Sunak’s misleading sick note numbers

The reason this becomes difficult to recall is that the topics on which Sunak decides to announce grand plans often feel a combination of pointless and cruel. Driving small boat immigration to the top of the political agenda has greatly increased the threat posed to the Tories by Reform, rather than diminished it.

Last week, Sunak added a new crackdown to his growing list – this time on those people who are too ill to work. The speech announcing it was a sufficiently muddled wealth that kindly hearts might inquire as to the health of whoever wrote it, as it seemed very much the product of persistent brain fog.

The core of Sunak’s complaint was the increasing number of people signed off as unable to work for health reasons, who have been judged as such by the state and so receive out-of-work benefits. 

But this issue was rapidly muddled by Sunak announcing reform to the “fit note” system – a “fit note” is what almost everyone still thinks of as a sick note, renamed by an earlier iteration of this 14-year-long Tory government. 

A sick note is essentially a note from your GP to your employer saying that you’re genuinely ill and unable to work, and are generally required for absences longer than five days. They are uncontentious and their logic is fairly well understood: if your employer is going to pay you not to work (first your salary and then eventually statutory sick pay), it is reasonable that a medical professional confirms that you’re sick. 

The fact it’s your GP making that assertion means that everyone agrees they’re qualified to make that determination, and also suggests that they are able to offer your treatment as appropriate for whatever troubles you. Sunak’s new system would hand over that determination to someone without a medical qualification, employed instead to try to reduce the number of sick notes. 

In this system, your employer would get a note from someone with no medical qualification, saying whether or not you’re really sick, and whether that private employer should still pay your wages. The logic is non-existent.

Worse was to come, though: through a neat bit of elision, Sunak’s remarks managed to suggest that around half the people who are judged to be unable to work are signed off with depression or anxiety – with a heavy implication, even in these supposedly enlightened days on mental health issues – that many of these people should be working.

Except these comments were premised on a misunderstanding of the figures, which are carefully and clearly explained by the Office for National Statistics. It is true that just over half of people judged medically unable to work have depression or anxiety – a total of around 1.35 million people.

However, the vast majority of those people – more than one million of them – had depression or anxiety as a secondary condition, rather than the reason for which they were signed off. Being ill for a long time can itself be a driver of both conditions, even without exacerbating it with the financial insecurity that comes with navigating a hostile welfare system. 

It is certainly a fiction that there are vast numbers of people signed off solely with depression or anxiety, let alone that it is somehow easy to get signed off with such conditions. 

Either No. 10 is so incompetent that they failed to realise what the numbers they were looking at meant, or else it is so callous that it didn’t care. Which of those two messages is it trying to send to voters – and who on earth thinks that’s a vote winner?