The Political Economy of Unhappiness

For the majority of its history, Britain’s National Health Service has scarcely ever considered the specific health needs of working people, other than those of its own staff. Almost by definition, the nhs was originally dedicated to supporting people who were outside of the labour market—new mothers, children, the sick, the elderly and the dying. British doctors issued ‘sick notes’, certificates that were given to patients, informing their employers that they were unable to work. But in recent years policy-makers have begun to challenge these assumptions, along with the binary split between health and illness, economically productive and economically needy, on which they rested. In 2008, a review of the health of Britain’s working-age population was published jointly by the Department of Health and the Department of Work and Pensions. Most strikingly, it calculated that the annual cost to the British economy of health-related absence from work was £100bn, only around £15bn less than the entire cost of the nhs.