Clampdown on sick notes3rd May 2008
As someone who spends a significant amount of time monitoring healthcare newsflow I can tell you that the last month or so has been atypical.
Strangely, for this time of year, there has been little in terms of new policy initiatives and the politicians have been relatively quiet. It seems the state of the economy - and the knock-on effect on the banking sector - is currently diverting attention; whatever the cause the NHS political football is presently not in play to any significant degree. Unless you can forge a link with our flailing economy...
When money is tight - and in macro-economic terms it hasn't really got much tighter than it is at the moment - it always helps to review where what money we do have is going. Very timely then the announcement that 175 million work days are lost each year due to illness, costing the economy £100 billion in lost productivity, benefits and taxes (page 5). By coincidence £100 billion is roughly the annual budget of the NHS so this means that we spend just as much treating people as we lose in revenue due to their ill health, effectively a double-whammy. It also means we can quantify the total cost of ill health to our nation which is of the order of £200 billion. To put this in perspective, the total government spending budget for 2008 is just over £600 billion.
Keeping people at work - or getting them back to work as soon as possible - therefore has to be a priority, not just to avoid the short term costs of lost productivity and taxes but also to prevent people from entering the downward spiral of dependency which has seen the number of people claiming benefits triple over 30 years.
There are lots of aspects to this problem but a key issue is the ease in which sick notes are obtained. In this respect Alan Johnson appeared to be ahead of the game; he had already initiated discussions with GPs to encourage them to be more proactive in tackling Britain's sick-note culture (page 6) before the above figures were announced. Or maybe he just had access to the figures before the rest of us but I prefer to give him the benefit of the doubt.
Specifically, Mr Johnson wants GPs to write "well notes" setting out what work an employee is able to perform rather then just signing them off. He is not "asking GPs to police the system" - countering an understandable concern of doctors (page 16). However, with 2.7 million of our population currently on benefits, it is clear an overhaul is needed, not just to boost our economy but also to boost the mental health of those in the system whose esteem would be increased by being in meaningful employment.
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