Sick workers need occupational health, not doctor’s notes

Emma Haslett is right: with sick notes at an all-time high, the impact on the UK’s economy is undeniable (“Poor mental health among British workers leads to 5m sick days and bill of billions”,  Business, 29 March). Yet, the current debate overlooks one major solution: the underutilisation of occupational health professionals.

While GPs are often constrained by time and resources, occupational health services are specifically designed to assess functional capacity in the context of work. Rather than focusing solely on whether an individual is “fit” or “unfit”, occupational health professionals are trained to consider what a person can do, and how their work might be adapted to support recovery while ensuring that they can perform optimally.

This distinction is critical. Prolonged absence from work, particularly for common conditions such as mild to moderate mental health issues or musculoskeletal pain is often detrimental to wellbeing. Good work, when appropriately supported, is widely recognised as beneficial to physical and mental health. By shifting the emphasis from sickness certification, which if prolonged can become a passport to worklessness, to work capability, occupational health services can play an important role in addressing what is often described as a “sick note culture”. It enables a more nuanced approach: phased returns, adjusted duties, and practical workplace interventions that GPs are neither resourced nor trained to provide.

If the nation is serious about reducing long-term economic inactivity, and supporting people back into meaningful employment, we must move beyond a system that relies so heavily on GPs as gatekeepers of work absence. Greater integration of occupational health into mainstream care, alongside improved access for employers and employees alike, would be a far more constructive step forward.

Professor Neil Greenberg, President, Society of Occupational Medicine, London NW1

Whatever your view on the rights and wrongs of Girlguiding being a single-sex organisation, it is clear that any six-year-old child who threatens to cut off a body part requires psychological help (“Girlguiding facing mass exodus after setting deadline for trans girls to quit”, 29 March). To say this threat could have been caused by Girlguiding’s recent decision to abide by the law demonstrates a lack of regard both for safeguarding and the truth. The headline refers to a “mass exodus”, but the article mentions that a letter objecting to the rules has amassed 450 signatures out of 80,000 volunteers – fewer than 1% of volunteers seems like a small number to me.

Kath Checkland, Hathersage, Derbyshire

It would be very hard for Labour or the Conservatives to close the loopholes that help large corporations and rich individuals to avoid paying their fair share of tax – because they cannot afford to upset their rich donors on whom they increasingly rely for funding (“After the donor cap and crypto ban, what if we all chipped in to fund our political parties?”, 29 March). This is one important reason why Ceri Thomas is right to call for state funding of political parties.

In addition, we need multi-member constituencies (as was the case for MEP elections) for parliamentary elections to bring in roughly proportional representation and allow most people to be represented by at least one MP from their preferred party. Together, these measures would make the House of Commons truly representative of the electorate.

Richard Mountford, Hildenborough, Kent

Alan Milburn is right to call the rise in young people not in education, employment or training a “ticking timebomb” (“School system is creating a ‘wasted generation’ which is unprepared for work”, 28 March). Too many, especially those with special educational needs and disabilities or facing multiple disadvantages, are being failed by a system that does not meet their needs.

We work with some of the most marginalised young people who are dealing with a complex mix of challenges including bullying, mental health issues, drug use and poverty. From our experience running education centres, what works is smaller class sizes, skilled staff and teachers, one-to-one support and practical learning so they can get back on track and progress into employment or further education. Access to support and services beyond the classroom is vital too.

Enver Solomon, Chief Executive, Nacro, London EC2M

Bridget Phillipson’s dog Maisie is a Jack Russell terrier, not a “jack russell” (“The Observer Walk”, 29 March). I trust Maisie wasn’t asked to comment.

Richard Houghton, Manchester

Photograph by Anna Stills/Alamy Stock Photo