Putting work coaches in GP offices is a model that has been piloted before, and is currently being trialled in South Yorkshire – reportedly with some success. It adheres to a key principle of engaging people in jobseeking – if people can’t or won’t come to employment services, you have to take employment services to them, delivering support with and through people they already trust. This has come through clearly in our co-design working with people who have experienced unemployment in Greater Manchester to develop new support services or improve existing ones.
But this model has its risks – particularly if the government goes further and puts pressure on GPs to sign a smaller number of people off sick. An asset-based model for the fit-note – focusing on what people can do, not what they can’t – has widespread support. But bringing punitive-seeming measures into GPs office risks damaging the trust that makes the model appealing. There are also concerns that this could lead to further ‘presenteeism’, a major drag on productivity.
We should be wary of any policy solutions which involve a ‘stick’ – a tighter sanctions regime, or more work-search requirements for part-time Universal Credit claimants. The problem that the government seeks to solve is one of economic inactivity – people who, by definition, are not seeking support to get back into work. The sinister reputation of Jobcentres is one of the things keeping people away from their doors, and more punitive activity will not encourage anyone to go to them for help.
If the Government wants to support more people with long-term health conditions to remain in and return to work, for example, it should first look to its own Health is Everyone’s Business green paper, which recommended a subsidy to help small and medium enterprises purchase occupational health support. The recently announced £1million ‘innovation fund’ may stimulate some interesting ideas, but they won’t change anything if sustained investment doesn’t follow.