Labour Market Activation Policies for the Long-Term Ill – A Sick Idea?

Abstract

This paper addresses the failure of activation programmes to achieve a rapid return to work when they are directed towards the long-term ill. The empirical basis for the paper is an analysis of the outcomes for 691 individuals in Sweden chosen for a reactivation policy programme to shorten their sick leave and increase their chances of returning to work. The outcome at the end of their long-term illness when compared to those not selected for an activation programme shows that the programmes failed both to reduce the length of sick leave or to improve the chance of a return to work. The paper discusses who is chosen for such a programme and the process involved. It also discusses why these programmes are continued although they do not succeed. Two possible reasons are suggested. In an atmosphere of mistrust promoted by the government against those claiming social benefits, one reason is that the programmes help bureaucratic decision-making to legitimise moving large numbers of individuals off the sick rolls and into early disability pensions. This is accomplished by employing activation programmes as ‘sorting mechanisms’. The other reason is that the state provides a degree of flexibility for the employer by producing and funding a secondary labour market for individuals with reduced capacity for work while allowing the employer a chance to escape the constraints of an employment contract. The paper concludes by arguing that re-activation programmes should be viewed as part of a larger transformation of the labour market and as a possible governmental policy mistake in the reformation of the social rights of the dis-able bodied.