Devil’s advocate: DWP and the riddle of the missing numbers

Practising occupational health is like reading crime fiction: as you investigate health issues, you’re never quite sure who did it until the final pages.


There’s no better time than the summer to sit down with a good book to solve the latest mystery. This summer’s hot new release for would-be OH investigators was by one of our favourite authors, the Department for Work and Pensions. Intriguingly titled No-One Written Off, readers might wonder to what this refers. Turning page one is like boarding the Orient Express or a river boat on the Nile. Exactly who’s not being written off?


It’s not most Incapacity Benefit claimants who are being ‘written off’. In the UK, we’ve managed to almost quadruple their number in the past 30 years – we have 2.6 million and rising. The aim is to get less than half of these back to work (by some indeterminate date in the future). At the current rate of reduction (140,000 in five years), it will take about 35 years to hit this target. It also means that we’ll still have more than twice the number of claimants as there were 30 years ago.


It’s not those absent from work due to illness who are being ‘written off’. They may get a new certificate. However, despite the fact that the latest debates on this have been running for at least a few years, there won’t be consultation on this until later this year. So absentees are only being ‘written off’ for the time being.


As the OH story unfolds in chapter three, new threads are introduced to hold the reader’s attention.


Apparently, “action planning is a proven technique to… help employers consider the steps they can take to enable an employee to make a swifter return to work.” Is action planning a “proven technique” in our efforts to reduce sickness absence or even plan a return to work? Any evidence is omitted. But, like any good work of literature, it is important that we don’t let scientific facts reduce our enjoyment of the creative fantasy.


The presence of Job Centre Plus advisers in GP surgeries is being expanded. So far, these advisers have only had 500 referrals each year (out of a potential pool of 2.6 million). But like any good work of fiction, it is important not to let the overwhelming implausibility of success reduce our enjoyment of the story.


There are other threads for the avid reader to pursue, such as who are the steering group of specialists that Dame Carol is leading to develop a National Strategy for Mental Health and Employment? But the biggest mystery of all happens to be the simplest: what happened to consultation question 19? Although the government has provided 29 questions to aid consultation, question 19 has mysteriously disappeared. It seems from its position, it would have related to some aspect of Dame Carol’s report. But perhaps it referred to a legendary elixir of working life. Perhaps we will find out in the sequel. And perhaps we will never know.


Consultation runs until 22 October. No-one may have been written off, but a 19 has. Now there’s a real mystery to get your teeth into this autumn.

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