The Commission says the report is a “comprehensive plan for a modern 21st century health creation system” that is “aimed at kick starting a once-in-a-generation rethink of national health policy, to revitalise both wellbeing and the UK economy”.
Its analysis concludes that health could solve many of Britain’s most pressing economic challenges, including low growth and productivity.
New findings include:
- As of the end of 2023, an estimated 900,000 extra workers are missing from work. If trends continue, economic inactivity due to sickness could hit 4.3 million by the end of this parliament, up from 2.8 million today.
- These 900,000 missing workers could mean an estimated £5bn in lost tax receipts in 2024, while better population health could save the NHS £18bn per year by the mid-2030s.
- Some occupations – including elementary occupations, and caring, leisure and service roles - have seen particularly high rates of workers becoming inactive due to sickness
The Commission says: “Our health is a key determinant of our ability to participate in work. But work is also important to our health. This link extends beyond whether we have work or not – which is important – to whether we have good work and fair terms or not.”
It adds that coercive mechanisms such as increased conditionality and sanctions rarely work: “Instead, we propose that we increase the extent to which people can try work over a period of months without risk of losing their existing award (either their work capability status, their exemption from reassessment or through tapering). This ‘try first’ approach would give people greater means to not only find work, but to find appropriate work that suits for the long term.”
However, it says that there are still many potential pitfalls that could mean work remains “a high-risk prospect (or perceived as a high-risk prospect)” for Disabled people and people with chronic conditions in receipt of benefits, including:
- the risk of reassessment for limited capability for work will mean many claimants prioritise maintaining the security of their current award, rather than seeking or trying work;
- any new “health element” of the social security system - even if detached in theory from work capability is still likely to make work riskier for recipients, in an otherwise highly conditional and coercive social security system;
- there may be contradictions between personal independence payment and work capability that cause people to worry about losing out if they try work;
- even if reassessments of capability for work were paused, a lack of public trust in the benefits systems means people might perceive a risk of finding work, even where there is little, “without an iron-clad and simply put government guarantee”.
The recommendation that a period in which anyone with a disability or chronic health condition can try work – with no risk to either their benefit status or the size of their award should be “formally and explicitly integrated into our social security strategy, whatever the shape of any other reforms.”
“The benefits of this scheme in making work more viable (including by changing people’s perception of the risks) will help reduce rather than increase DWP costs (particularly in the context of costs rising rapidly).
This ‘right to try’ would be supported by better integration of NHS services and job centres – an idea that the new government has indicated is under consideration.”
In addition, the Commission recommends:
- higher standards for healthy work
- a focus on job security
- a legal right to disconnect from work
- the introduction of 'support for people outside employment' - specialist employment support for Disabled people and people with long-term conditions
- joint working between the DWP and NHS to design and trial inclusive routes into employment.
Ken Butler, DR UK’s Welfare Rights and Policy Adviser, said: “The current UC rules already mean that if someone has a limited capability for work (LCW) and loses universal credit (UC) due to obtaining work they will retain their (LCW) status if reclaiming UC within six months.
“However, this is not a guarantee that they will not then face a new work capability assessment (WCA).
“If the Government is to introduce reforms to the WCA then this should only be done in co-production with Disabled people to understand what effective models are for supporting Disabled people to move towards work.
“Support should be offered to prepare for work without any threat to benefits. This must include the removal of conditionality and benefit sanctions.
“Disabled people face disproportionate barriers to accessing work and staying in work. The systemic reasons for this are many, including discrimination in the workplace and societal barriers such as inadequate transport, lack of training and a lack of support for those who acquire disabilities while in work.
“The Disabled People’s Manifesto and the Disability Employment Charter outlines many ways that these barriers should be tackled.”
The Commission’s report Our greatest asset: The final report of the IPPR Commission on Health and Prosperity is available from ippr.org.