Want the long term sick bill down? Add the money into the overall budget for the NHS, minus a cut for paying off the deficit. It will look good on the NHS figures as extra spending on Hospitals (Propaganda I know but hey, at least it will now actually show up on the national accounts). And then let Doogie Hauser MD make a choice, he can either spend the extra money on people with Leukaemia, or spend it on the long term “sick” who find work interferes with their squash game. Instead of passing the buck onto somebody else by signing Mr Workshy off sick, Gregory House M.D. will want, nay have, to pick the people who are in genuine need.
Plus, of course, it gives a kick up the arse to two of the most arrogant sections of society: those who are happy to steal from people because they cannot be arsed to work, and doctors.
Plus, of course, you get to abolish the government departments that deal with sickness benefits—thus cutting more useless parasites from the state pay-roll.