Starmer ditches plans to end Britain’s ‘sick note culture’
Scheme to tackle worklessness abandoned even as crisis in long-term illness grows
Sir Keir Starmer has scrapped reforms designed to end Britain’s “sick note culture”, The Telegraph can reveal.
A flagship Tory plan announced last year proposed to let work specialists, rather than GPs, decide whether employees were fit enough to do their jobs.
The reforms were an attempt to tackle the surge in sick notes – now officially called “fit notes” – after they more than doubled from 5 million in 2015 to 11 million in 2022, fuelling Britain’s worklessness crisis.
However, a Labour minister in the House of Lords confirmed in a written response to a parliamentary question this week that the drive has now been abandoned.
Baroness Sherlock said: “The Government has no current plans to reform the fit note (Statement of Fitness for Work) in terms of the content of the form or the healthcare professionals who are legally allowed to issue them.”
A Department for Work and Pensions (DWP) spokesman confirmed it was the first time the Government has said publicly it is not going ahead with the reforms. A Labour source argued they were lacking in detail.
The number of people deemed unable to work owing to long-term sickness hit a record high of 2.8 million in early 2024, up from 2 million before the Covid pandemic.
The increase, in part driven by an increasing number of people citing mental health illnesses, has put growing pressure on the Treasury’s revenues.
Tens of billions of pounds of taxpayer money is expected to be needed to cover the UK’s benefits bill, including supporting those on long-term sickness, between now and the next general election due in 2029.
Critics of the current sick note system have questioned whether there is enough incentive for GPs, who get paid for appointments where sick notes are signed off, to reject requests.
Given the tightness of the public finances and the current push to find savings, the Treasury, No 10 and the Department for Work and Pensions are aligned in the need to identify potential welfare budget cuts.
Rishi Sunak’s plan was to use figures with more work expertise, rather than just GPs, to sign off sick notes.
Mr Sunak said last year: “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.”
He added later: “We’re also going to test shifting the responsibility for assessment from GPs and giving it to specialist work and health professionals who have the dedicated time to provide an objective assessment of someone’s ability to work and the tailored support they need to do so.”
A formal call for evidence was then issued by the Tory government. It warned “there is currently not enough capacity or specific work and health expertise in primary care to make an effective assessment of a patient’s ability to undertake work”.
The move to ditch these plans will prompt fears that the actions of Liz Kendall, the Work and Pensions Secretary, will fail to live up to her tough rhetoric about the need to tackle the ballooning welfare budget.
Sir Keir has also been criticised for once again giving in to the unions after the British Medical Association (BMA), the trade union which represents doctors, criticised the Tory plans.
A senior BMA figure accused Mr Sunak of “hostile rhetoric” on sick notes.
The move to ditch the sick note reforms follows Sir Keir’s decision to hand train drivers and junior doctors above-inflation pay rises in an effort to end strikes.
‘Capitulation’ to unions
Helen Whately, the Tory shadow work and pensions secretary, said: “Changing how fit notes work is essential to getting the benefits bill down.
“But despite Labour talking tough in public, in private they’ve capitulated to the unions and canned our plans. This is bad news for taxpayers, and it’s also bad news for people being written off under the current system.
“Getting the welfare bill down requires tough decisions, but in seven months in office Labour have achieved absolutely nothing.”
Lady Sherlock, a work and pensions minister, also confirmed that the Government would still be taking forward eight new “trailblazer” sites that will test new ways of helping people back to work.
It is understood that three of these sites will look at how fit notes are working, meaning there remains some wider interest in how they are being used, even though the Sunak proposal has been dropped.
A DWP press spokesman could not offer any additional information about what specific changes to fit notes will be explored in these pilot schemes.
The three trailblazer sites will be in the North East, South Yorkshire and West Yorkshire. Specific locations and more details about how they will work are expected to be unveiled in the coming months.
A DWP spokesman said: “We inherited a broken welfare system, with a spiralling benefits bill and soaring inactivity levels. We are already testing new approaches to the fit note system in economic inactivity hotspots as part of our wider plan to Get Britain Working.
“We will also bring forward all-encompassing reforms to the entire health and disability benefit system through our Green Paper in spring.
“As part of this, we will overhaul the broken assessment process which currently pushes people towards welfare instead of work, taking into account the role of the fit notes process.”
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