GPs will be required to tell the employers of sick patients what tasks they can perform in a new “well note” designed to reduce the number of people on incapacity benefit, The Times has learnt.

Alan Johnson, the Health Secretary, will this week prepare the ground for controversial changes, saying that family doctors need to “change our sick-note culture into a well-note culture”. His aides acknowledge that the introduction of a new “well note” risks inflaming GPs, already angry over demands that they improve access, but insist they are not being asked to police Britain’s benefit system.

The Health Secretary is speaking before the publication of a report by Dame Carol Black, the National Director for Health and Work, that recommends a series of measures to keep workers in their jobs when they become ill. A new version of the sickness certificate used by doctors and recognised by benefits agencies and employers is being prepared. It “will encourage GPs to offer fitness-to-work advice to patients and employers,” Dame Carol has told occupational health professionals.

In a speech to the British Heart Foundation on Wednesday, Mr Johnson is expected to say that employers will come to recognise the need for a “work-health balance”, just as they have accepted the economic benefits of flexible working. He is to say that organisations should do more to assess and treat conditions at work, particularly those such as back pain or stress-related illnesses, which cost hundreds of millions of pounds each year in lost productivity.

But it is the Health Secretary’s call for GPs to issue “well notes” that is likely to cause the most controversy. “Incapacity benefit should not be a one-way street that starts in the GP’s surgery and stops at the dead end of a lifetime on benefits.

“The evidence shows that far from being bad for health, work is generally good for people’s health. In fact, staying in work or returning to work is often in a patient’s best interests. We want to explore what else GPs can do to change our sick-note culture into a well-note culture,” he is expected to say. Ministers, well aware that they risk angering doctors’ leaders, insist that most GPs are not aware of the evidence showing the health benefits of work. A new national education programme will help train them to offer advice to employees and employers.

A senior health official said: “Because those who aren’t in employment are likely to be in poorer health and use health services more, it is in the interest of GPs to do this too. We need to get better at identifying what those who have been signed off work can do, not obsess about what they can’t do.”

Action to reduce the 2.64 million Britons on incapacity benefit is becoming increasingly urgent for the Government in the face of the Conservatives’ welfare reforms. Last month the Tories announced their proposals to reassess claimants, weeding out those able to work.

A report by the Public Accounts Committee found that six out of ten of those on incapacity benefit have been living on it for more than five years.

Nine out ten of those going on to the benefit both want and expect to return to work. Officials say that many of those signed off sick have back or neck pain, depression or heart and circulatory problems. “They are serious conditions but not ones that make long-term unemployment inevitable,” one official said.

Half of workers signed off with back pain for six months return to their jobs, a figure that drops to 25 per cent after a year.

The CBI estimates that 175 million working days are lost to ill health each year. The Health and Safety Executive says that 36 million of these days are because of occupational ill-health.

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