PM targets the sick with benefit cuts

ON FRIDAY (April 19), Rishi Sunak announced that his Government knew more about sick individuals’ needs than doctors.

In an effort to stigmatise yet another vulnerable group ahead of a General Election, the Prime Minister declared that he wanted to end the UK’s “sicknote culture”.

Wherever you look, it seems the parliamentary Conservative Party is at war with one culture or another. The ill and disabled are just the next in line.

A RISING TIDE OF ILLNESS

It’s not that the PM doesn’t have a vague point underpinning his rationale.

In Great Britain, 4.2 million working-age individuals – one in ten – claim a health-related benefit.

That number could rise to 5.4 million (12.4%) by 2028–29, a rise of more than 2 million since 2019– 20.

The rapid increases in health-related benefits cases that began around the beginning of the pandemic are projected to continue.

Before the pandemic, both incapacity benefits and disability benefits saw about 20,000 new claims per month. By November 2022, that had risen to 51,000 and 43,000 respectively.

In addition, the number of economically inactive people in the UK - those neither working nor claiming benefits - has markedly increased.

Calculations using forecasts from the Office for Budget Responsibility and the Scottish Fiscal Commission imply that 5.4 million working-age individuals (12.4%) will receive a health-related benefit by 2028–29. That assumes that the rates of new awards will slow from their current levels but still be far above the pre-pandemic norm. If the recent pace of new awards persists, the number of recipients in 2028–29 would be 5.8 million.

As a result of the rise in cases, spending on disability and incapacity benefits for working-age people rose by £12.8 billion to £48.3 billion between 2019–20 and 2023–24 (2024–25 prices).

The latest forecasts imply a further rise to £63.7 billion by 2028–29 – a £28.1 billion increase.

For context, total expenditure on ALL working-age benefits in 2028–29 (including incapacity and disability benefits) is forecast to be £144 billion. Meanwhile, Old Age Pensions already cost the Government £138bn, a figure forecast to rise to £165bn by 2027.

The current asylum system costs the UK around £3bn a year.

PROPOSALS NOT EVIDENCE-BASED

The Prime Minister said: “We don’t just need to change the sick note; we need to change the sick note culture so that 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 get 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.”

Although the rising cost of these benefits will be a pressing concern for the next Government, the lack of clarity on what is fuelling the rise makes designing the right policy response much more difficult.

The idea that the increasing number of claimants is a transitory phenomenon following the Covid pandemic is for the birds. The change seems long-term.

Although the number of new claims is highest among young workers, one-in-six of 60-64-yearolds now get a healthrelated benefit.

Mubin Haq, Chief Executive of the abrdn Financial Fairness Trust, said: “Before the pandemic, around one in thirteen claimed a health

related benefit. That could rise to one in eight by the decade’s end. This matters as the growth in poor health and disability increases the likelihood of people being locked out of the workforce at a time when the UK faces acute labour shortages.

“A range of fators, such as the pandemic, NHS waiting times and conditionality in the benefits system, are likely to contribute to this rise. However, much remains unknown.

“Cutting or reducing access to benefits would lead to severe hardship for millions with additional needs and fail to address the underlying conditions we now face.”

GOVERNMENT FOCUSSED ON EFFECTS NOT CAUSES

Therein lies the fundamental problem with the PM’s announcement.

The Government has no idea what is driving increased claimant numbers or rising economic inactivity.

given his leadership of a parliamentary party of which Liz Truss is a member, Mr Sunak appears unaware of the debilitating effects of poor mental health.

The PM gave no clue how the Government would fund a new system, who would carry out fitness assessments, what qualifications they would have, or even how he proposed to square the circle between the demand for staff and its supply.

Government contractors’ farcical handling of PIP claims and the Universal Credit fiasco suggest that trying to do things on the cheap via outsourcing could prove an expensive disaster.

Until Mr Sunak can answer those questions, his announcement is little more than performative and empty rhetoric.

The Centre for Mental Health claims the Prime Minister’s comments about mental health and work are not based on robust evidence and could lead to policies and practices that do more harm than good,

Centre for Mental Health chief executive Andy Bell said: “There is clear evidence that mental ill health is becoming more prevalent among younger people in particular. Mental health services are struggling to grow fast enough to keep up with rising demand for essential support.

“Suggesting that this is due to an overmedicalising of the everyday challenges of life, while too many people struggle to access the mental health support they need, may discourage people from seeking vital support when they need it.

“Being in work can be positive for many people’s mental health, but only in workplaces with good working conditions, fair treatment and decent pay. Supporting better mental health at work would help more people to fulfil their potential and return to time to see more patients.

“Recent progress means issuing these notes can now be undertaken by “other doctors, nurses, occupational therapists and physiotherapists.

“With a waiting list of 7.5 million—not including for mental health problems— delays to diagnostics and resulting pressures on GP practices, patients cannot get the treatment they need to be able to return to work.

“So rather than pushing a hostile rhetoric on ‘sicknote culture’, perhaps the Prime Minister should focus on removing what is stopping patients from receiving the physical and mental healthcare they” need, which in turn work if they need time off prevents them from going for their mental or physical back to work.” health. D’ Kathryn McKinnon,

“The Prime Minister’s chair of the occupational suggestion that Personal medicine committee, Independence Payment said: “The announcement eligibility may be further of ‘a move towards a restricted for people with national occupational mental health problems health service’, as DWP will cause great concern Minister Mel Stride put to many people for whom it, can be a positive step this benefit is a lifeline. for the UK workforce and “PIP is a benefit paid economy. However, we

nd regardless of whether have concerns with the a disabled person is in level of detail provided. work or not to help with Specifically, how this will the extra costs of being be delivered considering disabled. It’s already hard the level of staffing, to get. Restricting it further training and supervision, will cause more people to as the existing OH lose vital support. workforce is already under

“If the disability benefits pressure. system is ‘unsustainable’, “We need to see the the Government should details on how it will be take action to deal with the implemented. This seems causes of higher numbers like an announcement of people needing support made out of nowhere with for their mental health, no thought or reasoning not take away the help into how huge this could people get to deal with the be to occupational health, consequences. which “is currently a commercial enterprise in the UK.

“We believe that every worker in the UK deserves to have access to occupational health (OH) and medicine. As it currently stands, OH is often a benefit certain employers give.

“The PM’s announcement put more emphasis on occupational medicine through the Work Well program, which was announced in budget 2023 and then went silent.

“We hope this leads to universal occupational health services for all workers in the UK and would like further details from the Government.”

BMA: “PM MUST DITCH HOSTILE RHETORIC”

Dr Katie BramallStainer, chair of England’s General Practice Council, said: “Fit notes are carefully considered before they are written, and a GP will sign their patient off work only if they are not well enough to undertake their England’s “We recognise the health benefits” of good work. Most people want to work, but when they are unwell, they need access to prompt care.

“Further review of how fit notes are issued may relieve the administrative burden on GPs, freeing up