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Dame Carol Black, inventor of the Owellian ‘​fit note’​ for sick people, has recommended in a report published this week that GPs lose the power to sign working patients off sick for more than the first four weeks of any illness. Instead, an Atos type organisation would decide whether patients were entitled to remain off sick. Black has also urged the scrapping of the assessment phase of employment and support allowance (ESA), forcing sick people to claim JSA until their ESA claim is decided.

The government commissioned an independent review of sickness absence in February 2011 to look at long-term sickness and to consider more specifically how to manage and prevent long-term absence from work. The report considered two main issues: sickness absence in work plus the benefits system.

In respect of sickness absence in work, the report recommends a series of measures designed to support employees to remain in work. It recommends the setting up of a new Independent Assessment Service (IAS) funded by the government. After four weeks of sickness doctors could refer their patients to the IAS for an “​in-depth”​ medical assessment.

From the government’​s point of view such a system could prevent many thousands of people from beginning a claim for ESA because they would no longer be signed off sick and, as with GP certification, it is extremely unlikely that there would be any right of appeal against such a decision.
The report also recommends the government revise fit note guidance so that fit notes “​move away from only job-specific assessments”​. The report also recommends the setting up of a free job-brokering service accessible to anyone off sick for 20 weeks or more.

The public sector is selected for particular criticism. The report recommends that the public sector improves absence management and that the government reviews occupational sick pay in the public sector. Other measures recommended in the report relate to financial and administrative support for employers.

In relation to the benefits system the report recommends abolishing the assessment phase of ESA. This would mean that when unable to work due to ill-health, claimants would first have to sign on for jobseekers allowance (JSA) “​following clear advice and support from Jobcentre Plus and supported by their doctor who has a better understanding of the benefits system”​.
When claimants have had a work capability assessment (WCA), which the report recommends should happen earlier in the process, only then can claimants receive ESA if found to be too sick to work. As happens now, some claimants with the most serious conditions would be awarded ESA without having to have a face-to-face medical assessment.

If found fit for work claimants would remain on JSA.

A major concern with such an approach is that some claimants would fail to meet even the most basic job seeking requirements because of their health, would have their benefits sanctioned as a result and would potentially fall out of the whole benefits system long before their WCA took place.
But from the government’​s point of view, taking sickness certification out of the hands of GPs and forcing sick people to claim a benefit intended for work-ready individuals are both excellent methods for cutting the benefits bill. What happens to individual claimants is an issue of no interest whatsoever..

The report can be downloaded from the DWP website