Reducing Sick Notes – Why the Government Should Accept the Recommendations from the Sickness Absence Review

Guest Blog By Stuart Carroll

Followers of the BBC comedy programme ‘Mock the Week’ will be aware of the “If this is the answer what is the question” round.  Dara O’Brian provides an answer and Hugh Dennis et al have to find the question. An example would be the answer is “Gordon Brown”.  The question was, “Who claimed to have saved the world?”  Not just farcical, but alas also sadly true.

Since entering office, Iain Duncan Smith (IDS) – the reformist Work and Pensions Secretary – has been doing something similar at the DWP: giving his Department the answers and then rightly demanding that chastened civil servants start asking the right questions in order to identify better policy prescriptions.  Let me give you an example.  The answer is £15 billion a year, 300,000 people, and 77% of cases. What is the question?  How much does sickness absence cost the UK; how many people are off sick long-term; and what proportion of GPs in a recent survey admitted they had signed off their patients with afflictions that were not physical?

IDS has also been playing out his own version of “Scenes we would like to see”; the final round in Mock the Week. Up on the DWP microphone, the Work and Pensions Secretary has declared his determination (and this time it would be foolhardy to underestimate it however quiet he may be) to see less people on incapacity benefit (currently 1.5 million) and more in work; an accountable and transparent assessment system; and an end to the scandal that is benefit abuse and the Les Battersby generation of incapacity cheats.  X-Factor fans will recall IDS “calling out” the ear-splitting Wagner on BBC Breakfast following allegations the tone deaf contestant had been claiming incapacity benefit for a frozen shoulder.  This was all despite his on-stage cart-wheeling antics and rather bizarre sinuous shape throwing.

However, unlike comedy and reality TV programmes, there is nothing to mock about Britain’s entrenched problems pertaining to long-term absenteeism. Rather, there is plenty to lament and, as IDS has positively set out, plenty to correct.  It is for this reason that Dame Carol Black, National Director for Health and Work, and David Frost, Director General of the British Chambers of Commerce, were commissioned in February 2011 to perform an independent review into this area.  Their findings, published this week, are refreshing and get to the crux of the issue.  On first reading, they are worth backing and I hope the DWP pretty much implements the proposals in their entirety.

The Government-backed review has recommended that people should be signed off for long-term sickness by an independent assessment service and not GPs, and also proposes the idea of tax breaks for firms which employ people who suffer from long-term conditions.  It is estimated the change could send 20% of people back to work and save £350 million a year in social security payments.  The time is now to correct decades of fudged policy.

The brutal truth is that successive governments – both Labour and Conservative – have consistently bottled it having lacked the stomach to tackle head on one of the greatest abuses and anomalies in our social security system.  Not dealing with it has been the easy thing to do.

The UK’s “head in the sand” policy has largely been a consequence of calculated political decisions (arguably correctness too) not to “rock the boat”, particularly in areas like my Father’s hometown of Newcastle where structural unemployment has been historically high following the fall of lame duck industries such as coal and shipping.  From Thatcher to Brown, governments have knowingly sought to depress unemployment figures in an attempt to demonstrate success in economic policy and in doing so been willing to see potential unemployment claimants signed off on incapacity benefit.  I mean are there really 1.5 million people who cannot work in any capacity whatsoever even part-time or voluntarily for a few days or hours a week?  There is a proportion that is severely infirm and incapacitated undoubtedly, but 100% is frankly impossible to believe.

This outdated approach might constitute good politics, but it is bad policy to borrow a Tony Blair phrase – something New Labour knew a lot about.  It has also proven to have a deleterious inter-generational effect by fostering a culture of joblessness and work-shy households where not to work is often the norm rather than some tragic exception.

Indeed, I recall at the tender age of 6 inquisitively asking my Grandfather why the next door neighbour had been indefinitely signed off on full pay by his GP at the “youthful” age of 51 (14 years before his scheduled retirement) due to a rare condition called “hot feet” (I am honestly not making it up). As an innocent “bairn”, I found this even more perplexing given that Mr. Y (for legal/human rights reasons, I cannot name the “gadgie”; for political reasons, I cannot make any reference to his cat!) seemed to have no problem walking the dog three times a day; sinking a few bottles of Brown down the local boozer; building his toy train set in the garden shed; and most unbelievably of all breezing off for regular holidays to tropical bounties such as the Caribbean and Mediterranean (you can only hope he put lashings of sun cream on those hot feet).

As my Grandfather laconically explained, “It is a racket Stuey lad, but it is easier for the Government to sign him off than make him redundant and have him parked down the job centre”.  No more questions Your Honour.  Before I had properly learnt to read and write, I had understood the absurdity of the UK’s incapacity (then called disability) benefit policy. Instead of tackling the UK’s employment challenges, the policy was to simply paper over the cracks.  If someone offers you early retirement on full pay, why not take it?

Of course, it is critical that those who are truly incapacitated with severe disabilities, and who are clearly unable to work, are fully protected and supported, and continue to receive the welfare and support they rightly deserve.  The principles of fairness, compassion and opportunity must always be the backbone of our society, and when I see all that tax come off my monthly payslip I am comforted by the fact that some of that cash goes direct to help fellow citizens less fortunate than myself.  Yet the recommendations in the Black/Frost report offer the chance for the UK Government to finally take steps to start dealing with this problem and implement a system based on principles and meaning rather than the mockery of decades gone by.  After all, there is nothing really that funny about answers like £15 billion, 1.5 million, 300,000 and 77%.  Just ask IDS.

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