Rishi Sunak will today claim that Britain is suffering from a ‘culture of illness’ as he warns there is a risk of ‘over-medicalising’ normal concerns by diagnosing them as mental illnesses.
In a speech on how to reduce the number of people getting sick from work, the Prime Minister will say the government plans to try to get “work and health professionals” to issue fit notes, with social distancing of general practitioners who fulfill this role.
Sunak will say he is concerned about the rise in long-term illnesses since the pandemic, largely caused by mental health problems, with 2.8 million people now “economically inactive”.
On mental health, he will say that he will “never dismiss or downplay the illnesses that people have,” but he will also argue that there is a need to “be more honest about the risk of over-medicalizing the daily challenges and concerns of life”. .
His language echoes that of Mel Stride, the Work and Pensions Secretary, who has claimed that doctors too often ‘label or medicalise’ conditions that have historically been seen as ‘the ups and downs of life’.
As part of a new attempt to overhaul the system, Sunak says one part of the reforms will test whether responsibility for issuing sick notes should be shifted from ‘overburdened’ GPs to ‘specialist work and health professionals who have the dedicated time require an objective assessment of a person’s ability to work and the tailored support he/she needs to do so.”
The law was amended last year to allow any doctor, nurse, pharmacist, physiotherapist or occupational therapist to issue a suitability certificate, in addition to GPs, who traditionally oversee the system. No. 10 last night would not clarify whether the government intended to further expand the criteria to allow non-medical professionals to also issue or amend eligibility certificates.
Sunak will suggest in his speech that GPs will ‘standard’ report people sick for work, with 11 million fit slips issued last year, with 94% assessing people as ‘not fit for work’. No. 10 claimed that the Fit Note system has “opened the floodgates for millions of people to be thrown out of work and onto welfare without getting the right support and treatment they need to stay in work”.
However, extracts from the speech released to the media on Thursday evening did not address the issue of the NHS’s mental health capacity, with NHS bosses warning that “overwhelmed” services were unable to cope with a large post- Covid increase in the number of people needing help.
Dr. Sarah Hughes, director of mental health charity Mind, said: “We are deeply disappointed that the Prime Minister’s speech continues a trend in recent rhetoric conjuring up images of a ‘mental health culture’ that has ‘gone too far’. .
“This is harmful, inaccurate and contrary to reality for people across the country. The truth is that mental health care is at a breaking point after years of underinvestment, with many people becoming increasingly ill as they wait for support.”
She added: “It is deeply damaging to suggest that it is easy to both get a job and access benefits. It is an insult to the 1.9 million people on a waiting list for mental health care, and to the GPs whose expert judgment is being questioned.”
James Taylor, strategy director at disability charity Scope, said: “Much of the current record levels of inactivity is due to the fact that our public services are crumbling, the quality of jobs is poor and poverty is growing among disabled households. ”
Employment experts said the number of fit notes issued – 11 million last year – has not increased since before the pandemic.
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“Fit notes are not the driving force behind the increase in economic inactivity. They are not responsible for the high unemployment caused by poor health. Economic inactivity is caused by people who are already unemployed and have been unemployed for a long time,” said Tony Wilson, director of the Institute for Employment Studies.
Plans to reform the fitnote system were first announced by Jeremy Hunt in the autumn statement. A new service called WorkWell will be launched this year in 15 areas, described as “early intervention work and health support and assessment”. This will largely be aimed at people with mental health and musculoskeletal conditions, with people with good notes attending sessions with ‘work and health coaches’ in an attempt to get them back to work.
The last Labor government introduced ‘fit notes’ instead of ‘sick notes’ in 2010 to put a new emphasis on doctors certifying what patients can do, rather than what they cannot.
Alison McGovern, Labour’s acting secretary for shadow work and pensions, said: “We’ve had 14 Tory years, five Tory prime ministers, seven Tory chancellors, and the result has been record numbers of people excluded from work because they are ill. terrible costs to them, to businesses and to taxpayers who pay billions more in ever-increasing benefit bills.”
Ruth Rankine, the director of the NHS Confederation’s primary care network, said its members “have long called for a review of the fitness note process, which can be managed more effectively by trained professionals helping people back to work”.
But she added: “The deeper problem isn’t the system – it’s that people are sicker than they were and they have more complex health care needs. This is why it is vital that the Government begins to view investment in the NHS as an explicit tool for economic development and also that the Prime Minister leads a national health improvement mission to shift the focus from simply treating disease to promoting health and well-being. ”