Changing perceptions about sickness and work: judging capacity for work and locating responsibility for rehabilitation

The Government's welfare to work agenda is premised on changing expectations and attitudes regarding the relationship between sickness and/or disability and work. At the core is an assumption that work is a good way of enhancing the well-being of working age people. There are also economic gains in ensuring potential benefit claimants move back into employment. This paper focuses on policy around job retention and vocational rehabilitation and argues that there are lessons to be learned from research about the need to change expectations and attitudes amongst several sets of stakeholders. In 2003, the Government set out to boost the evidence base for effective practice in vocational rehabilitation through the Job Retention and Rehabilitation Pilot and its focus on person-centred case management. Qualitative findings from the pilot's evaluation show that employees', employers' and health professionals' perceptions of the relationship between work and health can provide barriers to rehabilitation. This paper discusses ways of changing perceptions adopted within the pilot, and highlights the importance placed on informing and empowering individuals, collaborative working and providing timely and flexible support. In the light of these findings, recent policy announcements and plans indicating the Government's ongoing efforts to effect change in perceptions and attitudes are critically examined.