Prime Minister Rishi Sunak will consider tightening long-term sick leave rules in a bid to reverse a rise in the number of Britons permanently dropping out of the workforce.

Labor force participation among the UK’s working-age population fell to its lowest level since 2015 due to rising long-term illnesses and rising student numbers, while other large, wealthy countries have seen increases since 2020.

In excerpts from a speech delivered late on Friday, Sunak said the rising number of people unable to work due to mental health problems was a particular concern.

He said: “We need to be more ambitious about helping people get back into work and more honest about the risks of over-medicating everyday challenges and life worries.”

According to official figures, around 9.4 million Britons aged 16 to 64 (22% of that age group) are neither in work nor unemployed, compared with 8.55 million before the outbreak. Of these, 2.8 million are chronically ill and 206,000 are temporarily ill.

Last year, the UK’s budget watchdog said a quarter of people out of work due to long-term illness were waiting for treatment, although it added that shortening waiting lists to their 2015 lengths might only see 25,000 people return to work.

More than half of those with long-term conditions reported suffering from “depression, neurasthenia or anxiety”, although many said this was a secondary condition to their main health problem.

Sunak’s office said medics were too willing to issue repeated notices approving extended sick leave, rather than advising people on how to return to work, paving the way for people to access long-term illness benefits.

Sunak said he wanted to try to shift responsibility for assessment from GPs to healthcare workers, responsible for “making an objective assessment of someone’s ability to work and providing them with the tailored support they need to do their job”.

“Not only do we need to change sick notes, we need to change the sick note culture, so the default job is the job you can do, not the job you can’t do,” he said.