Sicknote culture: The role of GPs in reform

Major reforms of the benefit system are set to dramatically reduce the number of British workers on long-term sick leave, but experts are warning that the government must start working more closely with GPs to get people back in the workplace.

A new, more stringent system of testing the capacity to work will be introduced next year and the Department for Work and Pensions (DWP) is predicting that as many as half those taking it will fail.

According to officials, the proposed test is far more robust and will reduce the number of people entering the sickness benefit system by as many 20,000 every year.

The reforms are designed to focus more on what individuals are able to do at work, rather than simply signing them off sick, and will be backed by a package of support to help people access the skills they need.

Dr Sayeed Khan, chief medical adviser at manufacturing body EEF says the measures would help ease the huge problems around long-term sickness, but that much more was needed to train GPs.

“The current system isn’t fit for purpose so I think the new test should be welcomed. It will be much better at assessing people’s fitness for work, and it’s vital we look at what people can do, rather than what they can’t.

“There needs to be changes to the sicknote system, but even under the current rules there is scope to work more closely with GPs and raise awareness of how the system can be better,” he explains.

Khan, also a Health and Safety commissioner, says that getting people back to work and supporting them is vital for both their own health and the needs of society.

The results of a pilot scheme where GPs were given more training around sickness absence are currently being assessed, and Khan says there needed to be more engagement with doctors if the problem is to be resolved.

“There needs to be a cultural shift because worklessness is so damaging and it seems to have rocketed in the past few decades,” he says.

A study released last week seems to back these claims, by showing that working can actually have a beneficial affect on health, attitudes and beliefs.

The Institute for Employment Studies (IES) found that active partnerships between people and their workplace has real potential for improving health problems.

Darcy Hill, lead author at IES, said the impact on the economy and the social welfare system is pronounced and expensive.

“Implementing workplace health interventions in the most successful way requires the commitment of employers, the co-operation of workers and a sensible way of bringing together their collective needs.”

Currently, more than 2.6 million people claim incapacity benefits at a cost to the country of more than £12.5bn. At a time of crippling staff shortages this is clearly untenable.

Ben Willmott, employee relations adviser at the Chartered Institute of Personnel and Development (CIPD) agrees that more should be done to get GPs on board.

“The government rhetoric about ‘ending sick-note Britain’ will ring hollow until it does more to stem the tide of people falling into long-term sickness in the first place.

“What employers are crying out for is more support from GPs when they are dealing with people who are in danger of slipping into long-term sickness absence – particularly with problems with mental ill-health. All the evidence suggests that a phased return to work in the relatively early stages of such health problems can be far more beneficial than the disappointingly common response of GPs to simply ‘sign people off for another couple of weeks,” he explains.

The new Work Capacity Assessment will be introduced in October 2008 when Incapacity Benefits are scrapped and replaced with the new Employment and Support Allowance.

The new test will look at physical and mental disabilities and examine a person’s ability to carry out tasks likely to be needed by employers – such as using a computer keyboard or a mouse.

Work and Pensions secretary Peter Hain, says the move is about improving people’s long-term prospects and helping them understand how employers can cater for their needs.

“We know that many people want to work – work is good for you and your long-term wellbeing and we don’t think it’s right that in the past people were effectively written off. We want to work with people to get them back into jobs and help them stay there,” Hain says.

However David Coats, associate director of policy at The Work Foundation, warns the changes must not force disabled people into unsuitable jobs.

“Policy is facing in the right direction, but it is important to stress that forcing disabled people into bad jobs is not the name of the game.

“Any attempt to toughen the benefit test for the proposed employment support allowance must be accompanied by a renewed and serious commitment to expand training, skills and apprenticeships,” he adds.

It’s clear that a more holistic approach involving government, employers and GPs is needed to combat the so-called ‘sicknote’ culture, but this must be balanced sensitively with the needs of people with genuine problems.

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