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Millions risk being doomed to live on benefits, sick leave architect says

Dame Carol Black fears too many people are doomed to an 'inexorable path to unemployment'; Photo: Paul Grover

Sick notes issued by GPs are no longer «fit for purpose» as Britain's overwhelmed health system allows more people to «slide» into unemployment, the government's new occupational health czar has said.

< p>Dame Carol Black, who oversaw the creation of the current fit-for-use system, said its failure risks dooming millions of people with preventable illnesses to a life on benefits.

Former president of the Royal Society College of Physicians played a crucial role in building current system. Its independent reviews in 2008 and 2011 led to the sick leave being renamed «fit».

However Dame Carol said the program had failed because an increasingly «fragile» NHS had left doctors with no choice but to issue repeat sick leave, leaving people who could have been working stranded outside the workforce .

Almost 94% of the 7.5 million people who saw a GP or other qualified health professional about fitness in the past year were made redundant. Many do not need to return to work for up to 12 weeks, and in some cases longer.

Dame Carol, who has previously been tasked by both Labor and the Tories to look into the causes of health-related economic inactivity, warned that both parties had failed to create a safety net that would allow people to continue working.

The rheumatologist accused successive governments of «stopping halfway» key policies, calling a flagship scheme introduced in 2015 to help people cope with their health problems as «little more than a call centre».

< p>She warned that too many people are condemned to an “inexorable path to unemployment”.

Benefits paid to people of working age currently cost taxpayers £69 billion a year, and Rishi Sunak has vowed to overhaul the system and tackle what he called the «sick leave culture».

The Prime Minister also wants to transform the «suitable sick leave» system developed by Dame Carol and introduced by Labor in 2010 to reduce the burden on GPs issuing sick leave. them.

Last year, ministers changed the law to allow fitness certificates to be issued to any doctor, including nurses, pharmacists, physiotherapists and occupational therapists.

Carol's reforms aimed to keep more people with health problems in work, suggesting how employers could make adjustments to accommodate them. This will help make people «ready» for work.

Dame Carol, who has worked as a doctor for three decades, says her «fit note” The system was supposed to keep more people employed. Photo: Eleanor Bentall

She said: «The intention was that the appropriate note would be the start of a journey that would try to keep as many people as possible as close to the labor market as possible.» and get them back to work as quickly as possible.»

However, Dame Carol said the overstretched NHS was unable to make good use of the system due to pressure on it.

«To unfortunately, less than 10% are actually “eligible notes.” This is very low. So I must come to the very sad conclusion that we have failed.”

The UK is currently experiencing its worst ever disease crisis, which is increasing unemployment.

p>The proportion of working-age people economically inactive due to long-term illness has risen steadily over the past four and a half years, from two million in the summer of 2019 to 2.8 million today.

The total number is now 9.4 million of working age who are economically inactive, the highest level in a decade.

Dame Carol, who is now chair of the British Library, said the current contract process was allowing people to «lose touch» with the idea of ​​returning to work.

NHS data shows more than 30,000 in December 2023 alone people have been kept off work for between five and 12 weeks due to mental and behavioral problems.

Dame Carol, who worked as a doctor for three decades, said people should not be given sick leave for more than «four to six weeks» without thoroughly assessing next steps.

“If you are someone who works more than six weeks with a medical certificate, we know that you will begin to go down a trajectory where you will not return to work.”

One in six people leave their job due to poor health to return to work in the first year after dismissal. However, after 12 months, this figure drops to one in 20.

“When you are out of work for 20 weeks or more, very few people manage to get back.”

p>

By The Office for Budget Responsibility (OBR) estimates that more than half of the 2.8 million working-age people who are inactive for health reasons have been out of work for more than three years, and half a million have never had a job.

The recent surge in sick leave is being driven by the crisis mental health and a sharp increase in back and neck problems. Of the 30,000 people discharged from the program in December, most were excluded due to conditions related to anxiety, depression or stress. Almost 13,000 of them were associated with diseases of the musculoskeletal system.

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