Is the UK Suffering from a “sick-call Culture”?

Rishi Sunak said last week it was a “moral mission” to reform social care in the UK, cutting benefits and getting people with health problems back to work.

The rise in the number of people not working due to long-term illness, which has risen by 850,000 following the pandemic, is economically unsustainable, unaffordable and unfair to taxpayers, the Prime Minister said – and is also fueling migration.

According to Sunak, this occupational health crisis is at least partly due to a “sick-in culture” in which young people are “over-medicated” for their everyday fears, disability benefits are “abused” and too many people are offered cash instead of therapy.

However, official data suggests that both this diagnosis and the proposed solutions are flawed.

Are too many people reported sick?

It doesn’t look like there is a “sick leave culture” in the UK. Data published by NHS Digital shows the number of fit notes issued by GPs has fluctuated during the Covid pandemic, but was no higher at the end of last year than in 2019.

On average, workers in the UK take fewer sick days each year than in almost any other advanced economy – and this appears to be closely linked to the UK’s relatively poor statutory sick pay rate.

A full-time minimum wage worker would receive little more than a tenth of their usual wage if they were on sick leave for a week and their employer did not top up the statutory rate – almost the lowest replacement rate in the OECD. Many low-income earners are not even qualified for this.

How quickly are utility bills rising?

Since 2019-2020, the number of working-age adults receiving a means-tested disability pension because they are classified as unfit or unable to work has increased by 700,000 to 3.2 million. The Office for Budget Responsibility, the financial regulator, estimates it could reach 3.8 million by 2028-29.

Over the same period, claims for disability benefits – which are not means-tested but are intended to help people with higher living costs – have shot up from 2.3 million to 3.3 million and are expected to reach 4.6 million by 2028/29. to reach.

The Institute for Fiscal Studies, a think tank, estimates that more than 10 percent of the population now receives at least one of these benefits, with a growing share receiving both benefits.

The increase is affecting all age groups, but has been greatest among young people. The IFS has found that a 20-year-old is just as likely to receive health-related benefits today as a 39-year-old was in 2019. A high proportion of new claimants have a mental or behavioral disorder.

Do people medicalize the everyday stresses on their mental health too much?

Sunak’s claim that young adults are over-pathologizing everyday fears seems unfounded. Louise Murphy, an economist at the Resolution Foundation think tank, notes that most claims made by 16- to 25-year-olds relate to ADHD, autism and learning difficulties.

Helen Barnard, director of policy at the Trussell Trust, said many older people had both physical and mental health problems – and were unemployed not because they were depressed, but “because they are ill, unemployed, struggling to access support and are faced with financial difficulties.” depressing”.

Analysts have cited deteriorating health among the population – coupled with longer NHS waiting lists – as one of several factors that could be responsible for the rise.

The cost of living crisis could also cause people who previously felt it wasn’t worth applying for benefits to apply, noted Tom Waters, deputy director of the IFS. It was also “plausible, but far from confirmed” that stricter conditionality for unemployment benefits would encourage people to instead apply for more generous disability benefits if they were able to do so.

Does illness hinder the workforce?

Although the rise in benefit claims is strong, unreliable data makes it difficult to know the extent to which deteriorating health is affecting the UK workforce.

The Office for National Statistics’ labor force survey – the main source of data on inactivity – shows a shocking 850,000 rise in the number of working-age adults who say a long-term illness prevents them from working since the start of the pandemic.

This increase in health-related economic inactivity is, according to the ONS, the main reason why the UK working population has not returned to its pre-Covid size. Employment levels are still 110,000 lower than at the end of 2019.

But a decline in survey responses has made the LFS unreliable — at least since last summer and possibly since 2020 — so this data comes with a major health warning. This contradicts payroll data and the ONS labor market survey, both of which point to much stronger employment and labor force participation.

“I worry that much of the analysis and policy recommendations may be based on flawed data,” Harvey Daniell, a Bank of England economist specializing in labor markets, posted on X following Sunak’s speech.

Will a crackdown on benefits solve a workforce crisis?

Political analysts fear Sunak’s crackdown on benefits – even though it could reduce the cost of welfare to the exchequer – will make sick and disabled people poorer rather than help them find work. “It’s easy to cut disability benefits, but it’s hard to get people into work,” Waters said.

The Prime Minister wants to tighten eligibility for incapacity and incapacity benefits and in some cases limit their generosity, while giving people quicker access to therapy and tailored work support.

In November the OBR said plans to tighten incapacity benefits announced in the autumn statement would save the Treasury £1bn a year but would only increase employment by 10,000 – while an expansion of therapy and work support could put 40,000 people into work.

The government will publish details of a stricter regime for disability benefits. The company is also launching local pilot programs that integrate work and health support under the WorkWell brand. But an existing job support program aimed at people with disabilities will be abolished.

Barnard said some investment had been made in the type of health and employment support needed, but ministers were pushing a “really damaging” narrative that implied people were “emerging as long-term sufferers”. . . because they don’t bother.”

The Trussell Trust had seen more disabled people using its food banks because they couldn’t afford essentials – not even bus fares for hospital appointments, she said, adding: “We need a social security system that enables you to get well .”