Sick leave should be agreed by independent assessors, says report

People should be signed off for long-term sick leave by an independent assessor rather than their GP, a government review will recommend.

The independent review, due to be published next week, is also expected to call for businesses to be given tax breaks for hiring patients with continuing and unpredictable conditions.

The welfare minister, Lord Freud, said the reforms could lead to "fewer wasted lives". He said the government wanted to intervene earlier to stop patients drifting into unnecessary ongoing state support.

A job-finding service to match people with long-term illnesses to suitable work is expected to be another recommendation of the government-commissioned review.

People who are signed off sick would also be put on to jobseeker's allowance, rather than employment support allowance, for a period of three months. They would receive less money and have to prove they were looking for work.

Freud said GPs would still have a role in writing sick notes for up to around four weeks leave but after that point an independent assessment of the patient's needs should be carried out.

He told BBC Radio 4's Today programme: "That's the point at which you can get into drift. If you start having no support at all for the next 28 weeks there's a very large proportion of people who then drift of into state support and very long-term support and it's quite unnecessary in many cases."

Freud signalled that the new independent assessment would consider what work someone seeking long-term sick leave could do and not just consider whether they were able to continue their current job.

He said: "GPs are not experts necessarily in occupational health and secondly there's two tests going on – the GP is signing people off for a particular job but actually in the end the assessment will be when they apply for long-term state support. The assessment will be 'can you do any job?'. That difference means that people can fall between the two assessments."

The Independent Review of Sickness Absence, led by Professor Dame Carol Black, the UK's national director for health and work, and the former head of the British chambers of commerce David Frost, is looking at ways of cutting the estimated £60bn cost of working-age ill health.

Black told the BBC: "What the GPs say is they don't have time to do an in-depth functional assessment and nor have they had any training in occupational health so we think it's providing a new unique service that both employers and GPs need."

Frost said when people were off sick for longer than four weeks they started "to lose the will to work".

"What we've got to do is to find a way of actually working with them, encouraging them and providing real, practical help. And that's what the assessment service would do," he told the BBC.

The deputy chair of the British Medical Association's GPs committee, Dr Richard Vautrey, warned that if the reforms turned out to be "a punitive process just to try and save money without the best interests of the patient at the heart of the process then it will fail".

Labour MP Dennis Skinner said: "Last year, the government said GPs should be accountants in charge of the money that is spent in the NHS. This year they want assessors to be GPs. It's crazy. No wonder the country is going to the dogs."

The proposed reforms come as the government is embarking on a major and controversial overhaul of the welfare state. The first independent attempt to quantify the impact of more stringent medical tests and the greater use of means testing warned that the tough welfare reforms will force over half a million people off incapacity benefit and cause widespread poverty in some of Britain's most disadvantaged communities.

Around 600,000 people would disappear from the benefits system altogether under changes to be introduced by 2014 and would often have to rely on family members for financial support, warned researchers from Sheffield Hallam University.