In 2008, Dame Carol Black said:

Replacing the sick note with a fit note would switch the focus to what people can do instead of what they cannot.

Gordon Brown’s government subsquently replaced the ‘sick note’ with a ‘fit note’ which put a new focus what people could do instead of what they could not.

Yesterday, Rishi Sunak said:

We need to change the sick note culture so the default becomes what work you can do – not what you can’t.

It might seem like money for old role, but nevertheless, let’s focus on what Sunak can do, not what he can’t.

In 2008, 2.4% of all working hours in the UK were lost to sickness absence. By 2022, this had ‘spiralled’—Sunak’s word—to 2.6%. For what it’s worth, at the demise of the last Tory government in 1997, it was 3%.

In 2008, 2.6 million people were waiting for NHS treatment. By 2023, that had almost tripled, from 2.6 million to 7.7 million.

Here’s what Sunak, and perhaps Sunak alone, can do: look at those figures and conclude that people are staying off work too readily, and that the welfare system needs to be—Sunak’s word—’tightened’.