United Kingdom's Sick Note Culture
Skip to main content

Sick note culture
May 30, 2024

An analysis of Rishi Sunak’s plan to tackle the misuse of sick notes and address the underlying labour shortage concerns

Rishi Sunak recently announced his plan to tackle the UK’s so-called ‘sick note culture’. The prime minister said that it is economically unstable to sustain the rise in the number of people who are on long term sick leave and welfare benefits post pandemic. Is he right? We decided to do a fact check.


  • According to Financial Times, the number of people on long-term sickness leave at the end of 2023 is no greater than the 2019 numbers. The UK has the lowest sick leave numbers compared to any other advanced economy, thanks to the low statutory entitlement for sick pay. 
  • When considering a different perspective, the ONS’s reweighted labour force survey data provides insights into how long term sickness and the continuing labour shortages have resulted in an increase in net migration and pressures that accompany it.

Sunak’s Plan

Currently, a sick note (technically known as a statement of fitness for work) is needed if absence from work goes on for longer than 7 days, and can be issued by a GP, nurse, occupational therapist, pharmacist or physiotherapist. Rishi’s proposal is to make it harder for employees to get sick notes by introducing a more objective assessment of their fitness to work and taking this job away from GPs. There are also plans to toughen up the eligibility criteria for PIP (personal independence payments) for those with disabilities.

Our Thoughts – Is this a good idea?

The Positives

  • Economic benefits: There will be economic advantages, of course. By making it more difficult to obtain sick notes from GPs, employees will be encouraged to return to work sooner, which will minimise disruptions, save employers the cost of sick pay, and reduce the burden on other employees who have to cover for absence.

The Negatives

  • Public health consequencesIf employees are discouraged from taking sick leave when they are infectious with colds or flu for example, there will be an added risk of transmission of these illnesses to healthy employees. We only have to think back to 2020 to know that other infectious diseases can become a very serious threat to public health quickly. Employers must be careful of this and be mindful of their general duty to ensure the health, safety and welfare of employees.
  • Access to healthcare: As the news headlines remind us on a daily basis, timely access to primary and secondary healthcare can be difficult in the UK. Employees who do not have access to private healthcare provision may struggle more to get treated and recover quickly. If this means that they could be denied sick pay then the policy could disproportionately affect employees who are vulnerable and already economically disadvantaged.

So, while this headline grabbing policy may seem like the magic pill to end the UK’s sickness problem, the reality is that there are complex issues at play which require much more detailed prescription.