COVID-19 is showing us that a health issue can not only devastate the lives of those directly in the path of the virus, but can also close shops and high streets, force hundreds of thousands of businesses to struggle and place millions on furlough or out of work. Never has the fundamental link between health and the economy been more clearly underlined.
Yet there is little in the way of joined up public health and economic policy for the Government to draw on going forward. The economy is steered by policies such as Rishi Sunak’s Winter Economy Plan – which barely mentions health – and the UK’s industrial strategy, published in 2017, which has scant references to the importance of health as a component of the economy.
At a local level, opportunities to link health and the economy – to ensure a healthy, productive workforce – are being missed. Devon and Somerset’s Productivity Plan rarely discusses the health of the workforce, yet the local Clinical Commissioning Groups are co-signatories to the green paper behind this strategy. In comparison, Greater Manchester’s Local Industrial Strategy makes ‘population health’ an explicit aim and cites health over two hundred times.
Does this matter? You could see COVID-19 as an unusual event and argue it is not necessary to go to the lengths of rethinking the relationship between public health and the economy – we can simply develop a vaccine or learn to live with the virus and continue with our lives.
Well it matters because, where health and economic policy are joined up, the social and economic benefits are huge. For instance, mental health hugely affects productivity – how efficiently a business can create a profit. The Centre for Mental Health estimates that poor mental health in the UK workforce costs businesses almost £35 billion a year with an annual cost to the whole UK economy of nearly £100 billion a year. By far the largest share of this is not sick pay, but through employees who are at work but unwell and under-performing – this is known as ‘presenteeism’.
We could take Manchester’s lead and focus more on health and the economy. Mental health provision there is being pioneered as part of employment support. Imagine being unable to work effectively because of mental ill health but knowing that your employer and local authority understands and can offer tailored support.
There are wider economic issues which affect health. These include being in work or not, wage levels, contracts terms and conditions, lack of or low sick pay and other entitlements.
So how could we begin to tackle health and the economy? Government could incentivize health in the workforce through tax reliefs and also legislate to make employment law more health conscious. Local and national authorities could also unleash the power of the billions of pounds of public money they spend by insisting that firms they contract with adopt work-place wellbeing measures.
Employers could pay all staff a proper living wage as a minimum; ending in-work poverty and the ill-effects of inadequate housing and poor nutrition. Employers can aim to offer decent jobs with a sense of purpose and fulfilment, they can reduce zero-hours contracts and improve sick pay. These things are known to protect mental health and wellbeing. Businesses could develop more responsibility with a purpose to tackle social and environmental issues and do so with innovation and creativity.
Sound far-fetched? Well these businesses exist. They are called social enterprises – famous examples include The Eden Project and The Big Issue. These businesses thrive and trade ensuring that the health and wellbeing of their staff and their communities is part of their work. Their ethos is one where the health of everyone is as important as making a profit. Recent research in Plymouth shows that 94% of social enterprises there offer support around health and wellbeing for their staff.
COVID-19 has shown us that things need to change and that health and economic thinking need to become more connected. Social enterprises are twenty years down the track with this and the rest of the world needs to catch up. We need to build back better and understand more deeply that without health there is no economy.
By Lucy Blackley and Gareth Hart, Directors of Iridescent Ideas CIC