The appointment of the former health secretary Jeremy Hunt as chancellor is particularly timely, given one of the largest problems facing the British economy: the growing number of working-age adults who are “economically inactive” – meaning they are neither employed nor looking for work – because they struggling with long-term sickness. Long-term sickness is being driven by two key factors: long Covid and people being signed off sick until they can access NHS care.
While the mortality rate for Covid-19 has fallen significantly through vaccination and treatments, the disease is still the cause of chronic illness. Of those who have been infected, an estimated 5.5% have debilitating symptoms including fatigue, recurring fevers, brain fog and heart, lung and kidney damage. A recent study in the Lancet estimated that about 22% of people with long Covid were unable to work due to ill health and another 45% had to take reduced hours. Many countries will start to see waves of Covid every three months, leading to many more people developing chronic illness and leaving the workforce.
The other major factor is the inability to access timely NHS care – the people waiting for months for surgeryand specialised services. ONS data indicates that among those who had left their previous job due to a health-related condition such as illness or disability, 35% were on an NHS waiting list. The NHS is unable to cope with the volume and quality of care needed (largely due to neglect by the UK government, of which Hunt was a part, over the past decade).
We need people to work in cafes or deliver mail. We need people to empty rubbish bins or teach children. The government keeps talking about “growth”, but is failing to see that if it wants a higher GDP it needs active workers to produce more goods and services.
This is not new information. Since the 1980s, the World Bank has promoted the concept of “human capital” to justify investments in health and nutrition in low- and middle-income countries. For instance, in a 2005 World Bank document on nutrition, it says: “The challenges of development require a strong human resource base – a workforce that is physically strong, mentally alert and healthy. But malnutrition robs a country of these resources.” This logic was used to justify investments in India to improve health: the benefits to productivity and growth would far outstrip the money put into improving health. GDP could be increased by between 2% and 3% in India if malnutrition were addressed.
This lesson from 1980s India seems to have been lost on Liz Truss and her government. If the focus is still on growth, the route to that must involve investment in people so that they are healthy enough to work. Yet current policies are making the British population even more unhealthy. Even after the U-turn, the mini-budget is focused on giving substantial amounts of money to those who are already wealthy. In the end, an economy is only as healthy as the people within it, and it’s time we had a government that understands that basic principle.
Prof Devi Sridhar is chair of global public health at the University of Edinburgh
