A certain number is often brought up in passing in Westminster briefings, given a quick nod, and then quietly pushed to the back of the agenda. That amount, £212 billion, is how much sickness costs the UK economy every year. It’s not an estimate. Not a model for the worst case. The working number, which comes from official data, that shows how much the country loses every year because its workers are getting sicker and less able to do their jobs.
Sometimes this person is at the top of the news, which is hard to miss. It’s written about in reports and think tank summaries, but then it’s gone. That’s a story in and of itself.
In Britain, about 2.8 million adults of working age are not working because they are sick for a long time. That number has gone up by about 800,000 since 2019, and it’s happened in all kinds of fields, age groups, and places. Younger workers’ mental health problems have become a major factor, but musculoskeletal problems and long-term illnesses also play a role. About 53% of people with health problems in the UK are able to find work. Over 66 percent of people in similar EU countries say the same thing. There is a big gap. In European terms, it’s pretty amazing.
The fact that people are noticing this now makes it harder to brush off as background noise. The former chair of John Lewis, Sir Charlie Mayfield, has spent most of the last year leading the Keep Britain Working Review. This is a program that has more than 250 employers, ten mayors’ offices, and all three devolved administrations working together. EDF Energy, British Airways, Tesco, Royal Mail, Sainsbury’s, and Royal Mail. These are not small groups on the edges. They make British work life possible, and as a group, they’ve come to the conclusion that the way the country handles employee health is seriously flawed.
It is worth it to think about Mayfield’s own framing. The idea that the workforce is already here and can drive economic recovery is called “growth hiding in plain sight” by him. This is because the current system wasn’t made to keep people at work, it was made to process them out of it. He’s talked about meeting people who were fired for months and never heard from their boss again. He quickly clarifies that it’s not because employers are mean, but because the system doesn’t set any expectations for contact, doesn’t provide a way back, and doesn’t even provide a shared framework for what recovery in the workplace should even look like.
The fit note system is at the heart of this problem. At the moment, 93 percent of fit notes just say that an employee is “not fit for work.” It’s almost never used that way in real life, even though the system was redesigned years ago to handle nuances like partial capacity, changed duties, and phased returns. The note is written by a doctor, who is probably not trained in occupational health and is short on time. That’s the end of the story. The worker wanders off. The boss has to wait. The weeks turn into months.
Reading through the review’s results makes it seem like the UK has built a complex system for dealing with sickness instead of preventing it or making it last longer. Part of the story can be seen in the amount of statutory sick pay: at £118.75 per week, Britain has some of the lowest amounts in Europe. There isn’t always any occupational health infrastructure in small and medium-sized businesses in the UK, even though they are the backbone of the employment market. The system relies too much on the NHS to fix a problem that is really at work.
A new Workplace Health Intelligence Unit is being set up to keep track of employers’ sick days, successful returns to work, and disability participation. This is the kind of body that probably should have been around ten years ago. Workplace health performance has never been systematically seen before because there hasn’t been a central way to track what’s working and what isn’t. This explains a lot about how things got to this point.
It’s still not clear if the new political leadership will take this seriously enough to do something big about it. The welfare bill, which is expected to take up almost 24% of all government spending, makes things more urgent. However, urgency and good policy are not the same thing. Mayfield’s review makes it clear that early intervention, better communication, and small investments in structures can make a real difference, without the huge costs up front that often stop the government from acting. There is evidence. The bosses have signed up. Now and then, the data is being gathered.
It’s possible that things are different now. They might also show up in next year’s report, briefly mentioned, and then forgotten.
