The UK is said to be experiencing an epidemic of working-age illness.
Growing numbers of people are living with chronic conditions and diseases that force them out of employment altogether.
But just as many – around a fifth of working-age adults in the UK – are estimated to be living with what one think tank described as a work-limiting condition.
The Health Foundation says the issue has become such a problem it could even threaten the UK’s economic performance.
It’s an epidemic the government say they want to tackle. This week, in a set piece speech Prime Minister Rishi Sunak blasted the country’s “sicknote culture”, which he said is costing the tax payer £69 billion a year.
In comments that drew ire from disability charities and health campaigners, Mr Sunak claimed some choose to live on benefits as a “lifestyle choice”, linking this to the UK’s “spiralling” welfare bill.
The prime minister says his party will make it harder for some people to obtain a sick note, and those who are still out of work after 12 months of support would have their benefits stopped entirely.
Such a system would see so-called specialist work and health professionals assess whether someone is fit to work and what they could do, and the medical evidence required for a Personal Independence Payment (PIP) award would increase.
PM: Culture change needed
Mr Sunak argued: “We don’t just need to change the sick note, we need to change the sick note culture so the default becomes what work you can do – not what you can’t.”
With the management of disability welfare benefits devolved, some of these proposals would require support from the Scottish Government – who say they are opposed – before the rules could be changed.
The SNP’s social justice secretary Shirley-Anne Sommerville branded the prime minister’s comments “heartless”, questioning the effectiveness of sanctions.
But she pointed out that some benefits in Scotland are linked to a person’s ability to access Scottish benefits are linked to their eligibility for support under the UK system, meaning changes there could affect Scots indirectly.
Rishi Sunak’s concern about Britain’s growing illness rates is not unreasonable.
Official statistics suggest there are 2.7 million people with long-term sickness who are “economically inactive” – up by a third on 2019.
As the Health Foundation points out, these trends aren’t new. It’s a problem researchers have been looking at since the 2008 financial crash.
Neither is it a revelation that some groups in the UK are harder hit than others, with the poorest more likely to be unwell.
Britain’s ailing health is not new
Chris Rocks, of the Health Foundation, explained: “The 2008 financial crisis had a major impact on society – we saw an economic downturn and public spending cuts.
“The pandemic and subsequent cost of living crisis exacerbated trends, but the signs were there before Covid-19 hit.
“Access to healthcare has become more difficult, while those fundamental building blocks of health – such as good housing and adequate incomes – are under strain.”
It’s a picture most of us will recognise as the cost of living only seems to increase.
Many can’t afford to do the things we know can improve our health – mentally and physically, so it’s no surprise that health inequality is only set to worsen.
If you live in one of the most deprived areas, research suggests you’re likely to be diagnosed with a major illness up to a decade before someone living in the most well off parts of the country.
By 2040, more and more people will be diagnosed with conditions like chronic pain, type 2 diabetes and anxiety and depression.
Neither Rishi Sunak in his speech, or the Scottish Government in theirs, seemed keen to talk about the underlying problem.
Instead, in a political hurry to be seen to be doing something, Mr Sunak may have prescribed the wrong solution for a problem he has fundamentally misdiagnosed.
Cure may prove a tough medicine to swallow
More and more of us are too unhealthy to work, but the answer from government surely cannot be to just force a sicker population into work.
If the nation’s health has deteriorated as much as the figures would suggest it has over the last 15 years, politicians must take some responsibility.
Rather than tinker with welfare rules, a braver politician would have set out a package of actions to cure the country’s ailing health.
That would require reform of healthcare provision in the UK, tougher requirements on employers to look after the health of their workforce, and a stronger welfare safety net for those struggling with the cost of living.
If your view is a short term one which can only see merit in saving cash to balance the books, this could prove to be a medicine that’s hard to swallow.
But if our goal is to do more than simple savings, in the long term these actions may just arrest the decline in the country’s health.
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