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Tired stereotypes of the long-term sick have returned

To reduce the rise in economic inactivity, people need holistic support not punitive sanctions.

By Tom Pollard

Every month last year, the Office for National Statistics (ONS) released new figures showing a rising number of people unemployed and not seeking work (referred to as being economically inactive) due to poor health and disability. But after the September release reported a record 2.6 million people in this situation, the monthly reporting stopped.

The ONS was concerned about the quality of their survey data and, in turn, the reliability of their figures. Five months later, they have released updated figures, but the outlook on health and disability has only got worse. Another 200,000 people have been added to the economically inactive due to long-term sickness category, taking the total to 2.8 million.

This is a huge problem, not only for the prospects of each of those people and their families, but for the country as a whole. Having almost 7.5 per cent of the working age population unavailable for work means job vacancies go unfilled. Employers report the difficulties they have finding the skilled workers they need to run their businesses and grow. The labour market remains tight. But it also means huge amounts of money are being spent on health-related unemployment and disability benefits, with costs projected to hit almost £80bn a year by 2028-29.

The political response on the right has largely been to try to wish the problem away by questioning the veracity or severity of the barriers people are facing. A steady stream of comment pieces have argued (without presenting much in the way of evidence) that it just can’t be the case that so many people are as unwell as they are claiming.

In this vein, the government is planning to reclassify hundreds of thousands of people in the benefits system, meaning they receive less money and are subject to more requirements to prepare for work. However, according to the Office for Budget Responsibility, less than 3 per cent of those reclassified will likely end up back in a job as a result.

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The reality is that we have become more unwell as a nation, particularly in the wake of the pandemic. This has been exacerbated by growing and deepening poverty and crumbling public services. Meanwhile, jobs at the lower end of the labour market are often poor quality, poorly paid and insecure, all of which contributes to poor health, and particularly poor mental health.

Labour has talked about the importance of access to health services, which is undoubtedly part of the solution but will not be sufficient for many of those who have been out of work for a long time and struggle to see themselves back in a job.

Many people in this group, with the right support around their health and employment, could potentially return to work. I’ve spent more than a decade working on policy in this space, but also a number of years working in front-line NHS mental health services. Someone’s prospects of working come down to a complex interplay of their health, confidence, wider socio-economic circumstances, previous experience and skills, and the support available to them.

The critical ingredient when people are supported from long-term unemployment back into work is the relationship with the person providing this support. There needs to be genuine engagement built on trust, an understanding of what sort of work the person would be willing and able to do, and what barriers they will need to overcome to achieve this. People also need to feel secure enough to take the risk of trying to re-enter work, and confident that they won’t be left financially stranded if things don’t work out.

But our social security system often runs counter to all of these needs. The financial support people receive is woefully inadequate, leaving them focused on a precarious struggle to make ends meet day-to-day, rather than being able to plan for the future. Even the Work and Pensions Secretary, Mel Stride, recently acknowledged that relieving financial pressure on people can help them to move towards work. The minister has also said that genuine support needs to be provided to help people back into steady employment, having been asked by journalists why the UK was “a nation of slackers”.

People often face a battle to get their health conditions and disabilities recognised by the Department for Work and Pensions, and are then understandably wary of losing a higher rate of benefit and associated protections. Many are particularly fearful of requirements to move towards work under the threat of sanctions – referred to as “conditionality”.

Conditionality fundamentally undermines the trust and engagement required to support someone back into suitable employment. Even when this approach does appear to work, the evidence suggests it pushes people into poor-quality jobs. The widely held political commitment to it is driven more by perceived public demand than evidence. Last year at the New Economics Foundation, we set out the case for how to retain some degree of accountability in the social security system while ensuring decent and genuine support, in our report From Compliance to Engagement”.

Improving access to health support and good-quality jobs will be vital in tackling the growing crisis of long-term unemployment due to poor health and disability. However, a meaningful response will need to take seriously the question of how inadequate benefits and the threat of sanctions undermine people’s ability to overcome barriers and consider a return to work.

[See also: Britain is an entrepreneurial nation]

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Select and enter your email address Your weekly guide to the best writing on ideas, politics, books and culture every Saturday. The best way to sign up for The Saturday Read is via saturdayread.substack.com The New Statesman's quick and essential guide to the news and politics of the day. The best way to sign up for Morning Call is via morningcall.substack.com Our Thursday ideas newsletter, delving into philosophy, criticism, and intellectual history. The best way to sign up for The Salvo is via thesalvo.substack.com Stay up to date with NS events, subscription offers & updates. Weekly analysis of the shift to a new economy from the New Statesman's Spotlight on Policy team. The best way to sign up for The Green Transition is via spotlightonpolicy.substack.com
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