The perils and risks associated with worklessness have only recently been recognised and given an evidence base¹. These demonstrate that economic inactivity and the ways it can be effectively addressed must be placed high on the list of priorities to be tackled by both public and occupational health. But what of the evidence that work is good for health and wellbeing? This lacuna in knowledge and understanding has recently been closed by a detailed systematic review of the medical and scientific literature which provides compelling evidence that, with very few exceptions, work and in particular employment is good for health and wellbeing². The time is ripe to achieve the tipping-point to gain a shift in cultural attitudes to health and work, and particularly so among healthcare professionals.

Moreover the majority of people in receipt of state incapacity benefits report subjective health complaints which are in many ways no different to the common health problems (CHPs) which have been shown to have a high prevalence in the general population^3,4. Unexplained symptoms in people accessing healthcare^5,6 may well be another feature of the failure to gain a proper understanding of the nature and origins of perceived illness manifesting as CHPs, and to develop effective interventions. There is extensive clinical evidence that personal beliefs aggravate and perpetuate illness⁷ and play a central role the more subjective the health complaint¹. Psychological and social factors need to be addressed as obstacles to recovery and (return to) work. Chronicity and incapacity are not inevitable in people with CHPs. Given the right support, opportunities and encouragement these health problems can be effectively managed. Illness, sickness and Incapacity need urgent recognition as psychosocial rather than medical problems. More and better healthcare will not provide the answer. Evidence is accumulating that interventions principally based on cognitive and behavioural practices substantially improve recovery from ill-health and significantly increase the likelihood of return to work among incapacity benefit recipients who participate in condition-management programmes as part of the Government’s Pathways to Work Pilots. Asound endorsement of these approaches has been the recent decision by government to extend the Pathways to Work initiatives across the country in the next few years.