London Briefing/Chris Johns: Tony Blair has returned to one of his favourite activities, "reform". While he clearly likes to try and reform lots of different things, his track record is patchy: success has been noticeable by its absence.
But he should get full marks for effort, particularly when we look at the latest attempt at welfare reform. An earlier attempt to do something about long-term unemployment triggered one of the many backbench revolts that seem to mark most of Blair's efforts to change things.
Britain spends about £146 billion (€211 billion) a year on welfare spending. Blair wants to save £7 billion of this by enabling and persuading people classed as sick and disabled to go back to work.
The government reckons that around one million of the 2.7 million currently receiving incapacity benefit can be returned to gainful employment. Although they would never be so crass as to admit it, officials hope a series of carrot and stick measures can be successfully deployed.
That 2.7 million is a big number and represents almost 10 per cent of the work force.
The fact that so many people can be in receipt of incapacity benefit triggers a number of predictable responses. Most obviously, there is sympathy for those who are too ill to take part in economic activity, despite obviously wanting to do so.
Ministers are fond of quoting surveys that show how a vast majority of these sick and disabled people want to work but can't. Whenever reform of the benefit system is proposed, we often see images of wheelchair-bound people protesting about potential loss of income. It is easy to see why some MPs are very nervous about offending this vulnerable constituency.
Some of the reforms are aimed at reducing the barriers that prevent sick people from gaining the jobs they could do but are, for one reason or another, prevented from doing. But there is also an unspoken subtext: some of the 2.7 million are not that sick.
Whether this is true or not, I have no idea. It would help if we had some decent statistics to work with. "Too sick to work" should be something that is amenable to objective medical assessment.
Indeed, the authorities have implemented a series of steps that an individual must go through if they are to be registered as eligible for incapacity benefit.
Naturally, the (pre-reform) process starts with a GP, who can sign somebody off for up to 28 weeks. At that point, the patient is handed over to a government agency, possibly involving further assessment. Clearly, a lot of people manage to clear the necessary hurdles.
Various pilot "back to work" schemes have been tried with varying degrees of success. Nobody dares to suggest this might involve getting the work-shy back into employment. That is too politically incorrect and unfair on those unable to work.
But the background chatter often mentions depression and back pain as the two most common ailments among those 2.7 million people.
According to some estimates, up to 40 per cent of those on incapacity benefit are depressed. One line of argument suggests that it is no coincidence that so many people cite illnesses that are not terribly amenable to testing. Some GPs have admitted that when faced with somebody complaining of a bad back, there is nothing to do but to sign them off work.
If somebody says they are in pain, it is impossible to prove otherwise. Many GPs respond to criticism by making the not unreasonable point that they are not the gatekeepers of the benefit system. Under the latest proposals, incapacity benefit will end in 2008 to be replaced by "employment and support allowance". Anyone assessed as able to work will get help to do so; benefits will be cut for anyone refusing to take part in the scheme.
Critics worry about the potential impact on society's most vulnerable members. The question remains: why are there so many sick people in Britain? And if some of them are reluctant to work, what are the attractions of living on £76.45 a week?
• Chris Johns is an investment strategist with Collins Stewart. All opinions are personal
