How does Wes Streeting think hospitals have the capacity to persuade the long-term sick into work - Jayne Dowle

May I suggest that instead of posting job advisers in hospitals to persuade the long-term sick into work, Wes Streeting actually spends some time on the wards? He’s keen to launch a new scheme to encourage those hospitalised with mental health problems to find jobs and reduce the benefits bill.

Many a doctor, nurse, ward manager and health/social worker will have heard of the Health Secretary’s plans and rolled their eyes in frustration. Just what they need; another job role to account for.

NHS sources say employment advisers, who already work with some GPs, are often seen as “peripheral” to care and are often not taken seriously enough by doctors in specialist mental health services.

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Does Streeting really think it’s that easy? Has he ever spent time, day to day, deep in the heart of an NHS ward, where key information goes inexplicably missing, emails sit unanswered, messages aren’t relayed and yes, staff often call in sick themselves, on their knees with the sheer pressure of it all?

Health Secretary Wes Streeting addresses the the Labour Party Conference in Liverpool. PIC: Stefan Rousseau/PA WireHealth Secretary Wes Streeting addresses the the Labour Party Conference in Liverpool. PIC: Stefan Rousseau/PA Wire
Health Secretary Wes Streeting addresses the the Labour Party Conference in Liverpool. PIC: Stefan Rousseau/PA Wire

Perhaps he is yet to try and navigate personally the labyrinthine and disconnected relationship between the NHS and social care, which isn’t just for the needs of the elderly. Adding an in-house employment coach to the mix seems a step too far, and certainly too early to roll out before pernicious existing issues are tackled.

Something must be done about the number of people not working, but is a hospital ward really the best place to start?

The number of people out of work due to ill health is growing by 300,000 a year, according to analysis by the Health Foundation thinktank and Labour’s plan comes as it seeks to cut public spending and boost growth.

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The Office for Budget Responsibility has forecast disability welfare spending to be £39.1bn in Britain in 2023-24, about 3.1 per cent of the government’s 2024-25 spending of £1,226bn.

Only an irresponsible government would ignore this. However, adding yet another layer of bureaucracy to a system already falling apart under its own stress without actually considering the complexities of patient care is nothing more than a sticking plaster.

The Health Secretary’s plans, which have the support of work and pensions secretary Liz Kendall, are understood to want to expand a model used at the Maudsley psychiatric hospital, in south London, which deploys employment support, such as job seeking, CV writing and interview training to in-patients.

It's reported that through the Maudsley trial, some 40,000 people with mental health problems accessed employment support.

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Norman Lamb, the chair of South London and Maudsley NHS foundation trust, told the Times newspaper, which first reported the plans, that “every clinical team across the country [should be] thinking employment is a legitimate and important goal of recovery for people”.

It's laudable, but what works in the setting of a specialist hospital and what might work across the whole of the NHS are two very different things. What has measured success in a hospital dedicated to looking after people with mental health conditions should come with massive caveats when thrown into the wider mix.

James Taylor, director of strategy at the disability charity Scope, acknowledges that Labour’s plans are “nowhere near as harsh as [the] previous government in terms of rhetoric” but argues that the focus on cutting the welfare budget “doesn’t recognise public services are failing and not supporting people early enough”.

There will be people in hospital suffering from a wide spectrum of mental health-related conditions and others suffering from acute physical problems which make it difficult, if not impossible, to go to a workplace. Mental and physical symptoms – loss of confidence, fear of the outside world, difficulties with self-care, organisation and time management, poor mobility, heart problems – often overlap.

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As Taylor suggests, we need “a compassionate welfare system that recognises where people are with their health in relation to work. Currently employment support is largely punitive and there is a culture of mistrust and fear. Any reforms must address these issues first, not simply replicate them in different settings.”

And this is true. Jobcentre Plus – you’ll find one in almost every town and city - exists to help people find jobs and also administers benefits. The last time I was in our local one in Barnsley, accompanying a friend who had fallen on hard times, let’s just say it wasn’t the most invigorating of places.

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