The UK is becoming a sick society. I do not mean that in a figurative sense, that the country is suffering from an epidemic of depravity and knife crime — one Old Bailey judge lamented that he could not remember the last time he had to deal with a murder suspect who was older than 20 years old — I mean it literally.
Sixteen percent of the British labor force — one in six — report that they suffer from long-term health problems. This number has risen by just over one-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 labor-force participation — more than one-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.
Illustration: Yusha
This is a serious economic problem as well as a human tragedy, since health and wealth are closely aligned.
Since 1750, life expectancy and productivity have advanced almost in lock-step: The population has increased by about 2 percent per year — driven largely by a near doubling of life expectancy — and productivity has risen by 1.5 percent per year.
Economic progress led to better health, and better health powered economic progress. Today, the advance has slowed to a crawl: The British economy is stagnating, and life expectancy in the UK (81) has increased by just eight weeks since 2011.
The future does not look any better. The biggest growth in long-term illness has been in the 16 to 24 age cohort, with numbers rising by 50 percent compared with one-third in the overall population.
One in eight 16 to 24-year-olds claim that they are suffering from long-term health problems — as high a percentage you find in the 25 to 49 cohort. This is largely driven by mental health issues, but 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 illness could easily lead to a lifetime of unemployment.
One of the main aims of British Chancellor of the Exchequer Jeremy Hunt’s budget was to address the problem captured by two glaring figures: The UK has 1 million job vacancies — hence long queues and interminable telephone holds — but more than 7 million adults, excluding students, who are not in work.
He announced measures to reform disability rules so that disabled people can get back into work more easily. He acknowledged the prevalence of health scourges such as musculoskeletal problems and mental-health issues. He made money available to encourage companies to provide better occupational health. He announced pilot schemes for “health hubs” where people could go for advice, particularly on mental health and back problems, without a doctor’s referral.
He also rattled the saber of “more intensive conditionality” to prevent people from taking advantage of the system.
The government deserves to be praised for recognizing that health is a big problem, and for trying to tackle it from so many different angles.
However, the crisis is unlikely to be solved any time soon. The UK’s health troubles are deeply rooted in its regional disparities, over-strained National Health Service (NHS) and low productivity.
The problem of poor health is inseparable from the problem of poverty. The UK has a high level of social inequality compared with other rich countries — rich Britons can expect to live 15 years longer than poor Britons.
It has a high level of regional inequality — some parts of the UK are poorer than Eastern Europe — and a high level of childhood poverty.
Bad nutrition leads to heart problems, obesity and diabetes. Damp homes lead to breathing problems, particularly if they are infected with black mold, an epidemic in social housing. A dead-end economy encourages drug taking — Dundee, Scotland, has the highest incidence of drug deaths in Europe.
Health problems are particularly bad in former industrial towns in the north, Wales and Scotland, where a long tradition of manual labor was followed by a wrenching process of deindustrialization that led not only to high unemployment, but also a widespread sense of hopelessness.
In these regions, many people can spend one-third of their lives in a state of ill health.
The dismal state of the NHS is entrenching problems. The UK has one of the lowest ratios of doctors and hospital beds to patients in the Organisation for Economic Co-operation and Development. Waiting lists have doubled since 2016, and hospitals are carrying out 12 percent fewer operations than before the COVID-19 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.
The difficulty of getting through to general practitioner surgeries on the telephone means that some people simply give up. Long waiting lists for elective surgery mean that conditions can worsen, and holding down a job can prove impossible.
The recent spate of strikes over pay and conditions for nurses and junior doctors would only exacerbate the problem. Getting healthcare is turning into an evolutionary race in which, perversely, only the fittest survive.
The UK’s health problems also stem from its long-term productivity problems. Low productivity means that there is less money to invest in what former Bank of England chief economist Andy Haldane calls the country’s “social immune system,” not least the NHS.
It traps people in low-paying and repetitive jobs. 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 revitalizing investment.
Former British prime minister Boris Johnson often quoted Cicero’s injunction about the health of the population being the supreme law — salus populi suprema lex esto.
The deteriorating health of the UK is not only the supreme condemnation of recent government policy, but could prove to be the toughest barrier to improving the economy long-term.
Adrian Wooldridge is the global business columnist for Bloomberg Opinion and a former writer at the Economist. This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
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