Sick notes are to be scrapped and replaced with electronic “fit notes” to separate the work-shy from the genuinely ill and cut the benefits bill.

The system of GPs writing sick notes and allowing patients to stay off work for months on end is as old as the NHS and has barely changed in 60 years. However, ministers want to cut numbers claiming long-term sick benefits from 2.6 million to 1.6 million by 2015 and believe ending the sick-note culture is the best place to start.

Half the 600,000 people who open a claim for incapacity benefits each year have a job and begin by getting a sick note. Ministers are targeting this group, who are especially prone to mental health problems and bad backs, to try to get them to return to work as soon as possible and not allow them to drift on to benefits for good.

Instead of listing ailments and the time off work required, a fit note sets out what work a person could perform and how duties could be temporarily altered to take account of their health condition. The hope is that a fit note becomes the basis of a dialogue between employee and employer that would mean an earlier return to work.

Doctors’ leaders welcomed the measures, but did not want surgeries turning into a branch of government. They asked for a trial of the system before it is introduced nationally.

“We believe a Fit for Work service to help people back into employment may be the right way forward,” said Paul Nicholson, the chairman of the BMA’s occupational medicine committee.

“The new ‘fit note’ has potential, but we would like to see the findings of this evaluation because it’s crucial that GPs can continue to act as the patient’s advocate and don’t end up policing the system for the Department for Work and Pensions.”

The fit notes will be introduced from 2010.

Alan Johnson, the Health Secretary, said: “Sick leave costs an estimated £100 billion per year. But helping people stay in work doesn’t just have an economic imperative, it has a moral and social one too.”

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