Welfare, work and health
The chancellor has been in the headlines this week outlining proposed welfare reform. Jeremy Hunt has described a ‘social contract’ between those contributing to government revenues and those who cannot and instead depend on the social safety net through state funded welfare.
When it comes to work and health, the crux of the challenge is and has always been ensuring people who are unable to work due to ill health can access adequate state support, while helping others get the support they need to get to work and stay in work. If this is done well it not only balances the books and supports people of all health and function to contribute to the economy and government revenues, but it also drives improvement in health and economic outcomes for those able to work.
However, the disability employment gap is widening and the number of people economically inactive due to ill health continues to increase. Things are heading in the wrong direction. What sort of welfare reform would reverse this trend?
Arguably, focusing on welfare reform, where benefits are at the end of the pathway on work and health solutions, is unlikely to be fruitful. Instead, policy makers need to consider reforms that will support people with work and health outcomes earlier in the work and health pathway.
This relates to what we know about the duration of sickness absence and the chances of successful return to work. The longer someone is off sick, the less likely it is they will ever return to work.
The following timeline outlines key milestones in an employee’s journey to long term sickness benefits
Day one: individual calls in sick
Day seven: individual firsts sees GP team for fit note
Day 112: Individual can begin to apply for Employment and Support Allowance up to three months from when their statutory sick pay ends
Day 196: Statutory sick pay ends- individual moves on to Employment and Support Allowance
Welfare-led interventions will likely come in after day 100 of sickness absence, as the individual begins to apply for longer term state support. Rather than benefits reform, that people begin to navigate months and months into sickness absence and may seem punitive, focusing on work and health support much earlier in the journey will likely be a more effective and timely intervention.
There is opportunity for employer intervention from day one and a route to healthcare professional intervention from day seven. Occupational health support enables individuals, treating teams and employers move in the same direction of recovery and return to work, but is only available to up to 50% of employed people. Those in insecure employment and those who are economically inactive or are self employed face even higher barriers to accessing occupational support. Instead of a focus on welfare reform, policy makers should look for solutions earlier on in the sickness absence journey.