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

1 to 2 3 to 5 6 to 10 11 to 20 21+

%

5 10 15 20 25 30 35 40 45 50 Duration of Spell % of total time lost

% %

Dr Geoff Helliwell - 24 Feb 2017

Absence causation (UK CS) :

Others(inc psych) Accidents Symptoms Musculoskeletal Nervous/Sense Digestive Infective Respiratory 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 1 to 3 3 to 5 6 to 10 11 to 20 21+ Cause Probability Length of Absence

Causes of Absence 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