The problem, Sunak said recently, is that the country’s safety net encourages people with a long-term illness to take extended absences from work rather than figuring out what jobs they would be suited for given their condition. 

Instead the system should focus on “what people can do with the right support in place, rather than what they can’t do,” Sunak said in a speech at the Centre for Social Justice Friday. 

There is a “risk of over-medicalizing the everyday challenges and worries of life,” Sunak said. “If we fail to address this, we risk not only letting those people down but creating a deep sense of unfairness amongst those whose taxes fund our social safety net.” 

Sunak’s language is lifted almost verbatim from previous government officials who sought to reform Britain’s welfare system. As far back as 2007, Labour politician Peter Hain used the exact same wording of “sick note culture,” also focusing on “what can do rather than what they cannot do.” In 2015, former secretary of work and pensions and fellow Tory Iain Duncan Smith used the same two phrases. Duncan Smith was in attendance at Sunak’s speech at the Centre for Social Justice, the center-right think tank Smith cofounded in 2004. 

Social reform is a key part of the Conservative Party’s platform as it gears up for national elections later this year. After 14 years in government the Conservatives are widely expected to get trounced by Labour as voters express frustration with the middling economy and the party’s inability to connect with the young and economically disadvantaged. 

To kick-start the economy, Sunak and the Tories are pushing a set of reforms that aim to increase Britain’s labor force participation rate, including narrowing who should qualify for long-term disability benefits. On Friday, Sunak said he wanted to trim benefits for people with “less severe” mental health conditions.  

Since the pandemic there has been a rise in the number of people who are out of the workforce entirely. Referred to as “economically inactive” in Britain, these are people who do not currently have a job and are not actively looking for one. Currently, out of 37.5 million working-age people (defined as between the ages of 16 and 64), some 2.8 million, or 7%, aren’t employed because of a long-term illness. In 2019, prior to the pandemic, that number was 2 million. 

Sunak lamented the fact that Britain’s “economically inactive” cohort was growing after years of decline, and that the greatest increase among people not working because of illness was among the young—“those in the prime of their life, just starting out on work and family, instead parked on welfare.”

“I will never dismiss or downplay the illnesses people have,” Sunak continued, adding, “the situation as it is is economically unsustainable.”

Pushing those young people back into the workforce would not only help Britain’s economy, which as of February fell into a recession, but also improve their own health, according to Sunak. He said he believed “the growing body of evidence that good work can actually improve mental and physical health.” 

There is some evidence that holding a job can aid the mental health stability of people with certain conditions. Research from Mass General Brigham hospital shows people with bipolar disorder or post-traumatic stress disorder benefit from a job because it provides daily structure and purpose. 

At the same time, Sunak’s comments may ring hollow to a white-collar workforce struggling with record levels of work-induced stress and burnout. During and after the pandemic, employee mental health became an especially salient issue as workers found themselves grappling with a collective deterioration of work and society. The decline in the workforce’s mental health risks hurting their productivity and the economy more broadly, not to mention its human toll. 

What’s more, some 2 million people across England and Scotland are still suffering from symptoms of long COVID, according to government figures published this week, the symptoms of which can include weakness, shortness of breath, difficulty concentrating, and muscle aches.

Critics of Sunak’s plans also seized on the discrepancy between his comments and the current data showing a rise in mental health conditions. The editorial board of the liberal-leaning paper the Guardian called Sunak’s position “deeply misleading” in an op-ed published earlier this week. “What the U.K. has is a large number of unwell people,” the Guardian’s board wrote, taking issue with Sunak’s framing that the problem lies with the country’s welfare system.  

Meanwhile, government statistics indicate the U.K. is in the midst of a youth mental health crisis that could keep some 3 million workers out of the workforce. 

As part of his reforms Sunak advocated for a more rigorous screening process for recipients of long-term disability benefits, particularly related to mental health conditions. Britain should be “more ambitious in assessing people’s potential for work,” Sunak said.  

Elsewhere in his plan Sunak highlighted reforms to the vetting process that would include a shift away from excusing people from work toward one that would determine what work they are suited for.

Sunak also suggested incentivizing those on welfare to return to the workforce. Sunak said he wanted to “strengthen our regime” to get people who are on welfare back to being employed. One proposal Sunak made would require people on welfare to accept any available job or else lose their benefits “entirely” after 12 months. 

Labour Party leader Keir Starmer criticized Sunak’s framing of the issue, and said sick leave had become exacerbated in the U.K. because of the Tories’ mismanagement of the National Health Service. Starmer also belittled Sunak’s speech for being too similar to previous proposals, calling it “a reheated version of something they announced seven years ago.”