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15 November 2022

Sick Britain: where have the workers gone?

An unwell, understaffed country has emerged from the era of Covid-19.

By Anoosh Chakelian and Giacomo Boscaini-Gilroy

Editor’s note: This article was originally published on 27 October. It is being repromoted in light of the news today that a record 2.5m people are unable to work due to long-term sickness.

First it was the lorry drivers. Then the turkey pluckers. Now, it feels like every industry is struggling to recruit. For the past year, I haven’t reported from a single part of Britain without employers telling me how short-staffed they are: from a dearth of grape-pickers at an east Sussex vineyard to ice cream servers in north Devon, to bartenders in Wakefield to children’s social workers in Middlesbrough.

So with unemployment levels at a 50-year low, why for the first time are there more vacancies than workers available to fill them in the UK?

The answer goes beyond EU workers lost to Brexit, pandemic labour supply issues, or the discredited Big Quit theory – that we woke up to our meaningless 9-5 lives during lockdown and decided to resign en masse. While these may have had some impact, the real answer can be found in a clunky-sounding measure called “economic inactivity”: working-age people who aren’t working or looking for jobs.

There are half a million more people not working now than at the end of 2019 – a sharp reversal of declining economic inactivity over the past decade. The number of people classed as economically inactive because they are long-term sick has reached a record 2.5 million, according to figures from the Office for National Statistics (ONS).

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Data visualisation and analysis by Giacomo Boscaini-Gilroy

Over-50s are the main age group dropping out of the workforce. Again, this reverses a long-term trend: from 2004 to 2019, 130,000 fewer 50-64-year-olds were long-term sick. Now, all that progress has been undone, as 120,000 more 50-64-year-olds are long-term sick than pre-pandemic.

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This is not a case of wealthier people opting to retire early. The largest increase in workers dropping out is among lower-middle earners, less educated workers and renters, according to researchers at the universities of Essex and Edinburgh who shared their findings exclusively with the New Statesman. They are studying Covid’s impact on the labour market, and presenting their analysis of economically inactive over-50s to the Treasury and Department for Work and Pensions.

There are caveats, however. The growing number of economically-inactive people in poor health does not mean they left the workforce for that reason, noted an analysis by the Institute for Fiscal Studies. While rates of long-term sickness are notable and concerning, they may not be the key driver behind the trend (after all, the rise in health-related economic inactivity is concentrated among those who already haven’t been working for at least five years).

Much of the economic inactivity spike among younger groups seems to be driven by students – probably because of the many deferred university places during the pandemic.


Older workers tend to be leaving sectors that are in long-term decline, such as retail and manufacturing, or that were particularly exposed during the pandemic, such as health and customer services. They may feel unable to retrain for jobs in other fields.

There is another factor when it comes to women in particular. Women’s retirement age caught up with men’s in 2020. While sickness is the biggest driver of rising inactivity for older men, for women it’s rising retirements.

Dr Alex Clymo of the University of Essex said, “The state pension age had been rising for women over the last decade, pushing women to work longer. But that rise coincidentally stopped just as the pandemic hit, allowing more women to retire just as rising sickness has been forcing others out of work.”

Long-term sickness is having a bigger impact than retirement, however. So the question remains: why are people sicker than before the pandemic?

First, there’s the virus itself. Covid-19 was behind a big jump in sickness absence in 2021. Classed in “other”, it has leapfrogged minor illness and musculoskeletal problems since 2019, and “respiratory condition” absence has also gone up.


Data shows that people who are economically inactive (and not retired or students) are six times as likely as employed people to suffer “a lot” from long Covid.


But it’s not just about Covid itself. The NHS backlog is at a record high, with 6.8 million people waiting for hospital care. This is making people sicker. Mild conditions can become debilitating when neglected. “An increase in waiting time for physiotherapy, for example, will lead to increased patient need for painkillers,” a neurosurgeon at a London NHS hospital explained, “giving rise to a potential opioid dependency problem in the future and all the problems associated with this.”

Alika Agidi-Jeffs, a 31-year-old south Londoner and Southwark Council officer, had to take time off from July 2020 when he trapped a nerve in his left shoulder. The pain was excruciating, with pins and needles all over his body that felt “like my skin was on fire”.

The “NHS was so over-subscribed” that he was left waiting. This led him into a depression for the best part of a year. He couldn’t work, exercise or socialise. “It was a cocktail for disaster,” he told me. “Before that, I was happy-go-lucky, solutions-driven and upbeat but I became quiet, reserved and negative.” Now, he is still “on their list somewhere” for mental health treatment.

Inflation is also a factor, suggested Jeremy Bernhaut, head of policy at the mental illness charity Rethink. “The NHS rightly deserves attention given that decades of underfunding have made it difficult to access timely and appropriate treatment,” he said. “But there is often less focus on the drivers of mental illness, such as housing insecurity, money worries and social isolation, which have worsened.”

People in work are also sicker – particularly mentally. The number of people from before the pandemic up to the present who say they suffer from mental health issues because of work, or that they have been made worse by work, has almost doubled.


This higher level of sickness at work suggests another wave ahead of workforce dropouts. People with cancer, for example, are being left waiting for “information about the type of treatment they will receive, or how long it will take”, said Lisa Milnes, the work support team leader at Macmillan, a cancer support charity. “These uncertainties are leading many to postpone going on sick leave, despite feeling too unwell to work, because they simply don’t know how this will impact their sick pay.”

One certainty is that Tory ministers are concerned about the labour shortage – leading to internal rows over loosening immigration – and Labour has noticed. The shadow work and pensions secretary Jon Ashworth proposes a “reformed employment service” to give specialist, tailored help to over-50s. The next election, figures in the main parties suggest, will be fought over the “grey wall”.

[See also: NHS backlog tracker: How long are hospital waiting lists where you live?]

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