Britain is becoming a sick society. I don’t mean this merely in a figurative sense, that the country is suffering from an epidemic of depravity and knife crime. Sixteen per cent of the British labour force — one in six — report that they suffer from long-term health problems.
This number has risen by just over a third since 2010, to more than 7 million from 5.2 million, and it shows no sign of reversing, as it has in other European countries.
The long-term sick not only experience persistently lower labour-force participation (more than a quarter of economically inactive people are sick), but are also less productive when they do work, gravitating to part-time jobs and working fewer hours.
This is a serious economic problem as well as a human tragedy, since health and wealth are closely aligned.
Long-term health problems
Since 1750, life expectancy and productivity have advanced almost in lock-step — the population has increased by about 2% a year (driven largely by a near doubling of life expectancy) and productivity has risen by 1.5% a year.
Economic progress led to better health, and better health powered economic progress. Today, the advance has slowed to a crawl: The economy is stagnating, and life expectancy in the UK (81) has increased by just eight weeks since 2011.
The future doesn’t look any better. The biggest growth in long-term illness has been in the 16-24 age cohort, with numbers rising by 50% compared with one-third in the overall population. Fully one in eight 16-24-year-olds claim that they are suffering from long-term health problems — as high a percentage you find in the 25-49 cohort.
This is largely driven by mental health issues, though rising levels of obesity among the young also play a part. Given these are vital years for acquiring skills and establishing work habits, long-term sickness could easily lead to a lifetime of unemployment.
One of the main aims of UK Chancellor of the Exchequer Jeremy Hunt’s budget was to address the problem captured by two glaring figures: Britain has 1 million job vacancies (hence all those queues and interminable telephone holds), but more than 7 million adults (excluding students) who are not in work.
Health problems are particularly bad in former industrial towns in the North, Wales and Scotland, where a long tradition of manual labour was followed by a wrenching process of deindustrialisation that led not only to high unemployment but a widespread sense of hopelessness. In these regions, many people can spend a third of their lives in a state of ill health.
Dismal state of the NHS
The dismal state of the NHS is entrenching problems. Britain has one of the lowest ratios of both doctors and hospital beds to patients in the OECD. Waiting lists have doubled since 2016, and hospitals are now carrying out 12% fewer operations than before the pandemic.
These problems negate two of the great virtues of a free National Health Service — catching diseases early and getting sick people back into work.
Britain’s health problems also stem from its long-term productivity problems. Low productivity means that there is less money to invest in what Andy Haldane, the former chief economist for the Bank of England, calls the country’s “social immune system,” not least the NHS.
It traps people in low-paying and repetitive jobs. And poor productivity and poor health reinforce each other in a cycle of decline: The worse the condition of the workforce, the less likely you are to be able to attract revitalising investment.
Boris Johnson, the former prime minister, was fond of quoting Cicero’s injunction about the health of the population being the supreme law (“salus populi suprema lex esto”). The deteriorating health of Britain may prove to be the toughest barrier to improving the economy long-term.
Adrian Wooldridge is the author of “The Aristocracy of Talent: How Meritocracy Made the Modern World.”