Growth, Illness and Political Arithmetic

We keep talking about growth as though it lives entirely in tax policy, trade deals and planning reform. Meanwhile, around 2.7 million working-age adults are economically inactive because of long-term sickness. That figure rose sharply after 2020. Mental health accounts for a large share. Musculoskeletal illness remains significant. Post-viral conditions are now part of the increase.

This is not monocausal. But it is structural.

ONS estimates have at points suggested around 2 million people reporting Long Covid symptoms, with several hundred thousand describing daily activities as limited “a lot”. Many have not left work entirely. Some reduce hours. Others fluctuate. But labour supply is not binary. A sustained reduction in working capacity across hundreds of thousands of people accumulates economically.

Run the arithmetic conservatively and you are quickly into billions of pounds in foregone earnings and tax receipts each year.

Now compare political treatment.

Dementia research attracts tens of millions annually from NIHR alone. Alzheimer’s and related conditions are unquestionably serious. But they predominantly affect older people, many of whom have already left the labour market. Their economic impact is felt through care costs and family labour displacement rather than direct loss of taxable earnings.

Yet dementia commands sustained funding and strategic framing.

That is not an argument against dementia funding. It is an observation about political salience. Pensioners are numerous, politically engaged and economically powerful as a voting cohort. A condition that affects them carries immediate electoral weight across parties.

Post-infectious illness is different. It affects working-age adults more heavily. Its impact shows up directly in labour supply and productivity. But it lacks a cohesive constituency. Its sufferers are dispersed. The costs appear gradually in GDP figures rather than dramatically in hospital wards.

That contrast matters.

The deeper issue, however, is not simply research funding. It is institutional alignment. Health policy treats chronic illness clinically. Labour policy treats inactivity statistically. Welfare assessments remain largely binary. You are fit for work, or you are not. That structure works for permanent incapacity. It works less well for fluctuating conditions.

Post-infectious illness often behaves variably. Someone may manage limited hours for a period and then relapse. The current Universal Credit and work capability framework is not designed around that pattern. It can create friction between attempted partial recovery and benefit stability.

A system concerned with growth would treat variable capacity as a predictable feature rather than an anomaly. That means aligning NHS rehabilitation plans with DWP case management and allowing graded returns to work without resetting entitlement or triggering repeated reassessment cycles.

This is not a question of generosity. It is a question of design. If partial capacity is administratively discouraged, labour supply contracts unnecessarily.

Dementia shows that political urgency can override biological uncertainty when the constituency is powerful enough.

The question is whether labour supply erosion commands equivalent urgency when its constituency is diffuse.

That is not left or right. It is political arithmetic.

And arithmetic, eventually, intrudes.