Message for the Chancellor: Public health is an economic issue

‘What the government steadfastly refuses to acknowledge, let alone address, is the crisis of people not working, not because they don’t have to financially, not because they choose to live a leisure life, but simply because they can’ t, because of illness’


Natalie Bennett is a former leader of the Green Party of England and Wales. She is now in the House of Lords.

The UK unemployment rate is at its lowest since 1974. We see ‘Help Wanted’ signs in many shop windows, a multitude of employers – and not just the low paid – complain about the difficulty in finding staff.

The government is so desperate about the problem that it is now trying to push even harder on part-time workers to get them more hours – although the numbers are small and many of them will have good reasons for limited hours, caring responsibilities, illness or disability , or simply being in places where there is no more suitable work.

What the government staunchly refuses to acknowledge, let alone address, is the crisis of people not working, not because they don’t have to financially, not because they choose to live a leisure life, but simply because they can. t, for health reasons.

Nine million people of working age are recorded as “not employed”. Around 2.6 million of these are students, with at least 1.3 million being carers, mostly struggling to make ends meet on the grossly inadequate £69.70 a week they are paid. But that leaves many people behind, and the numbers show that the disease is preventing many of them from gainful employment.

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Well over 300,000 people have joined this group since the pandemic began – 2.46 million in total. The number is rising at the fastest rate in three decades. Experts say long Covid is only part of the story and of course doesn’t explain the high number before the pandemic.

The usual suspects are jumping up to blast the NHS over these numbers. And, of course, exhausted staff, insufficient financial resources and lack of workforce predictability are leading to long waiting lists, which will discourage some people from returning to work.

But what is not being said, and needs to be said, is that the terrible quality of public health here is a major factor. Poor housing conditions, terrible air pollution, poverty, unhealthy diets and insecurity are causes of ill health. They are the “social determinants of health” in technical jargon and are more important than any individual behavior or treatment.

They would then think that the government – with their obsession with growth – Focus on this clear threat. If they don’t care about public welfare and health for their own sake (and all indications are that they don’t), then surely they would be concerned about the impact on “the economy”?

Ensuring a healthier environment would help at least some of those people, who are now being pulled from inadequate long-term sickness benefits, to get back into paid work, so one might think there was an acute focus not just on the NHS and social care, but to create a healthier society. But you would be wrong. Because all indications are that this is a government ideologically driven to “cut bureaucracy” and let go of what they see as business “animals” and is actively acting to worsen public health.

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There is informed talk that the previous government’s extremely modest and inadequate obesity strategy should be abandoned. This, as the latest research on ultra-processed foods – which make up more than half of the UK diet – shows is another ill health, something I’ve long been trying to get the government to acknowledge.

There is the nonsensical plan to tackle the energy crisis with fracking. Aside from the fact that if public opposition were to be overcome, it would take at least a decade for significant gas supplies to materialize, this would have public health implications not only in the immediate vicinity of the sites (most of which are in areas on which is supposedly being “leveled up” by the previous government and where public health is particularly poor), but in the continued reliance on the burning of this fossil fuel. There is a growing understanding of the horrific effects of cooking with gas on indoor air pollution, and while the World Health Organization has in a major intervention called for a global fossil fuel non-proliferation treaty that fracking would violate.

Mental illness is a significant factor and a growing part of the total. We know that it is made worse by insecurity, to which the government could react very clearly, and the general state of our society, but again and again the government worsens the well-being of our society with fines and insufficient support.

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Then there’s inequality – which the government’s plans for tax cuts and the nature of its energy price cap will only increase. And inequality – as Kate Pickett and Richard G. Wilson demonstrated many years ago in The Spirit Level – is extremely bad for public health.

So I have a recommendation for Kwasi Kwarteng: sit down with the Ministers for Health, Housing, Transport and Work and Pensions and find out how you can improve public health. If you want a productive society, we need to get much, much better. And given what people want in a newborn baby – a healthy life – it’s a core human aspiration.

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