This article was written by John for The Times Red Box
Perhaps no other measure of social progress is as compelling as how long a newborn baby is expected to live. One of the greatest achievements of the twentieth century was that UK girls born in 1900 were expected to live just 52 years, but a century later they could expect to live beyond 80.
But now the picture isn’t so good. Life expectancy is barely rising at all, and healthy life expectancy – the years you can expect to live in good health – is falling for women for the first time in decades. We’re going backwards, and many of us are facing a longer, sicker, more frail and more painful old age than our parents.
All? Not quite. Things are much better if you’re born in a more affluent area, but worse in less-well-off ones. The latest data shows girls born in the poorest communities will die 7.9 years earlier than girls born in the wealthiest, and will live 19.3 fewer years in good health. Calculations from the Centre for Progressive Policy showed that 80 million years of life are lost as a result of inequalities in education, income, employment, crime and housing in England . That’s deeply, horribly unfair: after all, the accident of your or my birth shouldn’t dictate our destinies when it comes to our lifespans, or our chances of a painful old age. But at the moment, for most of us, it does.
Declining health matters for economic growth too. Today, there are over half a million fewer UK workers than before the pandemic, and two in three of them left because of ill health. As James Burdoch of the Financial Times has shown, the UK is the only developed country in the world where the percentage of working age people who have left the workforce has kept rising. This is not because older leavers are so rich they have taken early retirement, or because the benefits system doesn’t make it worthwhile to work – many of these people want to come back into the workforce, and are typically running down their savings rather than living off welfare. Ill-health has reduced our labour supply just when we need more workers to defeat inflation.
So the status quo will not do. Sorting out the NHS’s record waiting lists and recruiting more doctors and nurses is essential to deal with some very serious short-term challenges, but a National Hospital Service that just patches up sick people and sends them back into the same lives that made them ill in the first place won’t be enough on its own. We’ve got to think bigger, by focusing on the things that cause ill health in the first place, like the quality of housing, obesity and addiction to name a few. It is well known these wider factors account for around 80 per centof the health differences between communities, so why are they routinely, consistently ignored in policy debates about health?
For all these reasons, we’ve got to stop ducking the inconvenient truths about our declining, falling health. We need a health reset, which can be kicked off in three ways. First by making a fitter and healthier workforce a central pillar of the government’s plan for economic growth: we can’t expect to turn the dial on productivity if workers are increasingly struggling with chronic conditions and ill health.
Second by writing a cross-government plan to fix health inequalities once and for all. Imagine a world where the DWP or DFE made health a key objective of what they do, to focus minds on the central fact that health is created beyond the confines of hospital wards.
Third, government should act locally by boosting the family hubs programme so that they not only play an enhanced role in the health of children but also adults. A good start would be to locate district nurses on site to help identify problems early such as emerging mental health or musculoskeletal issues – two big reasons why people leave work.
The NHS can also do more of course, through new technologies around screening, diagnostic testing and data to support earlier intervention too. But the old adage that prevention is better than cure is even more true today than it has ever been. We cannot afford to wait any longer.