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Sick Note Britain: The Public and Medical Certification since the Second World War

Wellcome Trust Research Fellow in Medical Humanities (September 2017-August 2020)

Medical certification is central to the welfare state. There are numerous social, legal and financial benefits that can only be accessed if the claimant can “prove” that they meet certain medical criteria. Certificates are used for births and deaths, fitness to stand trial, sectioning under the Mental Health Acts, claims to social security, fitness to join certain occupations such as the armed forces or police, justifying absences from university exams and a host of other reasons in the public and private sectors.


The most day-to-day version of these certificates is the “sick note”. Doctors have been writing such certificates for centuries as “proof” that a person “really was” sick – both for the benefit of the claimant and those demanding evidence of sickness before offering money or services.


Sick Note Britain examines the sick note from the end of the Second World War through to the present day. It looks at how these notes were used, amended and regulated across a period of significant change in the British welfare state. But it also tries to uncover the deeper cultural understanding of what sickness certification represented to the British people and agents of the British state. Today, headlines about “Sick Note Britain” conjure images of a feckless, lazy workforce whose lack of productivity stifles national output in a difficult economic climate. Yet the lack of sickness protection for workers on zero-hours contracts and in the “gig economy” has also inspired campaign groups to question how sickness is determined and how individuals are provided for. This project emphasises that these concerns are not new and have a deep history.

This project is a Wellcome Trust Postdoctoral Medical Humanities Fellowship, grant number WT-208075/Z/17/Z.


photo of Ministry of Labour medical certificate, TNA
Ministry of Labour and National Service blank medical certificate, c. 1945.
The National Archives: PIN 7/368.