The system for signing young people off work with health conditions risks pushing them into long-term economic inactivity and damaging their employment prospects, government adviser Alan Milburn has warned.
The former health secretary, who is leading an independent government review into youth worklessness, criticised the use of GP fit notes (previously called sick notes) during a visit to the Netherlands. He told The Times that entering the welfare system after being signed off could leave young people dependent on health and disability benefits for many years.
Almost 1 million fit notes for mental health issues were issued by family doctors last year, according to NHS data cited by the newspaper. Milburn argued that having a health condition or receiving a diagnosis should not automatically be regarded as preventing someone from participating in the labour market.
Long-term absence risks becoming entrenched
Milburn described the current approach as damaging to young people’s future prospects, pointing to the likelihood of people remaining on health-related benefits once they enter the system.
“The fit note thing is just bloody insane. You get a fit note. You enter the welfare system. We know that once you enter the welfare system, you get a health and disability benefit,” he said.
“The stickiness kicks in. You stand a 50 percent chance of being on a health and disability benefit if you get it today in 15 years’ time. Everybody talks about the fiscal disaster. Fine, but most importantly, it’s a life chances disaster because we’re ruining the life chances of these young people.”
His intervention follows growing scrutiny of how fit notes are issued. A BBC News investigation surveyed 752 GPs and found 540 had never refused a request from a patient seeking to be signed off work because of mental health problems. Doctors who spoke to the BBC reported feeling unable to turn down some requests.
Milburn’s review is examining why increasing numbers of young people are outside the labour market, with health and disability among the issues under consideration. The latest Office for National Statistics estimate put the number of 16 to 24-year-olds not in education, employment or training (NEET) at 981,000 between April and June 2026.
The scale of the problem is considerably greater in Britain than in some comparable European countries. Fewer than 5 percent of young people in the Netherlands are NEET, compared with 13.6 percent in the UK, according to figures reported during Milburn’s visit.
Diagnosis should not close route into work
Milburn questioned an approach in which conditions including ADHD can become associated with an assumption that someone is unable to work.
“Just because you’ve got a condition, or even just because you’ve got the diagnosis, shouldn’t mean you aren’t able to work. What is it that we need to do to stop the notion that just because you either self-identify or are identified as having a condition, that automatically means you’re not able to participate in the labour market.”
Former England football manager Sir Gareth Southgate accompanied Milburn on the Netherlands visit and warned against allowing diagnoses to limit expectations of young people.
Drawing on his experience of young people with ADHD and autism, Southgate said appropriate education and opportunities could allow them to flourish.
“I’ve met lots of youngsters with ADHD, with autism, [who] have had the opportunity to have a different way of being schooled and are really thriving,” he was quoted in The Times as saying. “There are definitely so many good qualities for people with those diagnoses and we have to be very careful not to write those people off.”
Mentoring can help young employees
Southgate also emphasised the role of workplace relationships in helping people at the beginning of their careers, arguing that younger workers can benefit from spending time alongside colleagues who provide guidance and support.
He drew a comparison with his own career in football, where regular coaching provided a source of development throughout his working life.
“It’s one of the reasons I hate working from home. It’s great at my age. But if you’re a youngster, you need those mentors, the people that are going to look out for you, when all those complicated things that happen to you as a youngster … and help explain them.”
William Furney is a Managing Editor at Black and White Trading Ltd based in Kingston upon Hull, UK. His writing focuses on contemporary employment issues including pension schemes, employee health, financial struggles affecting workers and broader workplace trends.
- William Furney
- William Furney
- William Furney
- William Furney
