Janet Street-Porter: No wonder there are so many sick notes

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The Independent Online

The Health Minister Alan Johnson's latest big idea is that work is good for our health – and he is campaigning for what he calls our "sick note culture" to be turned into a "well note culture". As a soaraway slogan that doesn't even get past first base, but let's take a closer look at Mr Johnson's reasoning.

At the moment, doctors can sign someone off work for up to six months, after which they are passed to the incapacity benefits system. Mr Johnson wants doctors to be more pro-active in listing what kind of work someone who is ill may be able to do, offering advice about how to get fit enough to work, even if it is in a less active or part-time capacity. He also wants employers to set up clinics and health centres and to be more proactive in looking after the well-being of their workers. Dame Carole Black, the national director for health and work is undertaking a review into sick notes and will be making recommendations to the Department of Health in March.

The number of people claiming incapacity benefit has trebled to 2.7 million over 30 years – one of the highest levels in the EU, and even GPs agree that the current system is inflexible and in urgent need of reform. Only half those signed off work for six months suffering from back pain ever return to work, and that figure drops to a quarter if they have been off for a whole year.

The CBI estimates that a massive 175 million working days are lost annually because of illness – they think that sick notes focus too much on symptoms, and remove people for what seem arbitrary periods of time.

But surely the problem is, how can doctors really understand what their patients may or may not have to do at work. Isn't Mr Johnson expecting them to take on a role for which they do not have adequate information?

How can doctors encourage someone who is unskilled and has been unemployed for a long period of time back into the world of work? Their problems may be psychological, as well as physical. The benefit system itself needs to be more flexible, so that people receive some support during a period of rehabilitation for work.

Finally, Mr Johnson's task should be to make the world of work more attractive and healthy for workers. A new survey shows that the average manager puts in the equivalent of 40 days a year unpaid overtime – a staggering 89 per cent regularly work more than their contracted hours. The proportion working more than two hours a day unpaid overtime in most UK sectors from engineering to IT to education to health and social care is more than a third.

Tomorrow the TUC is staging a Work Your Proper Hours Day to bring attention to the fact that too many employees keep the UK afloat by working for nothing. The health implications of this amount of overtime on a regular basis are immense – and these are the workers not claiming incapacity benefit or sitting in the doctor's surgery waiting for a sick note.

When you add in the length of time now spent travelling to and from work and the fact that economic necessity forces many women into full-time work on top of bringing up a family, it's not surprising that the nation's health is suffering. Mr Johnson is right to reform sick notes, but employers need to understand that getting the right work-life balance is largely their responsibility and not something that can be devolved to over-worked GPs.

Palace drama is a royal treat

Hard to know which is more compelling, the testimony at the Diana inquest, or events unfolding on ITV's drama series The Palace, starring Rupert Evans as fun-loving Prince Richard, left.

Mohamed Fayed's conspiracy theories, outlined earlier this week, saw him name a cast ranging from MI6 to the "Dracula" royal family, a whole clutch of Lords, and various members of the Blair government.

Meanwhile, in the fictional Palace, Abi, the Prince's Private Secretary, has snogged him, but he doesn't know she's been writing a book about her experiences. This soap has been top viewing in the Dallas or Dynasty mould – if ITV have any sense, they'll be commissioning series two.

* Last year I made a film for television about foie gras, visiting rural France to witness the force-feeding of geese. The process was so disgusting that I could never eat the stuff again.

Spanish farmers are developing what they call "ethical" foie gras – placing feed out on the hillsides for the geese, which are free range, to eat, and then culling them humanely. The livers are smaller than the force-fed variety. This foie gras has won medals at international food fairs, but top chefs aren't keen. Personally I found it just as tasty, and guilt-free.

Now animal rights protesters have been campaigning to get foie gras taken off the menu at restaurants – but the tactics adopted by some extremists in Cambridge leave a lot to be desired. One Michelin-starred restaurant has been sprayed with slogans, received anonymous letters and had a brick chucked through its window.

It's important to understand that some foie gras is perfectly acceptable, but I fear the Animal Liberation Front aren't interested in the difference.

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