'Work is good for mental health': Sunak bats off criticism as he seeks to end 'sick note culture'

Personal Independent Payment (PIP) was one of the areas the prime minister focused on in his speech, and the reforms he announced will likely cause alarm to those claiming it, as Political Correspondent Carl Dinnen explains

Rishi Sunak has set out his "moral mission" to reform the welfare system as he called for more people to get back to work.

The prime minister warned against "over-medicalising everyday challenges and worries of life" in a speech on Friday, as he raised concerns about growing numbers of people deemed medically unfit for work, which have risen sharply since the pandemic.

He repeatedly stressed the system as it stands is letting people down by not being focused enough on the work they might be able to do, rather than what they can't do.

Of those who are economically inactive, half report suffering from depression or anxiety, said the PM - but data shows most of those report these illnesses as secondary conditions rather than the main one keeping them out of work.

The PM's proposals have been met with fierce criticism, with disability charity Scope describing it as a "full-on assault on disabled people".

Labour leader Sir Keir Starmer said the government "has broken the NHS" and urged it to instead focus on reducing the waiting list to get people back to work.

The British Medical Association echoed Sir Keir's calls and criticised Mr Sunak's “hostile rhetoric on sicknote culture” and cited the need to tackle lengthy waiting lists in the NHS to get people the care they need.

The PM rejected suggestions his welfare reforms were lacking in compassion, saying “the exact opposite is true”.

"Of course, those with serious debilitating conditions should never be expected to work," he said.

"But if you have a low-level mobility issue, your employer could make reasonable adjustments."

Mr Sunak insisted the changes – including benefits being stopped if someone does not comply with conditions set by a work coach and a pledge to “tighten” the work capability assessment (WCA) – are not solely about cutting costs.

Other proposed changes include having so-called specialist work and health professionals charged with responsibility for issuing fit notes instead of GPs – in a bid to end the “sick note culture”.

He suggested greater medical evidence could be required to substantiate a claim for personal independence payments (PIP), and that some people with mental health conditions may be offered talking therapies or respite care rather than cash transfers.

The PM said: “We now spend £69 billion on benefits for people of working age with a disability or health condition.

“That’s more than our entire schools budget, more than our transport budget, more than our policing budget.

“And spending on personal independence payments (PIP) alone is forecast to increase by more than 50% over the next four years.”

Disability equality charity Scope has questioned whether the announcements are being “driven by bringing costs down rather than how we support disabled people”.

The charity described proposals as feeling “like a full-on assault on disabled people” branding them “dangerous” and saying they risk leaving disabled people “destitute”.

Scope’s James Taylor said calls were “pouring into our helpline” from concerned disabled people, adding: "In a cost-of-living crisis looking to slash disabled people’s income by hitting PIP is a horrific proposal.

“Sanctions and ending claims will only heap more misery on people at the sharp end of our cost-of-living crisis.”

The speech comes a month after Work and Pensions Secretary Mel Stride faced criticism for an interview in which he said there was “a real risk” that “the normal ups and downs of human life” were being labelled as medical conditions which then held people back from working.

Comments were described as “disappointing” by the president of the Royal College of Psychiatrists, while the Centre for Mental Health charity said they risked “belittling people’s struggles”.

On Friday, in his vision for a “new welfare settlement for Britain”, Mr Sunak pledged not to dismiss or downplay illness, but called for a “more ambitious” approach to helping people back to work.

Mr Sunak described the government’s approach as saying “people with less severe mental health conditions should be expected to engage with the world of work”.

He referred to challenges presented since the pandemic, with the government saying a “significant number of working aged people have become inactive due to long term sickness which has in large part been driven by mental health conditions”.

Since 2020, the number of people out of work due to long-term sickness has risen significantly, reaching a record high of 2.8 million people as of February 2024, according to the latest estimates from the Office for National Statistics.

He also said there is a “growing body of evidence that good work can actually improve mental and physical health”.

The government said recent NHS data showed almost 11 million fit notes were issued last year, and said many are repeat fit notes “issued without any advice, resulting in a missed opportunity to help people get the appropriate support they may need to remain in work”.

Responses from healthcare professionals, employers and people with lived experience will be sought in a call for evidence launched on Friday.

He said: “Building on the pilots we’ve already started we’re going to design a new system where people have easy and rapid access to specialised work and health support to help them back to work from the very first Fit Note conversation.

“We’re also going to test shifting the responsibility for assessment from GPs and giving it to specialist work and health professionals who have the dedicated time to provide an objective assessment of someone’s ability to work and the tailored support they need to do so.”

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“Much of the current record levels of inactivity are because our public services are crumbling, the quality of jobs is poor and the rate of poverty amongst disabled households is growing.”

He added: “We hope this system has been designed with disabled people and has been crafted to work with them not against them.”

Alison McGovern, Labour’s acting shadow work and pensions secretary, said: “A healthy nation is critical to a healthy economy, but the Tories have completely failed on both.

“We’ve had 14 Tory years, five Tory prime ministers, seven Tory chancellors, and the result is a record number of people locked out of work because they are sick – at terrible cost to them, to business and to the taxpayer paying billions more in spiralling benefits bills.

“Today’s announcement proves that this failed government has run out of ideas, announcing the same minor alternation to fit notes that we’ve heard them try before. Meanwhile, Rishi Sunak’s £46 billion unfunded tax plan to abolish national insurance risks crashing the economy once again.”

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