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The writer chairs the commission for healthier working lives at the Health Foundation think-tank
The current debate on welfare and work risks overlooking a crucial fact: every year over 300,000 people in the UK leave their job and report a work-limiting health condition. Many do not return. But evidence shows that much of this could be prevented with the right support. Without it, more will fall permanently out of work, creating lasting costs for individuals, employers and public services.
This month, the government announced major changes to health-related benefits, with the aim of helping more people back into work. But cutting entitlements to disability benefits risks increasing financial insecurity and damaging health for those in real need of support — which makes it less, not more, likely that they will be able to work.
At the Health Foundation’s commission for healthier working lives, we have spent the past year exploring how to support people with health conditions that limit their ability to have a job. With 8.2mn working-age people now facing such challenges, the current approach is no longer sustainable. We need to prioritise prevention and early intervention to keep people employed when health issues emerge.
So, what have we found needs to change? First, many employers want to improve workforce health yet are held back by one-size-fits-all guidance, tight budgets and limited proof of what works. Sharing best practice within sectors can make it normal to support people who face a health issue. For example, by investing in trusted line managers and allowing them to offer changes such as flexible hours to allow for medical appointments. Shifts and workloads that keep people well have shown great results in pilot programmes.
Second, when health starts to affect work, support must come earlier and be more joined-up. State support often comes too late — after people have left their jobs and their health, finances and confidence have worsened. Some leading employers already invest in tailored occupational health and rehabilitation, with clear benefits for retention. These approaches should be more widespread. When somebody falls sick, they need proactive conversations with their employer about rehabilitation and changes that would allow someone to stay in or return to work.
Third, financial incentives must align better with prevention. Despite recent changes, statutory sick pay in the UK remains among Europe’s lowest — just £116.75 a week. Many employers, already facing rising costs, understandably struggle to offer more. But when it’s inadequate, employees are forced to choose between working while unwell or financial hardship.
A review of sick pay is long overdue and should be part of the employment rights bill currently working its way through parliament. For most businesses, higher statutory sick pay would have a small impact on payroll. But a review should also explore practical options to help businesses manage unexpected costs.
Better employment outcomes for people with health challenges are achievable — with an ageing population, it’s something we urgently need. The UK has seen positive changes when we tackle these structural blocks in the labour market. Employment rates among mothers have improved significantly, supported by a mix of workplace rights, financial incentives, practical help and cultural change. We now need the same long-term commitment to work and health.
If we really want to realise the economic and social benefits of getting Britain working, the focus must shift from short-term benefit cost cutting. History suggests these are unlikely to deliver significant savings or lasting results — they also risk real harm. The genuine opportunity lies in a concerted effort by government and employers to help people with health challenges remain in work.
