Reforms to benefits may be a rude awakening to our sick-note culture, find David Leask and Stewart Paterson.

DAVID LEASK and STEWART PATERSON

Nobody would call Paul McNeil a scrounger. A 26-year-old with agonising and crippling arthritis, he is determined to get off welfare. Now, thanks to sweeping reforms of sickness benefits announced yesterday, he and people like him might just get more help to do so.

Peter Hain, the Work and Pensions Secretary, yesterday said he would overhaul incapacity benefit, or IB, the main welfare payment for the long-term disabled, amid revelations that nearly 2000 people were now officially too fat to work in the UK.

The reforms were read by some as a declaration of war against those perceived as undeserving malingerers, spongers and fraudsters, and a sick-note culture that, in a decade, has let a million new jobs go to immigrants while unhealthy Britons rely on the dole.

Not so, claimed Mr Hain yesterday. Reforms, he said, were firmly aimed at the vast majority of IB recipients who, like Mr McNeil, desperately want to work.

IB will be phased out, replaced by a new benefit that was based on a new test, the Work Capability Assessment, that focuses on what claimants can do, not what they can't do. Mr Hain even gave examples of the kind of questions asked: "Can you sit in front of a PC screen and operate a keyboard or a mouse, rather than can you do a physically demanding job in an old industrial setting?"

Mr McNeil has heard that question before. Until he was 22 he was a successful landscape gardener and semi-professional footballer. Then, on his birthday, he suffered excruciating pain in his ankle and was taken to hospital. Within a year he was in a wheelchair, unable to walk unaided. He was out of his football team, out of a job and out of a long-term relationship. "Everything seemed to be falling apart," he said. "It was a massive blow to me."

Clearly Mr McNeil will never go back to heavy gardening work. But he's determined his talents - and love of plants - won't go to waste. Back on his feet - thanks to arthritis drugs and considerable willpower - he is studying computing and has launched his own small business, designing the gardens he once landscaped.

"I fought to be strong," he explained. "I said to myself: I am not going to let myself go down. There are people worse off than me.' At my worst, I was like a skeleton. At times I couldn't even speak to my mum and dad." Was he low? "Definitely."

One day Mr McNeil went into an office on an errand and was served by a man in a wheelchair and realised he could still have a career. "It made me feel so much better," he said. "People have got so many talents. We should not think that's all wasted. There's a job there for everybody."

Mr McNeil, true, has had help. Not handouts, help. He sought - and received - advice from a national charity, Tomorrow's People, that helps people out of long-term unemployment. Tomorrow's People is currently one of numerous bodies working with a Glasgow scheme, funded by Mr Hain's Department for Work and Pensions, to co-ordinate the fight against worklessness.

GlasgowWorks, chaired by entrepreneur Jim McColl, aims to raise the share of adults of working age in employment from a low 66% in 2006-2007 to 71% by 2009-2010. That means getting 17,200 people in Glasgow alone off benefits in four years. The disabled are the biggest challenge. There were nearly 57,000 people on IB in the city, at last count early this year.

"Half of them have mild or moderate mental health problems," said David Coyne, the chief executive of GlasgowWorks. "We realise it's going to be a challenge."

Glasgow has long been dubbed the sick-line capital of Britain. Scotland, after all, accounts for more than its fair share of IB, some £1.42bn or 11.4% out of a national bill of £12.4bn. Some, especially men who lost manufacturing jobs in the 1980s recession, have been on IB or similar benefits since Baroness Thatcher was in power. Mr Hain and his colleagues were quick yesterday to stress the IB problem's genesis. Their reforms, they said, would shave 20,000 off IB every year. The Tories had their own response. At that rate, Conservatives said, it will take 25 years to solve the problem.

The DWP yesterday declined to give any targets for introducing the new rules to existing IB customers. Reforms, a spokesman said, would be introduced "in time". Nobody is suggesting a big bang, of course. And there are still many who have to be convinced that the changes will work.

One is Frank Field. The Merseyside MP used to be welfare reform minister and he has previously described IB as a "racket". He wasn't impressed by the pace of reform. "It is still going to leave the vast majority on benefit until they retire or die," Mr Field said yesterday. "It needs to be tougher in the sense we should have a single rate of benefit instead of people graduating to a higher rate.

"There are people who are nervous about getting a job as they have tried before and lost out on housing benefit. Let them have a part-time job and build up to full time and let them keep benefit for a year."

Others too have long talked about the need to wean people off benefits gradually, rather than strip them of funds as soon as they find work.

Mr Field added: "If a message went out for people to try a job and you won't have to struggle to get back on welfare it would be a help. There are those that need extra help with work.

"When you see some of the bomb victims who were mutilated and many have gone back to work, it is quite possible.

"It is not ambitious enough and not enabling enough. There are those who need help and those who need pushing."

How do you push a person with a psychiatric problem back to work? Scotland remains desperately short of therapists. In Glasgow, Mr Coyne and his colleagues aim to train employers and supervisors to mentor those suffering from, say, depression or addiction.

Nationwide, though, there are those who fear the challenges facing mentally unwell people in the workplace will be underestimated in the new scheme. Margaret Edwards, head of strategy at Sane, the mental health charity, said: "We are concerned that those making the assessments of individuals' fitness to work should have sufficient training in the range of mental health problems that may affect a person's ability to take up a job."

Capability Scotland was also worried. A spokesman said: "Any monies saved on reducing the amount of incapacity benefit paid out should be reinvested into supporting sustainable employment for disabled people. This support must be offered to both employers and individuals."

Skills are the key, said Gerry Spence. He's a GP in Glasgow who has spent a lot of time assessing patients for benefit. He said: "I don't think this will make a jot of a difference. A lot of people would, if they could, go back to work. But the skills are not there, the jobs are not always there.

"Some people with serious physical disabilities are holding down highly responsible jobs. However, if you are a scaffolder or a binman and you have a heart attack, you can't go back to that job, but you maybe can't retrain as a computer operator.

"The tests right now are simple physical tasks to measure ability to work like walking or lifting, but there are often deeper reasons why people are unable to work long term. Then there employment prospects have disappeared. Employers do not want to take a risk on someone who has been long-term sick."

The system

JOB SEEKERS' ALLOWANCE

• The old unemployment benefit. Paid to those out of work and actively looking for a job.

• There are currently just under 825,000 "on the dole" in the UK today, half as many as a decade ago and one-third as many as at the height of the recession in the 1980s.

LONE PARENTS' INCOME SUPPORT

• Single parents who cannot work because they have childcare obligations usually get IS.

• The number receiving it has dropped by around one-third since 1997 and now stands at roughly 765,000.

INCAPACITY BENEFIT

• The only one of the big three benefits whose bill just won't come down in line with the rise in overall employment.

• There are marginally more people on IB now than there were a decade ago, although, at 2.6 million, the total number of claimants is down from the high of nearly 2.75 million hit in 2005.