Sick Note Britain

An urgent call to reform Britain's sickness culture, offering social--not medical--solutions.

Dr Adrian Massey has worked at the intersection of medicine and society for decades. He argues compellingly that our hyper-medicalized society has falsely equated sickness with illness, and sickness with unfitness to work--whereas sickness is primarily a social problem requiring social, not medical, solutions. Sick-Note Britain lays bare Britain's gross error: when doctors cannot 'fix' anxiety or chronic pain, workplace attendance is still treated as a matter for arbitration by our strained primary care service. What is needed is a tailored, employer-employee contractual solution, but obstacles block this approach: excessively complex employment law constraining both sides; an outdated benefits system that overburdens doctors and traumatizes the vulnerable; and a workplace culture that is too inflexible to keep sick employees in work. This is a blistering condemnation of a sham system that works for nobody, and an urgent call to rethink how we manage sickness--for the sake of our economy, our wellbeing, and our health service.

Sick Note is a history of how the British state asked, 'who is really sick?' Tracing medical certification for absence from work from 1948 to 2010, Gareth Millward shows how the sick note has survived in practice and in the popular imagination - just like the welfare state itself.

Sick Note shows how the question of 'who is really sick?' has never been straightforward and will continue to perplex the British state. Sick Note is a history of how the British state asked, 'who is really sick?' Tracing medical certification for absence from work from 1948 to 2010, Gareth Millward shows that doctors, employers, employees, politicians, media commentators, and citizens concerned themselves with measuring sickness. At various times, each understood that a signed note from a doctor was not enough to 'prove' whether someone was really sick. Yet, with no better alternative on offer, the sick note survived in practice and in the popular imagination - just like the welfare state itself. Sick Note reveals the interplay between medical, employment, and social security policy. The physical note became an integral part of working and living in Britain, while the term 'sick note' was often deployed rhetorically as a mocking nickname or symbol of Britain's economic and political troubles. Using government policy documents, popular media, internet archives, and contemporary research, Millward covers the evolution of medical certification and the welfare state since the Second World War, demonstrating how sickness and disability policies responded to demographic and economic changes - though not always satisfactorily for administrators or claimants. Moreover, despite the creation of 'the fit note' in 2010, the idea of 'the sick note' has remained. With the specific challenges posed by the global pandemic in the early 2020s, Sick Note shows how the question of 'who is really sick?' has never been straightforward and will continue to perplex the British state.

Medicine.

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