Jeremy Hunt, the chancellor, is expected to introduce measures to bring people with mental illness back into the workforce
"The economic times we are going through on top of the traumas of the pandemic [have combined to create] higher levels of distress in the population”. Andy Bell, chief executive, Centre for Mental Health
Chancellor Jeremy Hunt is to use his Autumn Statement to announce plans to reduce the number of people unable to work because of long-term mental health problems, the Financial Times has reported.
The paper said that Hunt and his colleague Mel Stride, the work and pensions secretary, are concerned about the rise in numbers of economically inactive people since the Covid pandemic. The increase has exacerbated an existing labour shortage and driven up the size of the benefits bill.
Hunt noted last month that only 45% of British workers had access to occupational health services. Stride’s plan to get more people back into work includes tax breaks and subsidies for workplace occupational health services. His allies told the FT that “a whole system change” is needed, including reforms to how sick notes are issued by doctors, so that GPs could refer patients to support schemes linked to work as part of their treatment. “People are currently being channelled into the benefit system when the reality is lots of them could work,” said the government source. “Good work can be part of the recovery journey.”
The Office for Budget Responsibility (OBR) estimated last month that a rise in health-related economic inactivity has cost the government £16bn more per year since the start of the pandemic. This was the result of a combination of a higher benefits bill and reduced income from tax revenues.
The number of people who are economically inactive due to long-term sickness is now 2.6m, up 23% over the past decade. Approximately £53bn is currently spent on sickness and disability benefits, which the OBR predicts will rise to £69bn by 2027.
Last month the Office for National Statistics (ONS) reported that more than 1.35m, or 53%, of those inactive because of long-term sickness reported that they had depression, bad nerves or anxiety in the first three months of 2023, although the majority reported it as a secondary health condition.
The number of “fit notes” issued by GPs (effectively a “sick note” that signs off a patient from work) has increased significantly over the past few years, from 3.1m in the year to March 2021 to 4.3m in the year to March 2023, according to NHS data. Mental and behavioural disorders were the most common diagnosis given on the notes, accounting for 350,000 of occurrences last year, up from 311,000 in 2020.
Over 60% of all mental health episodes requiring a “fit note” last year lasted more than five weeks, while a quarter lasted more than 12 weeks.
Andy Bell, chief executive of the Centre for Mental Health, a research and campaigning organisation, said “the economic times we are going through on top of the traumas of the pandemic” had combined to create “higher levels of distress in the population”.
He would like the government to consider financial incentives for companies to improve mental health support for their staff, comprehensive waiting time standards, similar to those for physical health, an increase in the mental health workforce and a more flexible sick-pay system.
Sir Norman Lamb, chair of the South London and Maudsley NHS Foundation Trust, told the paper that mental health was a “massively under-recognised contributor” to both “our productivity problem” and the drop-off in people active in the labour market since the pandemic. “It deserves much more attention than it is currently getting,” he said.
Lamb, the Liberal Democrat minister of care between 2012 and 2015, said that a “significant commitment” to invest in prevention services was needed, rather than simply providing more beds in acute psychiatric wards for people in crisis. “We need to shift from repair to prevention,” he said.
The steep rise since the pandemic in the number of people off work because of long-term sickness is cause for concern. From the government’s point of view, it means lost tax revenue, a higher benefits bill and a shortage of people to fill vital jobs. But it’s also a problem in its own right: something is seriously wrong when 2.3m people are too ill to work, many of them because they are experiencing mental health problems. While the proposals to introduce support schemes and better occupational health to encourage people back into work are sensible, Andy Bell is also right to ask for more flexibility in the sick pay system, and an increase in the mental health workforce to offer better help for workers experiencing mental ill-health. This is not a problem that can be dealt with through a quick fix.