Lovewell’s logic: Is the government right to reform the fit note?

Debbie Lovewell Tuck Editor Employee BenefitsWhat is your view of the government’s plans to reform the fit note system?

In a speech on 19 April, prime minister Rishi Sunak announced that the government will take steps to transform the sick note culture in a bid to reduce the number of individuals that are deemed unfit for work. He cited the statistic that of the 11 million fit notes issued in 2023, just 6% were signed ‘fit for work’. The government, therefore, plans to design a new system where people have easy and rapid access to specialised health and wellbeing support to help them back to work more quickly.

In order to achieve this, the government also plans to move responsibility for assessing individuals on their fitness for work, and issuing fit notes, away from GPs to specialist health and work professionals. They will be tasked with providing an objective assessment of someone’s ability to work, along with the tailored support they will require to do so.

But is this really the right approach? Many who are currently deemed unfit for work may well have the desire to return to employment, but are hampered by the current length of NHS waiting lists for both diagnosis and treatment. According to the latest Referral to Treatment data, published in February 2024, 7.54 million cases were on waiting lists, comprising 6.29 million individual NHS patients. Of these, approximately 3.2 million patients had been waiting over 18 weeks, while more than 305,000 patients had been waiting over a year for treatment. For individuals with very treatable conditions, such waiting times will undoubtedly have increased their length of absence from work.

This inevitably places greater pressure on employers which face having to cover individuals’ roles, resulting in potentially higher costs, depending on the organisation’s sick pay arrangements. While many employers now offer access to healthcare benefits, such as private medical insurance (PMI), second opinion services and mental health support to name a few, this places an additional burden on those that do not already do so but wish to facilitate faster access to treatment for their workforce.

Moving responsibility for determining whether individuals are fit for work and in what capacity away from GPs may help to ease current pressures on GP services, but the government would need to ensure that the as-yet-unspecified specialist health and work professionals received sufficient training in both mental and physical health. In the past week, some concern has been expressed that individuals could be deemed fit for work when this is not actually the case.

If the government’s plans do genuinely help individuals to access the treatment and services they need more quickly, then great. However, there is the concern that some may be pressed into returning to work before they are truly fit or capable of doing so.

Overall, the consensus seems to be that, if it presses ahead with its plans as they currently stand, the government must ensure no individual is penalised for a health condition or disability. If its aim is simply to foster the return of as many individuals to the workplace as possible, without addressing some of the fundamental causes of long-term absence, this will undoubtedly prove detrimental in the long term.

Debbie Lovewell-Tuck
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