The UK was once called the “sick man of Europe”, because its economy lagged behind continental rivals. But as a major report from the IPPR thinktank pointed out this week, these days the phrase applies literally.
A record 2.8 million people are out of work because of long-term sickness, with huge knock-on costs for the nation in benefits claimed and lost productivity – not to mention all the personal pain and misery.
This epidemic underlines the web of challenges Labour has inherited, weaving together poverty and welfare, the state of the NHS and the government’s back-to-work support.
For today’s newsletter, I spoke to Stephen Evans, director of the Learning and Work Institute, about how the UK became “the sick man of Europe” – and how to nurse the patient back to health.
Five big stories
Middle East | Israeli warplanes carried out dozens of strikes across southern Lebanon late on Thursday, hours after Hassan Nasrallah, Hezbollah’s leader, threatened “tough retribution and just punishment” for the wave of attacks that targeted the organisation with explosives hidden in pagers and walkie-talkies.
Environment | The amount of pesticide residue allowed on scores of food types in England, Wales and Scotland has soared since Brexit, analysis reveals, with some now thousands of times higher.
Politics | Cabinet ministers have begun rallying around Downing Street chief of staff, Sue Gray, calling briefings against her “appalling”. In an attempt to put an end to a series of damaging rows, Keir Starmer denied he had lost grip of his team and insisted he was “completely in control” of his No 10 operation.
Ukraine | Russia’s military command had anticipated Ukraine’s incursion into its Kursk region and had been making plans to prevent it for several months, according to a cache of documents that the Ukrainian army said it had seized from abandoned Russian positions in the region. The documents, shared with the Guardian, also reveal Russian concerns about morale in the ranks in Kursk
Gambling | Gamblers in Great Britain are betting £2.7bn a year through hidden-market websites, according to a lobby group that claims stricter regulation of the licensed sector would further fuel illegal gambling.
In depth: ‘There is an economic prize here’
The number of people unable to work because of their health had been ticking upwards for some years, but Evans says the real jump came after Covid. Part of this is likely to have been the knock-on effects of the virus itself, with long Covid continuing to cause problems for many workers, for example.
But Evans says a key driver has been the increasing number of people unable to work because they are struggling with their mental health. “There is a big rise in people citing mental health conditions, so that’s making up a much bigger proportion than in the 90s, say, when you still had some of the legacy of industrial changes in the 1980s,” he says. “With mental health, I think people are more willing to say they have a mental health condition – there’s more openness about this stuff and more knowledge and awareness – and there may well be a rising prevalence as well.”
Where physical health is concerned, musculoskeletal conditions such as back and neck pain are the leading cause of being unable to work, whether as a result of heavy lifting or being scrunched over a computer screen.
Long delays for treatment of both physical and mental conditions, as the NHS creaked and waiting lists lengthened in the aftermath of the pandemic, appears highly likely to have increased the number of workers struggling with their health.
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Turning things around
The potential benefits of turning around the increase in nagging long-term health conditions are significant.
The Learning and Work Institute estimates there are an extraordinary one million fewer people in the workforce than projections before the pandemic might have suggested.
The UK is an outlier here – we are the only G7 nation whose employment rate has not returned to its pre-Covid level, in part because of these health pressures. And without intervention, the IPPR’s analysis suggested the number of people out of work because of long-term sickness could hit four million.
Evans points out that one in five of this group say they would like to work. He argues that proportion might rise, with better health and employment support.
“The proportion who say they want to work is relatively low, but that’s partly because no one ever talks to them about the kind of work available, or flexibility. So it’s not like a fixed number,” Evans says. As it stands, only 1% of people out of work due to long-term sickness are in work six months later.
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Getting Britain working
Labour came to power pledging to tackle some of these challenges. Liz Kendall has announced a target of an 80% employment rate – in other words, 80% of the working-age population in a job. More details are expected to come in a white paper on how to “get Britain working”.
With the current rate stuck at 75%, Evans says that would mean an extra 2.4 million people moving into a job, whether from sickness or off the unemployment roll.
“There is an economic prize here. We believe the 80% employment rate could boost the economy by at least £23bn,” he said. That is the dividend in additional GDP growth as inactive people return to work. Evans argues there would also be a direct benefit to the Treasury of £8bn, as workers paid tax and claimed fewer benefits.
The upfront costs might be £200m a year, the Learning and Work Institute suggests. That may make it sound like a no-brainer; but Evans adds that it is likely to be a decade-long challenge, while the Treasury’s horizon tends to be shorter.
“One of the challenges is the current fiscal rules look at debt in five years’ time. This is about long-termism. Getting to 80% is a really good idea but it will take10 years to get there.”
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Best avoid benefit reforms
Evans says Labour will need to take action across a range of fronts, to help coax some of the long-term sick back into the workforce.
Health secretary Wes Streeting’s plans to reform and reinvest in the NHS will have to be part of the solution – and the economic benefits of getting people back into work provide a powerful rationale for getting that right.
Reducing the poverty and inequality that can leave people more vulnerable to health conditions – as the pandemic showed – is another part of the puzzle. The IPPR has pointed to the importance of combating obesity as a health but also an economic challenge.
Evans warns against another lever it may be tempting for ministers to use – benefit reforms. “I think benefit reform is a bit like squeezing a balloon and if you halt it in one area it pops out in another. So I would say the better thing is to improve health and inequality, sort out the health service, but also have some high-quality support on offer to people,” he says.
Some local authorities already run back-to-work schemes that help people to confront health challenges and support them back into a job. Evans suggests Labour make that approach much more widespread and easy to reach.
“You find people where they are: it could be the community centre, the GP surgery, the library, the shopping centre.” He adds: You can’t just tweak the benefits system and get there: you also need to look at what employers do, how the NHS is operating, levels of poverty – you need to look at all of those things together.”
What else we’ve been reading
Neo-fascist or pragmatic populist? Alexander Stille scrutinises the past and present of Italian prime minister Giorgia Meloni in this fascinating Long Read. Toby Moses, head of newsletters
This vivid piece by Czech undercover journalist Saša Uhlová reveals the depressing reality of life on the margins of the labour market, as a hotel cleaner in Ireland. Heather
Joe Lycett has made his name for himself as a bit of an artist – “I mostly make silly things” – alongside his comedy and TV presenting careers. Stuart Heritage talks to the polymath upon the release of his new book, Art Hole. Toby
From the inside of a defunct asylum, to the carriageway of the as-yet-unopened M25 – I really enjoyed this piece about Guardian reader’s quirky dates, inspired by Jeremy Corbyn once whisking Diane Abbott off to Karl Marx’s graveside. Heather
Alaina Demopoulos writes about the rise of Celsius, “Red Bull for women”, an energy drink marketed as healthy but with nearly as much caffeine as six cans of Coke. Toby
Sport
Football | Arsenal manager Mikel Arteta hailed his goalkeeper David Raya after the Spaniard’s miraculous double save earned his side a 0-0 draw away to Atalanta in the Champions League on Thursday.
Cricket | Travis Head scored an unbeaten 154 and Marnus Labuschagne contributed 77 not out as Australia successfully chased down a formidable 316-run target to beat England by seven wickets in the first of their five-match One Day International Series at Trent Bridge on Thursday.
Tennis| Emma Raducanu reached the quarter-finals of the Korea Open after beating eighth seed Yue Yuan in straight sets. The 21-year-old needed seven match points to secure a hard-fought 6-4, 6-3 victory over the eighth seed.
The front pages
The Guardian leads with “Hezbollah chief vows ‘retribution’ against Israel after wave of attacks”. The i follows the same story with “Middle East steps closer to regional war”.
The Telegraph splashes on “I’m still in control, says Starmer as feud erupts”. The Times has “Reeves told to reverse cuts after £10bn boost”. The Financial Times leads with “Consumer confidence takes tumble as households fear ‘painful budget’”.
The Mail looks at the Tory leadership contest, under the headline “English identity is under threat, warns Jenrick”. The Sun’s lead is “Ronnie & Laila’s 147 break”.
Something for the weekend
Our critics’ roundup of the best things to watch, read and listen to right now
TV
Jamali Maddix: Follow the Leader
This new series sees the comic (above) meet leading figures in cults and subcultures, from paedophile hunters to Moonies leader Pastor Sean. He’ll likely receive comparisons to Louis Theroux (whose production company is behind this show), but he has his own unique approach – one of Theroux’s greatest strengths is an ability to sit in awkwardness, while Maddix continually diffuses it, finding humour in its darkest moments. Leila Latif
Music
Jamie xx: In Waves
If your exposure to Jamie xx was largely via the understated band who gave him his pseudonym, his debut solo album – a celebration of London’s dance history – might have come as a shock. Nine years later, the mood remains vibrant on this follow-up, an album preoccupied with rapture, whether induced by chemicals or repetitive beats. But while In Colour was designed to be enjoyed at home, In Waves is more interested in the club. Alexis Petridis
Film
The Substance
Coralie Fargeat, known for the violent 2017 thriller Revenge, now cranks up the amplifier for some death metal … or nasty injury metal anyway. This is a cheerfully silly and outrageously indulgent piece of gonzo body-horror comedy, lacking in subtlety, body-positivity or positivity of any sort. It’s flawed and overlong but there’s a genius bit of casting in Demi Moore who is a very good sport. Peter Bradshaw
Podcast
Empire City
Widely available, episodes weekly
Journalist Chenjerai Kumanyika recently discovered footage of his father as a young man. The context was disturbing: the film was shot by the NYPD who were surveilling civil rights activists. It prompted Kumanyika to produce this damning series, which functions as an alternative history of the US police and a challenge to the notion that they have the safety of New Yorkers at heart. Phil Harrison
Today in Focus
How Lebanon’s pagers and walkie-talkies became deadly weapons
On Tuesday, dozens of people were killed when electronic pagers blew up. The next day walkie-talkies exploded. What was the goal of the attacks? William Christou reports.
Cartoon of the day | Ben Jennings
The Upside
A bit of good news to remind you that the world’s not all bad
Katie Ward was an aspiring young novelist who had just experienced her 44th rejection in a row when a colleague suggested she talk to her friend, a published author – who turned out to be the late Hilary Mantel, two years away from stellar success with Wolf Hall. There started a 15-year relationship in which Mantel would offer calm and assured advice to Ward over email. She urged her to write every day, and showed her that writing could be a kind pursuit.
“Hilary was a gentle person,” writes Katie, whose second novel, Pathways, was published in April. “She cared deeply about her readers and respected their intelligence. She nourished her readership with her storytelling, while still leaving them hungry for more.”
Mantel, who shot to fame in her 50s, also showed that sometimes you have to wait until you are mature enough to write your best work. But perhaps her most important piece of advice could be applied to a wider field than novel-writing: “Back yourself.”
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Bored at work?
And finally, the Guardian’s puzzles are here to keep you entertained throughout the day. Until Monday.
