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Is Sunak right about "sick-note culture"?

The phrase “sick note culture” is inaccurate, said a lecturer at Liverpool John Moores University

UK prime minister Rishi Sunak announced plans to reform welfare to tackle “sick-note culture” last Friday (19 April), if the Tories win the upcoming general election.

The reforms included stopping GPs from being able to sign people off work in order to target a "spiralling" disability welfare bill and to prevent “fraudsters” exploiting the “natural compassion and generosity” of the British taxpayer.

The prime minister is likely to call a general election in the second half of 2024.

Sunak said that specialist work and health professionals would be given the role of signing people off work instead of GPs. This proposal comes after the government legislated in 2022 to increase the number of medical professionals who could issue fit notes to include nurses, occupational therapists, pharmacists and physiotherapists, as well as GPs.

Sunak referred to limiting sick leave as a “moral mission” and added: "We don't just need to change the sick note, we need to change the sick-note culture so the default becomes what work you can do, not what you can't.”

A month earlier (21 March), the minister for work and pensions, Mel Stride, suggested that Britain’s approach to mental health awareness could be going too far and that people were being signed off work too easily for mental health conditions.

Read more: Mental health awareness could be "going too far": HR responds

Gemma Dale, business lecturer at Liverpool John Moores University, told HR magazine that the phrase “sick-note culture” was inaccurate in the context of long-term sick leave.

She said: “It seems to imply that this is a form of skiving, and that people who are fit to work are deliberately not doing so. I have seen no evidence for this. 

“The fact that people are off sick from work is not indicative that this is a broader cultural issue that needs to be solved, nor that these people are anything other than actually sick.”

Last month (28 March), mental wellbeing platform Headspace revealed that 49% of HR leaders had seen an increase in mental health absences in the last year. 

This included 40% of respondents who said that work stress had contributed to suicidal ideations and substance abuse problems.

Last week, Sunak said government spending on benefits for people of working age with disabilities and health conditions totalled £69 billion, which he described as unsustainable. However, he said that his proposed reforms would allow support for “those who genuinely need it”.

Dr Sarah Hughes, CEO of the mental health charity Mind, said: “This is harmful, inaccurate and contrary to the reality for people up and down the country. 

“The truth is that mental health services are at breaking point, following years of underinvestment, with many people getting increasingly unwell while they wait to receive support.

“To imply that it is easy both to be signed off work and then to access benefits is deeply damaging. It is insulting to the 1.9 million people on a waiting list to get mental health support, and to the GPs whose expert judgement is being called into question.”

Read more: HR leaders see mental health absences rise, report shows

Dale noted that employers could tackle long- and short-term absence by supporting employers with their specific needs.

She continued: “For a starter, see the latest guidance from the CIPD and Department for Work and Pensions. Above all, help people with reasonable adjustments. Disabled people often report issues with obtaining adjustments.

“Also look at your own data. Why are people sick? What managers do people work for? What in your organisation might be contributing to this? Tackling these issues is the key to reducing both short- and long-term absence.”

Vicky Walker, group director of people at Westfield Health, told HR magazine that employers should ensure employees continue to feel connected to work while on long-term sick leave, to help them return to work smoothly.

She said: “We’re grateful that we don’t have many cases of long-term sickness at Westfield Health. When someone is off sick for a long time, it’s important to work closely with them.

“When a worker is struggling with long-term sickness, we also ensure that teams and managers keep in contact with them to retain their sense of connection with work and their colleagues.

“This helps with a smoother return to work over an appropriate and healthy period of time.”