlement for Britain鈥�, the Prime Minister outlined the new challenges that have emerged since the pandemic particularly the unprecedented rise in inactivity and how the government plans聽to tackle them.
Before the pandemic, we had the second lowest inactivity rate in the G7, lower than France, Germany, Italy, USA and Canada.聽But since the pandemic, 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.
Latest figures from the Office for National Statistics suggest there are currently 2.8 million people who are 鈥榚conomically inactive鈥� due to long-term sickness, a near-record high. Of those inactive due to long term sickness at the start聽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.聽
Since the pandemic, total spending on working age disability and ill-health benefits increased by almost two-thirds from 拢42.3 billion to 拢69 billion and we now spend more on these benefits than our core schools鈥� 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聽the likelihood that they return to work 鈥� further exacerbating the rise in inactivity.
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:聽
鈥淲e 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鈥檝e been unthinkable, and I will never鈥痙ismiss or鈥痙ownplay the illnesses聽people have.聽
鈥淏ut 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鈥檚 too hard; or too controversial; or for fear of causing offence. Doing so,聽would let down many of the people our welfare system was designed to help.聽
鈥淏ecause 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聽body of evidence that good work can actually improve mental and physical health鈥�
鈥溾�hen 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.鈥澛犅�
Today鈥檚 fit note review builds on the significant steps we鈥檝e taken so far to break down barriers to work and tackle inactivity. This includes through our 拢2.5 billion Back to Work Plan which is already helping over a million people,聽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 provides a single, joined-up assessment and gateway into local employment support services, to help people manage their health conditions and get back to work sooner. This is part of an ambitious programme to support聽disabled people and people with health conditions to start, stay and succeed in work.聽
We are also testing reforms of the fit note process to integrate it more closely with WorkWell, enabling the people who need it to have a work and health conversation, with a single, joined-up assessment and gateway into local employment聽support services. It will also complement the role of Occupational Health in ensuring employers understand and benefit from more expert work and health support to retain and support those in work.
The fit note call for evidence is part of five key reforms the Prime Minister outlined in his speech to put work at the heart of welfare and modernise the welfare system to ensure it is fit for the future.