148. How Do You Decide Who Is Too Sick To Work?

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1:14Hello and welcome to The Rest is Money with me, Steph McGovern. And with me, Robert Perston. So there's loads to get through today. we want to talk about welfare reforms, this plan to try and cut£5 billion a year off the cost of the welfare bill, which is rocketing. And I just want to tell you a bit as well about a school I visited last week in a deprived area up in the North East, but are doing amazing things for their kids that I think we could all learn from in terms of education and employability and welfare and everything else. I think it plays into everything we're always talking about. So we'll talk about that too.

1:51But Robert, let's kick off then on welfare reform. So just to go through my big thoughts, I suppose, you know, one is plainly the amount that we're spending on, you know, what used to be called disability and incapacity benefits, rising to 70 billion quid a year over the next few years. it's a serious problem. It has been rising since before COVID by tens of billions of pounds and significant numbers of people writing themselves out of the workplace permanently. All this is really bad stuff. The question for me is how much of this is actually about the structure of the system and how much of this is about other things like the fact that we have genuinely got an explosion of people, particularly younger people, with mental health issues, problems.

2:51How much is it about the fact that work intrinsically in this country doesn't pay? We've got a low wage economy. How much is it about the fact that employers, particularly small businesses, don't feel supported when it comes to either keeping people who have got health problems on their books or hiring new people onto their books. And the big stat that I just need to get out there before we start is if you listen to ministers, you would believe that we have a low work economy. This is nonsense. It is the case that the numbers employed in this country have fallen compared to 2019. That is a fact.

3:38And it is also a fact that that is slightly unusual among developed economies. Most developed economies, the level of employment has returned to its 2019 level. But 75 % of people in this country are in work. And that is way higher than pretty much every competitor economy, including that beacon of alleged extraordinary success, the United States, right? There are four other economies where the employment rate is higher than the UK. OK, one of them happens to be Germany. Another one happens to be Iceland. You know, the notion that we are a failure as an economy measured by how many people are in work is rubbish.

4:34It's just not true. The issues are around, you know, essentially why we've got this explosion of mental health issues. number one, and number two, the extent to which the benefit system itself persuades people not to work or whether there's something else going on. And Robert, on that then, just to put it in context, let me give you some stats around it when we're talking about the welfare bill. So as you say, it currently costs about£65-70 billion a year. That is predicted to rise to£100 billion by 2030. And then the Institute for Fiscal Studies have some really interesting numbers in how many people we're talking about here.

5:17So it's something like 4 million 16 to 64 year olds. So one in 10 now claim either disability or incapacity benefits. And that is up from 2.8 million in 2019. 2019 and I guess to add to what you're saying I guess I've got a couple of hats on when I'm thinking about welfare and sickness and and how we we help the economy so as a business owner I'll come to that in a bit about the kind of way we're trying to manage that this this rise in in people who need time off work or need additional support and how you do that as a small business but just as a human since this has come out i have been like inundated with messages from people who have been talking to me about the the fear that they now have around these welfare changes so for example you know there was one person who is works in financial services she's you know highly qualified but through no fault of her own is is very ill waiting for an organ replacement uh is on an organ donation.

6:26She's on a waiting list for that. And she's really struggling to find any employer who will take her on. There's also someone else with a respiratory condition who's saying that she has to carry oxygen everywhere with her. She really struggles, has struggled to find an employer who's happy that in the winter months, she might have to take a bit of time off work to go into hospital so she's really struggling to find work but at the same time the benefit system's not working for her either because when she went through her pip assessment which to be honest sounds pretty horrendous from what everyone's been telling me she was rejected because the assessor said well she could walk across the car park and climb the stairs and and this is the real punchy thing was dressed nicely.

7:16Like, I mean, on every level, that just sounds ridiculous and pretty barbaric, to be honest, to be told that you're fine for work because you're dressed nicely, but yet you can't find an employer who'll take you on. So there's this real disconnect, I think. And I think the problem is, first up, you've got the government not being great at assessing how whether people are fit for work or not and secondly businesses not incentivized or equipped to be able to take on the people who the government's saying are fit to work so there's this huge disconnect here so clearly there's a lot of people there who are frightened now who for whatever reason through their additional needs their disability are not able to find work and they were frightened they're not going to get the money anymore.

8:07And we also know there's a lot of people who think the money's not enough and they're living in poverty. But on the other side of things, you've also got this kind of medicalisation of every issue in our lives. So here's an example for you. When I broke my arm a few weeks ago, I was due to go on holiday. So I had this cruise booked and it was happened. I broke my arm two days before I was meant to go and I obviously couldn't go so I needed to get a kind of certification off the doctor to say that I couldn't have gone on this trip in order to get my insurance and when I went to the doctor they were like oh yeah you want a fit no okay how long do you want off work like do you want one month do you want two months do you want three months I was like whoa whoa whoa hang on no no I just need this thing I'm going to be fine for work but I just need this thing to get my insurance and I just thought hang on a minute should the question to me not have been okay yeah I might have been in a job where I needed time off work and I might have needed that fit note or signal whatever you want to call it but surely it shouldn't be me deciding how long I have off work it should be a collaboration between you know some type of occupational health person and I just feel like there's just the problem with the system is there's no continuity the people who genuinely need it feel scared and afraid by these assessments which on the whole sound awful but yeah at the same time there's other people where the system that it feels like they're playing the system or they're just not getting the support they need so they just go yeah I won't work because that that'll be easier because I have no idea how I'll work with this ailment it's it's totally disconnected and you're not going to solve it by just making it harder for people to get the benefits when they need them you know it's I don't know what's your take on this Robert in terms of this idea of people playing the system because everyone, you know, there's lots of people are throwing these stats around saying there's very little evidence of benefit fraud for disability.

10:06And yet the numbers going up and up and up in terms of how much we're paying and how many people are on incapacity benefits. So I think there are so many huge and important issues here. Do I think we are living through another version? And do you remember that awful period when if you were on benefits, you were castigated as somehow leeching off the state? The idea was born of so-called benefit street, that basically we were living in a dependency culture where too many people just took advantage of, you know, we're going back decades here. Right. I don't think we're living through a period of people ripping off the state by pretending to be unwell.

10:52That doesn't seem to me to be the issue. Yeah, but I think the fundamental problem is everything in life has been medicalised now. So it's really hard as an employer to accommodate, I guess, everyone's needs. So let me give you a couple of examples that we've been dealing with recently. A lot of young people work in the businesses that have. and we had an occasion recently where one of the employees wanted a day off a paid day off work to get a tattoo and when we said well that is going to be you know you'll need to take that from your your leave your annual leave they said no because it's a medical appointment obviously then what do you mean it's a medical appointment and they said then it's for my mental health it's really important to me i get this tattoo for my mental health now they might have needed that tattoo for their mental health but what do you do in that situation as employer what did you do well we we let her have the day because who am i who are we to decide whether that is a mental health issue or not and that the problem is you it's really hard to work out genuine need and people who, you know, she might genuinely think she needed that for her mental health, so who are we to decide that or not?

12:14So you have to treat everyone the same. Hang on a second, hang on a second. Hang on a second. I mean, really? Really? This is my point. So what happens, Robert, what happens if we'd have said no, right, and then something had happened to her, or if, you know, like I was getting cancelled, what if she then went to the papers and tried to get me cancelled? You know, like you have to, in the end, you have to treat everyone the same because you have no choice. Because we are not, we don't. But you're not treating everybody the same. I mean, because none of your other employees are going to be coming to you with that kind of request, are they?

12:52But how do you know? OK, so here's another example. So one of our employees, part of their role at the end of the shift is to do a kind of tidy up once the day is done. But they said they couldn't do that because they felt it was too triggering. And again, I'm not qualified, we're not qualified to work out whether that is or it isn't. So you end up trying to like work your way through all of this without offending everyone who have got all these conditions and things which are medicalised, which, you know, to me, my attitude is they're taking the piss. but I'm not the judge of that because if you look at the stats now the you know one in ten people are now claiming disability or incapacity benefits more than half of that rise stems from an increase relating to mental health or behavioural concerns so what what do you do as an employer businesses can't all afford occupational health people but maybe the government needs to provide businesses with occupational health people on a more formal but that's my point really which is that what i'm assuming that at the end of the day charlie mayfield's government commissioned review will say is you know particularly for smaller businesses you know they have to have access to the kind of support that would allow them to keep you know struggling individuals on on their books.

14:18And that's, as I say, if you can do that, because just because you've got a mental health issue certainly doesn't mean that you're not a fantastic employee, that you can't be a fantastic employee in the future, that you're not super productive. Obviously, there are times when you hire somebody who, for all sorts of reasons, turns out to be wrong for you. But mostly, most employers I know would much rather keep people who know the business, you know, working with them, but struggle when somebody is going through this kind of sort of traumatic difficulty. And at the moment, you know, the default position is send them to the GP.

14:58GP will sign them off work. And that's, you know, it's bad for the business. It's incredibly bad for the employee because one of the terrible statistics is once you are off work in that way for more than a year, and certainly when you're off work for more than two years, the prospects of you ever going back shrink to infinitesimally small probabilities. Being signed off work in that way, even for a year or two, does terrible damage to the individual and their ability to earn a living. And there's a particular issue at the moment among younger people. And the statistics about the numbers of people, young people who are not in education or work or training, one in 10, these are terrifying numbers.

15:49But not only do we not have a plan from the government, the other thing anybody who's got friends or family who've got mental health issues knows is the health service simply can't cope. You cannot get a talking therapist from the NHS. It's impossible. Right. So, you know, so the idea that you are somehow, you know, overnight by taking money away from some vulnerable people, which is what is happening, going to suddenly create this culture where loads of people who are currently signed off sick for work will be back in work is ridiculous. you know ahead of for example way better provision of mental health support by the nhs to or even a structure you know i think that employers would pay something towards mental health support if it weren't prohibitively expensive um so if for example you had a government-sponsored scheme which broadly speaking brought together actually you can't just bring together existing therapists because there aren't enough of them.

17:00You'd also have to have a scheme to train up vast numbers of people to provide these services. But if you had a government sponsored scheme that effectively provided relatively low cost mental health support to employers, essentially a safety net so that their employees get access to the support they need, that would be great but we're months years away from seeing something like that but also don't you think though like there's so many so many things you have to contend with in life that have been medicalized and shouldn't be that's part of the problem here and maybe what are you saying so i'm not quite sure what you're saying because i don't believe you're saying pull your socks up and get back to work for somebody who's suffering from acute anxiety no but but no i'm saying that people are being told they've got anxiety and they've got things and they might not have that but then so that it might be that there's just they need some careers coaching to make them feel more confident they why does everything have to have a new I mean I don't disagree with you but yeah but I'm not I'm not hang on a minute I'm not saying you're I would be so amazing if we it comes back to the same fundamental point about education that I always go on about we are not equipping young people in school for life.

18:22We're just, we're not telling that, we're not going through all the things you're going to need in your life to be able to deal with the world of work and deal with the pressures of life. We are just putting kids through exams and it would be so much more helpful if we had just lifelong careers coaches or just people to help with when things in your life are overwhelming or whatever. But I don't, it just does my head in that everyone is kind of told when they are struggling with parts of their life and i'm not i'm i'm obviously not talking about serious serious mental health concerns i'm just talking about when people are struggling sometimes they are told you know i've got a friend whose dad died and she went to the doctors because she wasn't sleeping very well and the doctor was straight away right you're depressed put you on antidepressants she's like i'm not depressed my dad's died i'm sad and so it's like we are too quick to medicalize people we should be thinking about other ways of solving this and not just everything is a mental health issue yes there are lots of people i know who are struggling their mental health but there's also people who probably would benefit from just people to coach them through life a bit more to mentor them to you know inspire them give them confidence without them feeling like they've got something wrong with them.

19:37Yeah, but I think that's a very important point. And when I talked earlier about the provision of talking therapies, that is one part of the solution. Another part of the solution, as you say, is to provide much better access to what you would call a life coach or simply train up people who currently work for the DWP to provide much more sympathetic, much more creative advice to everybody, whether or not they're suffering from a physical or mental health challenge or just want a job. But just, you know, again, you want much more sophisticated and sensitive careers advice. But again, the notion that you can simply transform sort of job centres overnight to provide that kind of support is a joke.

20:39And so the bit of all of this, as I say, if you look at the philosophy of what the government's trying to do, it feels to me that the government's got its heart in the right place. but I just think they've put the cart before the horse because if you really want to save money on the benefits bill, you actually have to provide the employment support in a really comprehensive way initially. And if what you're doing is starting by taking money away from people, which is what they're doing, not only will that be cruel to a whole, to vast numbers of people who will be impoverished, and that is a concern.

21:25But also, I just don't believe in the medium term it saves you money. Because if you don't provide the support network to help people into jobs, even on lower money, they will not take work. Yeah, and what you've got currently from this announcement, from these welfare reforms, is loads of people who are disabled, who are not working, who are absolutely freaking out because they think that they're going to get this money cut. And they, you know, they're already telling all these stories about these really awful assessments they've had to go through and how scared they are now. And people whose family members are, you see, and you know, they're seeing their family members worry as well because of it all.

22:11So it just, as you've said, I think we're agreeing, it's been handled the wrong way. It's like, what support system are you going to put in? How are you going to incentivise businesses to take on people who might not be, you know, able to work full time, who will have additional needs that need catered for? How do you incentivise them and prepare them? And also, how do you do that without as well making loads of people feel shit about themselves and scared that they're going to end up with nothing? And that's not got to be good for everyone's health. It just, as you say, it feels like it's the wrong way around.

22:45Fundamentally, at the heart of so much of our problems, including this, is that we are a low wage economy. And unless and until we improve the skills base, we make work pay much more generously for the vast majority of people. We're simply not going to solve this among many other problems. And educate people properly so that they are prepared for all of this. Right. OK, we should probably go for a quick break now. Fantastic. Right, so what should we talk about now? So I was quite interested in your recent visit to a school. One of the things we talked about earlier in the programme, talking about the welfare reforms, was the way that schools, frankly, don't equip young people for the challenges of what we might call, ghastly phrase, the real world, the emotional and psychological challenges in many cases.

23:39But you've had a very positive experience of a school that's doing something a bit different from most. Yeah. And before I annoy every teacher from that summary suggesting that they're not doing enough, my issue is with the curriculum. It's not with what schools are trying to do. But I think what's really interesting about where I live, so up in the northeast of England, is there is a lot of obviously deprivation. We talk about it a lot. And there are a lot of kids on free school meals. So if you look at the average number of kids on free school meals across the country, it's about, I think it's about 25 percent.

24:16Up in the northeast, it's over 30 percent. I was at a school last week where 60 % of the children are qualified for free school meals. 60%. I mean, that is huge. But what was amazing about this school was the fact that they've done incredible poverty proofing so that when you're at the school, you have got no idea who's got money and who hasn't. And how do they do that? Tell me how they do that. There's this incredible atmosphere of genuine, inclusive learning. and the way they've done that is a couple of things right they've got this amazing head teacher she's called Catherine Jones she's been there 23 years she lives and breathes adding value to these kids lives what she has done is being with her business manager Ruth has been like this insane budgeter in the way that they for example they have managed to get a kind of a benefactor type person to pay for their school uniforms every year so this philanthropist a local philanthropist had come into the school, saw what the atmosphere was like and he was like, how can I help?

25:20So I think he gives something like she said 10 grand a year. And that means not a single child in that primary school has to pay for their school uniform. Now, 10 grand doesn't sound like a lot of money. I'm assuming that must be like cost price rather than retail price. But something like that is, you know, none of the kids have to worry about their parents being able to afford their school uniform. There's that. They also. and the reason I was there is I worked with an organisation called Magic Breakfast that helps schools give kids free breakfasts and again they do that with that it's not means tested it's not about who's on free school meals and who isn't it's literally all the kids went can go in on a morning and get you know a bagel or porridge or whatever it is and so I was there to see that in action but you know that a kid starting a day with a breakfast means they're going to be better at learning you you know the stats talk for themselves it's something like kids who are hungry um when they're learning end up getting two grades lower in their gcscs compared to kids who aren't and obviously we know the government want to kind of piloting the scheme of giving all kids free breakfast anyway and they're going through that at the minute sorry does this philanthropist pay for every child's school uniform yeah so so so you don't have to put your hand up and say you know I'm too poor.

26:42So everybody, so there's no stigma attached to it. Completely. Like this poverty proofing. Just interestingly, did you ask the head teacher whether she had looked at doing the same thing for school meals? Because once you've got 60 % on free school meals, there's a pretty strong argument for saying everybody should have it free. Because again, there's no stigma attached to getting it free. Has she thought about trying to raise money so that everybody gets it free? Yes, so everyone does. And also no kids pay for school trips either. So she's just managed to apply for enough grants and funding and manage her budget impeccably so that these kids in school, there is nothing different.

27:24So the kids in the school don't know, within the school, who's got money and who hasn't got money. Yeah, yeah, yeah, completely. That is a great thing. Yeah, they're all going on a school trip to Paris next week. And nobody's paid a penny? No, and some of these kids won't have even left the area where they live before and they're getting to go on a trip to Paris. Can I ask another question? Because one of the things that I hate about some of the newer generation, particularly of academies, is the extreme discipline. So I slightly prefer unruly schools where kids have the confidence to speak and put their hands up.

28:02Whereas some of these schools that are mega successful, you know if if you you know sort of say even the slightest thing out of turn in a in a classroom you're thrown out of the bloody class for an hour which i just i just think it knocks the initiative and the the confidence out of kids even if in some ways it produces an easier teaching environment i just wonder what the what the culture of this school was this culture was amazing like and it wasn't sanitized for me being there like because i went into every single class and went into their assembly and all sorts and i think um i didn't i didn't talk to her about discipline but she didn't seem there were you know the when i went into the classes but these weren't zombie kids they weren't these weren't zombie kids they weren't sort of sort of unnaturally quiet no no no they were all chatting well they were all asking me about bear hunt to be honest that show i've done for netflix because they'd all been watching it.

28:59So everyone was asking me like, what was Bear Grylls like and what was the craziest thing I did? And that was across all the different ages. And also, you know, there was quite a few kids there where English was their second language. And so they were, you know, showing me some of the writing they'd done and they were really confident and happy. And also I chatted to quite a lot of them at the school gate on the way in. And it was so heartening because this is an area like where I grew up and these kids were just dead chatty and confident and I didn't feel like they were being told to line up and walk in and don't speak to each other or stay silent.

29:34They just seemed happy. And like I say, I don't think you can, I've been in enough schools now to know which ones are happy and which ones aren't. And this was definitely one where whatever they've, this inclusivity they've created is really working and you're seeing genuine results from it, from value added. And, you know, I asked her about the issues around child protection. So I have another friend who's a head teacher of a really tough school and she spends 90 % of her time dealing with child protection issues, talking to social services, talking to the police. She has the social services in every week.

30:14Really tricky stuff. So I asked this head teacher, you know, is it after the same for you? Are you having to deal with a lot of social services? And she went, no, we don't have any. She'd have also managed to budget it. So we have one person dedicated to that, to child protection stuff. And actually, we know our family so well. We're on top of it when we think they're looking like they're heading towards problems. We try and intervene early. It's like a utopia of education. And I was saying to her, is Bridget Phillips been here? because it's very close to where Bridget's from, the education secretary.

30:50And she was like, yeah, yeah, she has. She's come in and she's seen it. I'm like, right, this is like a blueprint for how we should do education. And I'm not saying, obviously, we'd need to shed loads of philanthropists to pay for everyone's uniform. But if they found a way, surely other schools should be able to. It also made me think as well, there's probably more we could all be doing to help schools like that, to try and support the kids and have this absolute, I'm obsessed with poverty-proofing that we should not be separating and make any kid know that they are poor or indifferent to other kids because of their parents' wealth.

31:26We should not, kids should not know that as much as possible, as humanly possible. Obviously, they're always going to know a bit, but it would be great if they didn't really understand that. I think that's such an important point, and we should probably wrap up, but I need to ask you one thing that's been bothering me for a few days. As a Middlesbrough person... I know what you're going to ask. You know what I'm going to ask. I mean, do you take pride that Newcastle has won a rubbish trophy for the first time in decades or do you have to be a Geordie or from Saudi to celebrate? Listen, I am obviously as a Middlesbrough fan, like there is a lot of rivalry, but I'm really glad for the region.

32:12I can see already like how the, I mean, I did have a fellow come round to fix my sky on Monday morning and he could barely speak because he was so hungover. So there was a real lack of productivity on Monday. So sky is still not working for you, I'm assuming. Yeah, no, but, but, you know, I actually, I'm glad they won. There'll be people who are, you know, Mackhams and Smoggies who will be like, no, I can't believe she said that. Did I actually, did I ever tell you about the time I went to a Newcastle match with a friend and the local newspaper in Middlesbrough wrote that I was a traitor and they did this whole piece about how I was a traitor because I'd been seen in the Newcastle stands so then to try and counter this and my mum didn't speak to me for about a week I had to go I went to the riverside Middlesbrough's ground bought the full kit and stood outside the front of the riverside and got a photo to say I I'm not a traitor and they're not to put that out and then the you know the paper were like nah she says she's not a traitor but it was such an unbelievable moment but I anything that is positive in the North East I'm very happy for I'd have to say that it's it's interesting because I was thinking about it in my own case so truthfully you know if West Ham wins something or Brentford or Fulham you know I think fine okay yippee but Chelsea Tottenham no thank you I can see that I can see that right thank you very much for listening to us on the rest is money as ever you can contact us our email is restismoney at gmail.com or send messages to our social media pages but that's it from us bye bye bye bye