Labour and the sick note

Peter Hain on the Tories' plan to force the unemployed into work will fail. Plus the

In opposition, the Tories show they know little about dealing with the problems of poverty and worklessness that they helped create when in power. Their response to Labour's radical new approach to welfare, with its emphasis on creating skills, has been to become cheerleaders for the reactionary, discredited Wisconsin model of welfare reform, with its emphasis on unemployment and forcing all who can work into jobs.

As Gordon Brown signalled in a major speech on 26 November, employability rather than unemployment is the new challenge.

Over the past decade, huge progress has been made in reversing the Conservative legacy of entrenched unemployment, child poverty and benefit dependency, which tripled the numbers moving to Incapacity Benefit and cemented the "sick note" in the foundations of the economy.

Yet, behind the headlines of Iain Duncan Smith's much-quoted "compassion" for the poor, the Tories still believe poverty and disadvantage are self-inflicted and that the way to get the most vulnerable across the high wire from benefits to work is to remove the safety net. That is why they have latched on to the sink-or-swim philosophy inherent in Wisconsin.

From the late 1980s onwards, as governor of Wisconsin, Tommy Thompson (a Republican, and until recently a presidential hopeful) introduced a system of state-funded welfare. Over time, this meant abolishing "cash assistance" for anyone without children; lone mums with children as young as 13 weeks were forced into work; a cap was put on the benefits caseload regardless of demand; there were time limits on entitlement; and the whole system, including determining welfare eligibility, was privatised.

The result was that between 1994 and 2004, both absolute and relative child poverty increased, with disproportionate impact on black and Hispanic communities. Thousands of families with no work and no welfare were left to rely on charity. Benefit entitlement and distribution had to be taken back under state control when major contractors became plagued by fraud.

It is not surprising that the Tories would ignore the social impacts of such a policy. But behind the claims that Wisconsin reduced unemployment benefit claims to the state by 80 per cent is the fact that the private contractors used were incentivised to redirect people on to federally funded sickness benefits, which increased by roughly 40 per cent during the same period.

The actual reduction in benefit claimants was 15 per cent, a lower reduction than we have achieved in the UK in the past ten years. We have also proved that you can significantly decrease the numbers of families on benefits and still cut both absolute and relative child poverty. Indeed, that has been our motivation.

Although we have got 2.8 million more people into jobs and taken a million off benefits since 1997, there are still far too many on welfare. This is not good for them - people stuck on benefits suffer very high levels of illness and de pression, and their children underachieve. And it is certainly not good for the economy.

Our approach is driven by progressive values of full employment, opportunity for all and social justice. The old definition of full employment was measured in terms of low unemployment, which William Beveridge defined as a claimant count rate of 3 per cent or less. We have hit that every month since 2002. Our new approach defines it in terms of high employment; we aim for 80 per cent from the current 74 per cent.

To achieve that, we need to do still more to help those with disabilities, single parents and the long-term unemployed into sustainable and rewarding jobs: British benefit claimants becoming British workers in British jobs.

It means calling time on our "sick note" culture. Incapacity Benefit still accounts for more than half of the 4.5 million people of working age in Britain on an "out of work" benefit. In the past, they were in effect written off, more likely to die or retire than work again. Yet, with the right help, the majority could work, and the jobs are certainly out there for them among the 660,000 vacancies.

From next year I will replace Incapacity Benefit with a new Employment and Support Allowance. It will include a more rigorous medical assessment and place the emphasis on work, identifying what someone can do, not what they cannot. Roughly half of those who take the assessment are likely to be deemed able to work. We will require people to discuss with a personal adviser what they can do to increase their chances of getting a job when the time is right.

Rightward drift

It won't be easy: the longer people have been out of work, the more expensive, intensive and specialist is the help they need to get back into work and to make sure they can stay there. This requires considerable investment upfront and savings don't come back for some years.

Which is why David Cameron's October announcement that, at a stroke, £3bn can be found to fund tax cuts is fantasy. This is another black hole in Conservative spending plans. Pinning their colours to the mast of Wisconsin leaves the Tories' welfare policy in disarray, more slick spin than substance, and underlines their rightward drift on social policy.

Meanwhile, we have signed up more than 200 firms and organisations to our Local Employment Partnerships to help recruit the long-term disadvantaged jobless - youngsters, over-fifties, the disabled and lone parents. We will ensure they get the right training to be "job-ready". In return, employers will give them a fair shot at the job through a guaranteed interview or a work-trial.

There will be disabled people and lone parents for whom work is not an option, and I will ensure that they will be protected. But most lone parents want to work, not least because while on benefit their children are five times more likely to be in poverty, with a hugely increased risk of physical and mental illness.

Comprehensive and affordable childcare will be vital (increasingly there is provision in schools from breakfast to 6pm). We are encouraging employers to be more flexible and help employees balance work and family responsibilities. More than 80 per cent already do something towards this and our commitment to extend the right to request flexible working will boost this percentage further. We have also announced skills support for people on benefit, as there is evidence that welfare claimants frequently lack the skills to fill the jobs available.

There is a consistent vision of welfare running from Beveridge through Attlee to Gordon Brown: that a fair, prosperous and, above all, cohesive society can only be built on a system of social justice in which everyone who can work is expected to contribute to, and share in, national prosperity, while those who can't are protected.

There were times in the past century when these principles were neglected, with oppor tunities to work in effect denied to millions. Unconditional handouts, which made for a life of stunted ambition and thwarted opportunity, were a reality for too many. Neither should be acceptable to progressives in our pursuit of full employment and abolishing child poverty in our generation.

A new, progressive vision for our welfare system must be firm, fair and effective. The prescription from the right will once again be reactionary, stigmatising and self-defeating.

The dividing line between Labour and the Conservatives could not be starker.

Peter Hain is Secretary of State for Work and Pensions and for Wales

Peter Hain is a former Labour cabinet minister and was MP for Neath between 1991 and 2015 before joining the House of Lords.

This article first appeared in the 03 December 2007 issue of the New Statesman, Russia’s fragile future

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“I felt so frantic I couldn’t see my screen”: why aren’t we taking mental health sick days?

Some employees with mental health problems fake reasons for taking days off, or struggle in regardless. What should companies be doing differently?

“I would go to the loo and just cry my eyes out. And sometimes colleagues could hear me. Then I would just go back to my desk as if nothing had happened. And, of course, no one would say anything because I would hide it as well as I could.”

How many times have you heard sobbing through a work toilet door – or been the person in the cubicle?

Jaabir Ramlugon is a 31-year-old living in north London. He worked in IT for four years, and began having to take time off for depressive episodes after starting at his company in 2012. He was eventually diagnosed with borderline personality disorder last January.

At first, he would not tell his employers or colleagues why he was taking time off.

“I was at the point where I was in tears going to work on the train, and in tears coming back,” he recalls. “Some days, I just felt such a feeling of dread about going into work that I just physically couldn’t get up ... I wouldn’t mention my mental health; I would just say that my asthma was flaring up initially.”

It wasn’t until Ramlugon was signed off for a couple of months after a suicide attempt that he told his company what he was going through. Before that, a “culture of presenteeism” at his work – and his feeling that he was “bunking off” because there was “nothing physically wrong” – made him reluctant to tell the truth about his condition.

“I already felt pretty low in my self-esteem; the way they treated me amplified that”

Eventually, he was dismissed by his company via a letter describing him as a “huge burden” and accusing him of “affecting” its business. He was given a dismissal package, but feels an alternative role or working hours – a plan for a gradual return to work – would have been more supportive.

“I already felt pretty low in my self-esteem. The way they treated me definitely amplified that, especially with the language that they used. The letter was quite nasty because it talked about me being a huge burden to the company.”

Ramlugon is not alone. Over three in ten employees say they have experienced mental health problems while in employment, according to the Chartered Institute of Personnel and Development. Under half (43 per cent) disclose their problem to their employer, and under half (46 per cent) say their organisation supports staff with mental health problems well.

I’ve spoken to a number of employees in different workplaces who have had varying experiences of suffering from mental ill health at work.

***

Taking mental health days off sick hit the headlines after an encouraging message from a CEO to his employee went viral. Madalyn Parker, a web developer, informed her colleagues in an out-of-office message that she would be taking “today and tomorrow to focus on my mental health – hopefully I’ll be back next week refreshed and back to 100 per cent”.

Her boss Ben Congleton’s reply, which was shared tens of thousands of times, personally thanked her – saying it’s “an example to us all” to “cut through the stigma so we can bring our whole selves to work”.

“Thank you for sending emails like this,” he wrote. “Every time you do, I use it as a reminder of the importance of using sick days for mental health – I can’t believe this is not standard practice at all organisations.”


Congleton went on to to write an article entitled “It’s 2017 and Mental Health is still an issue in the workplace”, arguing that organisations need to catch up:

“It’s 2017. We are in a knowledge economy. Our jobs require us to execute at peak mental performance. When an athlete is injured they sit on the bench and recover. Let’s get rid of the idea that somehow the brain is different.”

But not all companies are as understanding.

In an investigation published last week, Channel 5 News found that the number of police officers taking sick days for poor mental health has doubled in six years. “When I did disclose that I was unwell, I had some dreadful experiences,” one retired detective constable said in the report. “On one occasion, I was told, ‘When you’re feeling down, just think of your daughters’. My colleagues were brilliant; the force was not.”

“One day I felt so frantic I couldn’t see my screen”

One twenty-something who works at a newspaper echoes this frustration at the lack of support from the top. “There is absolutely no mental health provision here,” they tell me. “HR are worse than useless. It all depends on your personal relationships with colleagues.”

“I was friends with my boss so I felt I could tell him,” they add. “I took a day off because of anxiety and explained what it was to my boss afterwards. But that wouldn’t be my blanket approach to it – I don’t think I’d tell my new boss [at the same company], for instance. I have definitely been to work feeling awful because if I didn’t, it wouldn’t get done.”

Presenteeism is a rising problem in the UK. Last year, British workers took an average of 4.3 days off work due to illness – the lowest number since records began. I hear from many interviewees that they feel guilty taking a day off for a physical illness, which makes it much harder to take a mental health day off.

“I felt a definite pressure to be always keen as a young high-flyer and there were a lot of big personalities and a lot of bitchiness about colleagues,” one woman in her twenties who works in media tells me. “We were only a small team and my colleague was always being reprimanded for being workshy and late, so I didn’t want to drag the side down.”

Diagnosed with borderline personality disorder, which was then changed to anxiety and depression, she didn’t tell her work about her illness. “Sometimes I struggled to go to work when I was really sick. And my performance was fine. I remember constantly sitting there sort of eyeballing everyone in mild amusement that I was hiding in plain sight. This was, at the time, vaguely funny for me. Not much else was.

“One day I just felt so frantic I couldn’t see my screen so I locked myself in the bathroom for a bit then went home, telling everyone I had a stomach bug so had to miss half the day,” she tells me. “I didn’t go in the next day either and concocted some elaborate story when I came back.”

Although she has had treatment and moved jobs successfully since, she has never told her work the real reason for her time off.

“In a small company you don’t have a confidential person to turn to; everyone knows everyone.”

“We want employers to treat physical and mental health problems as equally valid reasons for time off sick,” says Emma Mamo, head of workplace wellbeing at the mental health charity Mind. “Staff who need to take time off work because of stress and depression should be treated the same as those who take days off for physical health problems, such as back or neck pain.”

She says that categorising a day off as a “mental health sick day” is unhelpful, because it could “undermine the severity and impact a mental health problem can have on someone’s day-to-day activities, and creates an artificial separation between mental and physical health.”

Instead, employers should take advice from charities like Mind on how to make the mental health of their employees an organisational priority. They can offer workplace initiatives like Employee Assistance Programmes (which help staff with personal and work-related problems affecting their wellbeing), flexible working hours, and clear and supportive line management.

“I returned to work gradually, under the guidance of my head of department, doctors and HR,” one journalist from Hertfordshire, who had to take three months off for her second anorexia inpatient admission, tells me. “I was immensely lucky in that my line manager, head of department and HR department were extremely understanding and told me to take as much time as I needed.”

“They didnt make me feel embarrassed or ashamed – such feelings came from myself”

“They knew that mental health – along with my anorexia I had severe depression – was the real reason I was off work ... I felt that my workplace handled my case in an exemplary manner. It was organised and professional and I wasn’t made to feel embarrassed or ashamed from them – such feelings came from myself.”

But she still at times felt “flaky”, “pathetic” and “inefficient”, despite her organisation’s good attitude. Indeed, many I speak to say general attitudes have to change in order for people to feel comfortable about disclosing conditions to even the closest friends and family, let alone a boss.

“There are levels of pride,” says one man in his thirties who hid his addiction while at work. “You know you’re a mess, but society dictates you should be functioning.” He says this makes it hard to have “the mental courage” to broach this with your employer. “Especially in a small company – you don’t have a confidential person to turn to. Everyone knows everyone.”

“But you can’t expect companies to deal with it properly when it’s dealt with so poorly in society as it is,” he adds. “It’s massively stigmatised, so of course it’s going to be within companies as well. I think there has to be a lot more done generally to make it not seem like it’s such a big personal failing to become mentally ill. Companies need direction; it’s not an easy thing to deal with.”

Until we live in a society where it feels as natural taking a day off for feeling mentally unwell as it does for the flu, companies will have to step up. It is, after all, in their interest to have their staff performing well. When around one in four people in Britain experience mental ill health each year, it’s not a problem they can afford to ignore.

If your manager doesn’t create the space for you to be able to talk about wellbeing, it can be more difficult to start this dialogue. It depends on the relationship you have with your manager, but if you have a good relationship and trust them, then you could meet them one-to-one to discuss what’s going on.

Having someone from HR present will make the meeting more formal, and normally wouldn’t be necessary in the first instance. But if you didn’t get anywhere with the first meeting then it might be a sensible next step.

If you still feel as though you’re not getting the support you need, contact Acas or Mind's legal line on 0300 466 6463.

Anoosh Chakelian is senior writer at the New Statesman.

This article first appeared in the 03 December 2007 issue of the New Statesman, Russia’s fragile future