The £85bn reason we need to get sick people back into work

With nine million working adults neither in work nor looking for it – and three million claiming due to long-term sickness – Chris Blackhurst asks whether plans for employers to be more involved in fit notes can ever work

Despite its relatively upbeat title, the Government’s ‘Keep Britain Working’ report makes for grim reading. Headed by Charlie Mayfield, the former chair of John Lewis, the study finds that a large number of people are in fact not working due to ill-health and disability, and that total is rising.

His review, ahead of the Budget, finds that as many as one in five working-age adults – more than 9 million – are now what’s termed “economically inactive,” meaning they are neither in a job nor looking for one. For almost 3 million, the main reason is long-term sickness – the highest level on record.

If those figures are alarming, so too is the financial strain on the UK economy from what Mayfield calls a “quiet but urgent crisis.” The cost to the public purse, businesses and the individuals themselves is put as much as £85bn a year. The burden on the state caused by lost output, sickness benefits and the burden imposed on the NHS is described as “unsustainable.”

Until now, whether someone is too ill to work is largely regarded as a matter for them and their doctor. They present a sick note to their employer, and they are off. Mayfield wants that relationship to change, with the employer getting much more involved: “What we are proposing is a fundamental reset in terms of how health is handled in the workplace. We’re saying we have to move from [a] situation where, for most people, health is for the individual and the NHS – we have to move from that position to one where health becomes a true partnership between employers, employees and the health services generally.”

It is, he acknowledges, “not a small move, but a big move, and a fundamental reset.”

‘One factor in why so many people are not working is down to NHS waiting times. Employers on their own will not solve the problem: the NHS must step up as well’ (Getty)

He is right there. Asking employers to step up is fraught with difficulty. There is the added expense for them. In this suggested new set-up, bosses will be playing a more supportive role, actively helping staff return, possibly looking for other jobs they can do. That requires additional manpower, time and input on the management side.

Which can be absorbed if you’re a major corporation, but is not so straightforward if you’re a smaller enterprise. Mayfield’s report is backed by the government, and it claims more than 60 employers have so far agreed to take on his recommendations. They include household giants like British Airways, Tesco and Nando’s.

Others, though, may view this as something they do not want or need right now. They are still coping with the impact of last year’s surprise increase in employers’ national insurance, with the likelihood of further tax hikes to come. This, too, while Labour’s workers’ rights reforms are passing through Parliament.

Mayfield agrees businesses are finding the going tough at present, but says companies realise the advantages of investing in employee health and that doing more was a “win-win” for them and for the economy as a whole: “Employees must be in the lead. Some may resist that message amid tight margins and slow growth. But many already recognise they carry the cost of ill-health every day.” It will be interesting to see whether his enthusiasm is universally shared.

There is a certain irony in Mayfield publishing his findings just as John Lewis’s Christmas advert airs on TV. His former employer wants us to spend more money, while he is in effect imploring John Lewis and fellow employers to also spend extra.

There are confidentiality issues. Someone’s health is usually between them and their doctor. Quite how involved the employer can be in their recovery and supporting them without being privy to their records must be questioned.

What Mayfield would like to achieve is for workplace health schemes to receive official accreditation so they become fully integrated with the NHS app. Ultimately, the use of sick notes could be reduced and even disappear completely.

That is quite an ambition. One factor in why so many people are not working is down to NHS waiting times – they require treatment, possibly for chronic pain, and they cannot obtain it. Employers on their own will not solve the problem: the NHS must step up as well. That may be something the government would prefer to duck.