Chronic illness makes UK workforce the sickest in developed world

Sly Saint

Sly Saint

Senior Member (Voting Rights)
FT
This was being discussed on Newsnight last night and I was a bit concerned that they were pinning 'economic inactivity' largely on those with LTC.

Ever since Tsar Nicholas I’s rumoured coining of the phrase to describe the Ottoman Empire in 1853, the “sick man of Europe” has been a metaphor for decline. But for the UK in 2022, it is a precise diagnosis of an underlying problem that appears exclusively British.

By the time the Covid-19 pandemic had roiled on for a year of repeated viral waves, with their attendant cycles of social and economic restrictions, a significant exodus from the labour force was visible everywhere from the UK to the US, the EU and even Oceania. Millions dropped out of the workforce to recover from a bout with the virus, to care for a vulnerable relative or homebound child, or to take early retirement.

So it is not surprising that Britain’s labour force is smaller than it was in late 2019. But until now it has not been clear quite how exceptional the UK is in this regard, nor the cause of the malaise.
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In country after country, almost as quickly as people left the labour market, they returned. In the EU, there were 5.8mn missing workers by summer 2020, but by late 2021 inactivity rates were back on the pre-pandemic trend. All but one of the 38 OECD member countries had either completed their labour force rebound or were well on the way there by the first quarter of 2022.

Not in the UK. As 37 countries saw an ascent and descent in inactivity rates, Britain’s line kept climbing. Uniquely among developed countries, the number of working-age Britons who are neither employed nor seeking work has risen in almost every quarter since the end of 2019, and was higher in the first quarter of 2022 than at any time since the pandemic hit.

Chronic illness is the main driver of this stalled labour recovery. Of the roughly half a million Britons aged 15-64 missing from the workforce, two in three cite long-term illness as their reason for not holding or seeking a job. It would be easy to point the finger of blame at Britain’s handling of the virus, but the data suggest otherwise.
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Britain’s rise in chronic illness predates the onset of the pandemic.

With direct impacts of Covid ruled out, the most plausible remaining explanation is grim: we may be witnessing the collapse of the NHS, as hundreds of thousands of patients, unable to access timely care, see their condition worsen to the point of being unable to work. The 332,000 people who have been waiting more than a year for hospital treatment in Britain is a close numerical match for the 309,000 now missing from the labour force due to long-term sickness.
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https://www.ft.com/content/c333a6d8-0a56-488c-aeb8-eeb1c05a34d2

although this report would seem to say otherwise (at least for those aged 50-69)

Overall, it does not seem as if poor health is the primary driver of these increases in economic inactivity rates. The fraction of workers in their 50s and 60s moving from employment into being economically inactive due to ‘long-term sickness or disability’ has stayed relatively constant, with around 0.3–0.5% of 50- to 69-year-old workers per quarter making this transition both before and after the pandemic. Growth in health-related reasons for leaving the labour force only accounts for 5% of the overall growth in inactivity among this age group. And changes in transitions from employment to inactivity are similar between those with and without a long-standing health condition.
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https://ifs.org.uk/publications/16087

I'm guessing that targeting of LTCs will become a priority and bps/pro cbt proponents, who have already started moving into this area, will be taking advantage and offering further 'cost-effective solutions' (ie boom time for ACT, digital therapeutics etc)

eta:
see also ONS stats
INAC01 SA: Economic inactivity by reason (seasonally adjusted)
https://www.ons.gov.uk/employmentan...cinactivitybyreasonseasonallyadjustedinac01sa
In March 2022, ONS figures report 2.3 million workers in the UK aged 16-64 were economically inactive because of long-term sickness (with a long-term health condition that’s lasted at least 12 months).8 That’s more than 5% of the total population aged 16-64.6
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https://www.unum.co.uk/article/long-term-conditions-at-work
 
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This story seems a bit strong considering the data presented.

Here are the graphs relied upon for the argument about the UK's unique status: https://www.ft.com/__origami/service/image/v2/images/raw/https://d6c748xw2pzm8.cloudfront.net/prod/c4313390-0917-11ed-9f35-ab072796bed9-fullwidth.png?dpr=2&fit=scale-down&quality=medium&source=next&width=1260

For working age people outside the labour force, the UK looks to be around 21.5%.

That's lower than the EU average.

Different countries' graphs are different shapes, and a number seem unique in their own way, but I wouldn't feel comfortable concluding too much about any of them based on just what we were told in that article.
 
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Merged thread

UK:Economy. Long-term ill health now highest *on record*

Twitter thread on UK economic data - includes charts relating to long term chronic illness. May have impact on social attitudes to long term ill health and have relevance to advocacy. Also huge number of vacancies in health and social care at a time of low unemployment has long term implications for NHS and at home patient care.

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I think the lack of doctors, nurses, and other medical professionals, is having a big impact on numbers of the sick.

Also, the pandemic prevented many people from seeing a doctor at all so sick people have just got worse. To get an appointment with my surgery (face to face or on the phone) requires patients to stay on the line for an hour in the morning. People can't go to the surgery in person and make an appointment like they could before the pandemic. If someone cannot see a doctor at all then they may give up.
 
Ministers launch back to work drive for people signed off with mental health problems
A major back to work drive for people signed off sick with mental health problems will help Britain’s quest for growth, Number 10 has claimed.
Ministers want to boost the labour force by a further 100,000 people as they strive to cut the benefits bill.

The initiative comes after the Government was alarmed by a sharp rise in economic inactivity in the wake of the Covid pandemic. Downing Street has already announced plans to coax over-50s back into work.

Number 10 has pledged that £122 million will go towards helping put recipients of mental health support in touch with jobs advisers.

Therese Coffey, the Health Secretary, said: “The good health and well-being of the nation is also good for the economic health of the nation. Offering employment support to people under the care of NHS mental health services will help them start, stay and succeed in work, improving their well-being and resilience as well as growing our economy.”

It is thought that helping 100,000 people with mental health problems to either stay in or join the workforce could boost GDP by up to 0.25 per cent.

‘Helping drive down inactivity’
“The Government’s growth-focused agenda will deliver jobs, higher wages and greater opportunities,” said Chloe Smith, the Work and Pensions Secretary.

“Helping people access both clinical support for their mental health as well as employment advice gives them the tools they need to get into or return to work. This is vital to helping drive down inactivity and growing our economy so we can deliver more money and support for public services such as these.”

There are 640,000 more economically inactive Britons now than before the pandemic, according to ONS figures. Of that increase, more than half – some 350,000 people of working age – have been signed off as long-term sick.

A report published by the London School of Economics earlier this year found mental health problems cost the economy at least £117.9bn a year, equivalent to five per cent of GDP. It has previously calculated that 12.7 per cent of all sick days taken by Britons are because of problems such as stress and depression.

A survey of businesses carried out last December found that 57 per cent reported mental health problems as being a leading cause of absence.

In total, there are 2.5 million people on long-term sick leave in the UK, just under twice the current number of job vacancies.
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https://www.msn.com/en-gb/money/oth...d-off-with-mental-health-problems/ar-AA12Mvf5
 
People not looking for work due to illness hits record high

The number of people not looking for work because they are suffering from a long-term illness has hit a record high, latest official figures show.
The fall in the number looking for work has helped to push the unemployment rate to its lowest for nearly 50 years.
The jobless rate fell to 3.5% in the three months to August, the Office for National Statistics (ONS) said.
The number of job vacancies fell again, although the level still remains high with many firms struggling to recruit.
However, the squeeze on pay remains, with rises in regular wages failing to keep up with the rising cost of living.
ONS head of labour market and household statistics David Freeman said the number of people neither working nor looking for work had continued to rise over the past few months.

The economic inactivity rate - which measures the proportion of people aged between 16 and 64 not looking for work - increased to 21.7% in the June to August period, the ONS said. The number of those inactive because they are long-term sick hit a record high of nearly 2.5 million.
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My bolding

ETA: The first graph shows a sudden and very dramatic increase around the end of 2019, can anyone think of a reason for this? The article gives no reason for it.
Some of the comments suggest it's laziness.

https://www.bbc.co.uk/news/business-63204333
 
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But.....this cannot be......we had a world beating approach to covid...we were told......by a 'man'.

Better than anywhere else, faster than anywhere else, just better, in every way.

As implemented, as instructed by our leaders, by the best health service in the world, envied by the whole world, NHS

..and now........

What's been claimed, stated, forcefully, repeatedly, when coupled with 'this' - it just doesn't make any sense.

Rats cannot ordinarily produce large pork pies, in such quantity.

Possibly we have the best rats in the world.
 
When the pandemic really started getting a grip back in roughly Spring 2020 GPs vanished off the face of the earth, and even getting into A&E was difficult I think, and waiting times for anything and everything medical exploded. In my opinion GPs seemed to become mythical. Patients who did manage to see a doctor on Zoom or spoke to them on the phone would have comments added to their records saying "blood pressure is normal", "blood tests are normal", or similar dismissive statements despite the doctor not laying a finger on the patient and not seeing them in the flesh.

The other factor is that doctors have been shovelling more and more patients into the "mentally ill" wastebasket for years and the pandemic just accelerated that, so the number of people who get treatment for their physical ailments appears to be dropping all the time. If a physical ailment isn't treated, some of the sufferers may eventually get well on their own, but a huge number might just stay ill permanently. After all, anti-depressants don't cure cancer. And the people who are seriously mentally ill don't get good treatment either.

I would be interested in knowing how primary care doctors actually dealt with the pandemic in the EU. Did they see patients in the flesh?
 
If anyone finds it weird how there can be low unemployment with high number of disabled people, that's because there are several calculations for unemployment figures (to account for students, retired, etc.) and the one that is typically used doesn't include people who are disabled without being recorded as disabled. So when you have so many people who are disabled but not considered medically disabled, they are essentially considered as "not working and not looking for work", which is excluded from the typical unemployment figures.

And of course many of those "mentally ill" are not mentally ill and likely have chronic illness or other minimized issues, especially chronic pain. Labeling everything mental health doesn't make it so, but it does free the healthcare system of any responsibility or any of the rights and rules of medicine.

I have to say that aside from trickle-down economics, I have rarely seen a more blatantly-doomed-to-fail policy than betting the economy on getting sick people back to work without any form of actual help or support, simply coaxing them to it. And definitely not cheap, it's like paying to lose more in the end. So, basically the biopsychosocial approach.

About as smart as buying a huge number of pumpkins in late October because sales are trending up, up, up!
 
John Mac said:
My bolding

ETA: The first graph shows a sudden and very dramatic increase around the end of 2019, can anyone think of a reason for this? The article gives no reason for it.
Some of the comments suggest it's laziness.

https://www.bbc.co.uk/news/business-63204333
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This article (may be paywalled depending on previous access etc) The shrinking workforce is another very British problem presents some of the complexity:


"One crumb of comfort in this has been the perception that we are all in it together, and that other countries are experiencing similar problems. That, however, is not true. The UK, as Ramsden noted, “stands out” in comparison with other major economies, for rising inactivity and falling labour force participation.

The UK participation rate is 0.7 percentage points below pre-pandemic levels, a mirror image of the 0.7-point rise, the average among other big advanced economies. Germany has seen roughly a 1.5-point rise, and the EU as a whole more than a percentage point. This is why Britain’s labour market is so unusual at the moment. The unemployment rate, a very low 3.5 per cent, as noted, is at a level normally associated with full employment.

Fullness is not, though, what it was. Overall employment is still more than 300,000 below what it was before the pandemic, while for the private sector there has been a bigger fall, of more than half a million. The economy has not quite got back to where it was before Covid-19 and employment has even further to go.

Between 2010 and 2019 the UK was very good at generating jobs, in spite of unspectacular economic growth, with employment rising by an extraordinary 4 million people to 33 million. Those figures are unlikely to be repeated, or even an echo of them, as long as inactivity remains high and labour shortages the norm.

What is driving what the Bank deputy governor describes as a “participation puzzle”?

Most of it, as is well known, affects older workers, the over-50s. Their loss from the workforce takes with it skills, knowledge and experience, and is thus concerning. The Office for National Statistics has been exploring the motivations of these workers in leaving the labour market."

For older workers among the newly inactive over-50s, those in the 60 to 65 age group, deciding to retire from paid work was overwhelmingly the biggest reason, followed or accompanied by not wanting to work any more, or being made redundant. Some of these older workers surveyed by the ONS said they would consider a return to work, but a much lower proportion than for those in their 50s.

For the 50 to 59 age group of newly inactive, a quarter had taken early retirement and 18 per cent left the workforce for lifestyle reasons. But 72 per cent in this age group said they would consider a return to work, though slightly more than half reported mental or physical health problems and a quarter said their condition limited their ability to carry out day-to-day activities. Most of the rise in inactivity in the latest three months was due to long-term sickness. Stress was a big factor for those leaving work in their early 50s. That is why, according to the Institute for Employment Studies, while older workers are a potential source of untapped talent, employers have to make sure the opportunities are tailored to them, particularly those who left because of stress, ill-health or a lack of job satisfaction."
 
CRG said:
Most of it, as is well known, affects older workers, the over-50s. Their loss from the workforce takes with it skills, knowledge and experience, and is thus concerning. The Office for National Statistics has been exploring the motivations of these workers in leaving the labour market."

For older workers among the newly inactive over-50s, those in the 60 to 65 age group, deciding to retire from paid work was overwhelmingly the biggest reason, followed or accompanied by not wanting to work any more, or being made redundant. Some of these older workers surveyed by the ONS said they would consider a return to work, but a much lower proportion than for those in their 50s.

For the 50 to 59 age group of newly inactive, a quarter had taken early retirement and 18 per cent left the workforce for lifestyle reasons. But 72 per cent in this age group said they would consider a return to work, though slightly more than half reported mental or physical health problems and a quarter said their condition limited their ability to carry out day-to-day activities. Most of the rise in inactivity in the latest three months was due to long-term sickness. Stress was a big factor for those leaving work in their early 50s. That is why, according to the Institute for Employment Studies, while older workers are a potential source of untapped talent, employers have to make sure the opportunities are tailored to them, particularly those who left because of stress, ill-health or a lack of job satisfaction."
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I wonder if people leave the work force more often in particular sectors. At the start of the pandemic a young family member was looking at staff retention in residential care for adults with learning disability where jobs carried high levels of stress and relative to alternative employment in the same geographical areas lower salaries. Even without the pandemic they were anticipating significant staff losses.

With the pandemic on top of over a decade of government austerity in the UK social and health care and education have seen dramatically increases in work related stress, also they often have seen relatively high levels of Covid and so potentially high levels of Long Covid too.
 
Peter Trewhitt said:
I wonder if people leave the work force more often in particular sectors. At the start of the pandemic a young family member was looking at staff retention in residential care for adults with learning disability where jobs carried high levels of stress and relative to alternative employment in the same geographical areas lower salaries. Even without the pandemic they were anticipating significant staff losses.

With the pandemic on top of over a decade of government austerity in the UK social and health care and education have seen dramatically increases in work related stress, also they often have seen relatively high levels of Covid and so potentially high levels of Long Covid too.
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With unemployment historically low but with rapid increases in prices, those who have no choice but to stay in work will be taking every opportunity to move from lower paying jobs to higher paid ones, and lower paid jobs remaining unfilled because of the difficulties of work force/job matching. One of the characteristics of the 50+ not working cohort, is that there seem to be quite high levels of economic choice i.e as a group they are apparently free of the economic demand to work. That doesn't necessarily match to a cohort that is unable to work because of illness, in fact only 25% say they are in that category.

As much as anything else what the not working/not on benefits phenomena may represent is the well recognised imbalance in wealth distribution between generations in the UK with those 50+ far more likely to own assets, especially housing, which means living mortgage and rent free, and/or receiving rental and/or dividend income. Whether older workers in health and social care are more likely to move to the asset supported living option is difficult to parse, though jobs which are higher skill/higher salary would seem to offer the greatest opportunity - greater accumulated earnings, higher pension etc. So nurses but perhaps not care assistants.

A pandemic brings more than illness - it involves social disruption and we have to be careful not to put every socio-economic change down disease, people may change as response to disruption without the disease actually affecting them personally. Correlation not causation.
 
The early retirees I know who've given up work a few years ahead of state pension age have mostly done so because workplaces were just becoming more and more toxic, and they have at least some pension provision to fill the gap.

Staff management was farmed out to faceless HR departments who did it by algorithm, instead of the skill and experience of good managers who understood that a bit of give and take could work wonders in making staff feel valued and retaining hard-won skills and knowledge. Reliable older workers lost out to competitive youngsters for promotions, which was fine when they were capable and smart, but not when they were utterly clueless and made everyone's jobs harder.

There was also the assumption that systemisation of everything improved efficiency—this can be true if it's a good system, but too often it's borrowed wholesale from another context and bodged to fit. Then there's the realisation that offering good customer service costs money, and it's much cheaper to make sure customers can't get in touch easily in the first place, and offer no effective help when they do...

Faced with all that, and the crushing despair it creates in people who know that not only did everything used to work better but the staff even enjoyed their jobs, three or four financially tight years followed by a slightly reduced long-term pension can look like excellent value for money.
 
Sly Saint said:
Quarter of a million out-of-work young Britons plan to NEVER get a job, survey reveals


https://www.dailymail.co.uk/news/ar...-Britons-planning-NEVER-job-survey-shows.html

maybe the powers that be should be concentrating on this group of people.
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The research, in which 5,000 young people were questioned, was carried out by educational organisation City and Guilds and published in a report titled 'Youth Misspent'.

By. Not “for”. Not by a serious market researcher, then. I would want to know how the sample was recruited and how the results are weighted before trusting a survey so clearly designed to get traction in rags like the Mail.
 
Sly Saint said:
also in the Guardian, telegraph and other publications.
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A triumphant PR success for the City and Guilds course-floggers, then. They have aroused the nation’s newspaper-reading grandparents to check for fecklessness in the youngsters around the Christmas table, and perhaps they will attract one or two more aspirants to become qualified welders.

Long-term sickness and early retirement are more important to welfare and productivity policy makers by several order of magnitude, though.
 
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