‘Sick note’ crackdown: The charts and figures behind Sunak’s welfare reform claims

Rishi Sunak has vowed to end a purported “sick note culture” with a new “moral mission” to reform the welfare system if re-elected, calling the number of economically inactive young people in Britain a “tragedy”.

In a speech on Friday announcing welfare reforms, the prime minister said: “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.”

Mr Sunak pointing to figures showing that 94 per cent of the 11 million fit notes signed off by GPs last year denoted people as not fit to work.

Is the number of sick notes rising?

The latest NHS figures on the number of fit notes issued by the NHS from April 2023 to December 2023 show 7.9 million people were issued with a note. These include fit notes issued by other staff as well as doctors including nurses and occupational therapists.

This could well reach the 11 million figure recorded for 2022-23.

The number of people deemed “not fit for work” was 10.3 million in 2022-23. The remaining were individuals under categories such as “maybe fit for work”, “phased return” or “adapted work”.

How many people take sick notes due to mental health reasons?

Mr Sunak suggested that some Personal Independence Payment recipients with mental health conditions could be offered treatment instead of cash.

He claimed half of those individuals had depression or anxiety, without stating that these are reported to be secondary conditions in most cases.

In fact, Office for National Statistics analysis found in 2023 that nearly four in 10 people unable to work due to long-term sickness had five or more health conditions, underscoring the often complex range of ailments leaving people unable to work.

While the number of these individuals reporting depression and anxiety rose from 900,000 to 1.3 million in the four years to 2023, NHS figures show that mental health reasons accounted for just 10 per cent of sick notes issued between January 2023 to December 2023.

Mr Sunak’s comments come amid a rising waiting list for mental health services which is estimated to be at 1.9 million – up from estimates of 1.6 million in 2022.

In 2022-23, the target for the NHS was to have 1.8 million accessing talking therapy services. The NHS received 1.7 million referrals in 2022-23, however only 1.2 million started treatment.

Centre for Mental Health chief executive Andy Bell said: “There is clear evidence that mental ill health is becoming more prevalent among younger people in particular. And mental health services are struggling to grow fast enough to keep up with rising demand for essential support.

“Suggesting that this is due to an over-medicalising of the everyday challenges of life, while too many people struggle to access the mental health support they need, may discourage people from seeking vital support when they need it.

“Being in work can be positive for many people’s mental health, but only in workplaces with good working conditions, fair treatment and decent pay.”

Will the crackdown disproportionately impact women?

NHS figures show fit notes issued to female patients are consistently higher compared to male patients with 59 per cent of notes issued for women according to the most recent data.

How long are people off work?

The highest proportion of fit notes are issued for five to 12 weeks, according to NHS data. This is across all categories of illness.

Several unions have warned the prime minister the more pressing issue facing the public is the NHS’ waiting list which stands at 7.6 million.

UNISON general secretary Christina McAnea said: “The prime minister has promised and failed to cut NHS waiting lists.

“Worse still, his government has damaged the public services people were once able to rely upon to get better and stay healthy.

“Lengthy waits for NHS operations and treatment have left people languishing at home, too sick or injured to work. That’s a personal tragedy for them and terrible for the economy too.”

“Instead of hostile rhetoric on benefits, ministers should be recruiting to fill the huge gaps in the NHS workforce. That would increase capacity and allow more patients to be seen.”

How are people faring under the current system?

In his speech, Mr Sunak suggested that, if re-elected, his government could seek to reduce the number of people receiving Personal Independence Payments, potentially by looking at being “more precise about the type and severity of mental health conditions that should be eligible”.

But figures from the Trussell Trust food bank network suggest disabled people are still struggling under the current system.

While those receiving the daily living component of PIP receive between £72.65 and £108.55 a week, and £75.75 for the mobility component, the Trussell Trust has warned that it is “deeply concerned about the unacceptably high numbers of disabled people facing hunger and hardship”.

Sixty-nine per cent of people referred to food banks in the Trussell Trust network are disabled, and 48 per cent of disabled people have faced food insecurity, according to the group’s director of policy Helen Barnard.

“This represents a serious moral failure in our social security system,” Ms Barnard said.