Sickness and Workless-ness issues Tynwald Social Affairs Policy - PowerPoint PPT Presentation

Sickness and Workless-ness issues Tynwald – Social Affairs Policy Review Committee (PCA) -24 Feb 2017 Dr Geoff Helliwell, Consultant Occupational Physician

The data : • Residents (Census 2011) 84,497 • Census population (Census 2011) 79,179 (students, holidays etc) • Economically Active (Census 2011) 44,609 • In employment (Census 2011) 43,134 • Unemployed (Census 2011) 1,475 • Unemployed Jan 2017 601 • 2017 Population (calculation from unemployment) 46,231 • In receipt of incapacity related benefit (Hansard) 3,118 Dr Geoff Helliwell - 24 Feb 2017

The numbers depend on what you ask for : • Who thinks they are unemployed on Census 2011 = 1475 • Who is registered for work and claiming Job Seekers Allowance Jan 2017 = 601 • (JSA for Mar 2011 = 891) • So current thinks unemployed ~ 1000 • (likely in receipt of other benefits or unemployed and not in receipt of benefits) Dr Geoff Helliwell - 24 Feb 2017

Treasury “Pink Book” (2016 -17) data • 2014-15 Income support cost £34m, average £8407 per claim. (so approx. 4045 claimants) • 2014-15 In employment 48,280 (jobs) • 2014-15 in self employment 7,548 • (Use 50,000 as employment number) • Census 2011 has 25,759 not in employment – 16,247 in retirement (includes 75 under age 50) : • Long term sickness 1,129 • Long term disability 817 • Unemployed seeking work 1475 • “Others” 1018 Dr Geoff Helliwell - 24 Feb 2017

Best likely estimates for planning • Numbers from different government sources are not consistent • Employed and self employed 50,000 (includes 1500 over age 65) • Unemployed 1000 (2% of working population) • In receipt of Incapacity Benefit 4000 (8% of working population) Dr Geoff Helliwell - 24 Feb 2017

Incapacity & Unemployment (UK 1978-2010) Dr Geoff Helliwell - 24 Feb 2017

Sickness data : • IOM Civil Service 2012-13 reduced from 7.36 to 6.66 days lost (2011 was 8.4 days) Long term absence more than 60% of all absence • UK civil service (2015-16 Civil Service) 7.2 days • UK public sector (2015-16 Civil Service) 8.7 days • UK absence (Civil Service) 6.1 days • UK absence (CIPD) 5.8 days • (6 days is 2.6% Time Lost Average) Dr Geoff Helliwell - 24 Feb 2017

Absence – short, medium, long % 50 45 40 35 30 25 20 % 15 10 5 0 1 to 2 % of total time 3 to 5 % 6 to 10 lost 11 to 20 21+ Duration of Spell Dr Geoff Helliwell - 24 Feb 2017

Absence causation (UK CS) : Causes of Absence 0.8 0.7 0.6 0.5 0.4 0.3 Probability 0.2 0.1 1 to 3 0 3 to 5 6 to 10 11 to 20 Length of Absence Others(inc psych) Accidents Symptoms 21+ Musculoskeletal Nervous/Sense Digestive Infective Respiratory Cause Dr Geoff Helliwell - 24 Feb 2017

New claimants • Evidence that absence at 4 weeks is strong predictor of absence at 28 weeks. • Evidence that some diagnoses e.g. mental health, predict long term disability benefits • First intervention needs to be at 4 weeks • 40% mental health, 40% musculoskeletal • Assuming 50% of absence is over 4 weeks duration : • 715 interventions of 2-10 hours treatment duration • 6 practitioners – 2 Physio, 4 CBT Dr Geoff Helliwell - 24 Feb 2017

Dr Geoff Helliwell - 24 Feb 2017

Dr Geoff Helliwell - 24 Feb 2017

Existing claimants • Over 28 weeks (UK SSP) • Use Finnish “Workability Index” (WAI) : • Takes account of age • In use since 1998 (Finnish Post) – translated into 24 languages • 4 gradings : • 7-27 points – restore work ability • 28-36 points – improve work ability • 37-43 points – support work ability • 44-49 points - maintain work ability • For new claimants, assess at 13 weeks. • WAI gives priorities for intervention plan • Need case/disability managers to deliver Dr Geoff Helliwell - 24 Feb 2017

Long term claimants • Look at differential between JSA and Incapacity rates – aim to encourage financially to re-connect with rehabilitation to work. (Finnish trial of Universal Benefit) • Need to re-skill : • Malaysian rehabilitation scheme SOCSO/PERKESO – Return to Work programme - Education benefit - Vocational Rehabilitation • Commenced 2007 – injury process based on Finnish system, subsequent input from Commonwealth Disability (Aus) and Canada (training of case managers by NIDMAR) Dr Geoff Helliwell - 24 Feb 2017

Malaysian SOCSO experience : • Return to Work programme – 2,347 returned to work in 2015 (Injury recovery programme – multi-centre) • Rehabilitation Centre – 93 staff – 531 returned to work in 2015 (Rehab centre in Malacca opened 2014) • Vocational Rehab - 6,826 delivered (includes both above schemes) • Direct trading fund, similar to original National Insurance • Entirely web based Software based on Australia and German. • NIDMAR protocols in use around Pacific. Published by International Disability Management Standards Council – Vancouver, BC Dr Geoff Helliwell - 24 Feb 2017

An old trick revisited ? • Reserved occupations and quota (UK had 1994 to 1963) • Lift attendant, Commissionaire, Telephone Operator – 2% quota • Malaysia current vocational training and education grants; Wiring, Sewing, Air Conditioner repair, Fridge repair, Plumbing, Sewing, Secretarial. • What would reserved occupations look like in IOM ? Dr Geoff Helliwell - 24 Feb 2017

Summary • Exact figures for sickness and incapacity are hard to come by. • Needs more than one plan; • Prevent new cases becoming chronic – Mental Health and Physio services need resourced. • Manage chronic illness cases to remain in work – need qualified case/disability managers. Could train rather than import. • Manage Disability and re-skill long term IB claimants – make it financially advantageous to return to work. Needs Rehabilitation resourced – may need achieved over a number of years. • Best practice is not in UK – look to Canada, Malaysia, Finland. Dr Geoff Helliwell - 24 Feb 2017

Gura mie mooar eu Dr Geoff Helliwell - 24 Feb 2017