The Week, 12 November 2021

19 November 2021
By Sebastian Rees

On Tuesday, the Office for National Statistics released its latest labour market data. In good news, gloomy predictions on post-COVID joblessness look to have been put to bed. Over Summer, the highest ever rate of people started new jobs (7 per cent of all those in work), the unemployment rate is falling towards pre-pandemic levels and vacancies continue to grow strongly.

But as any policy wonk will tell you, never judge a situation by headline figures. Economic inactivity remains stubbornly high and is concentrated among disadvantaged young people and older workers. And it's largely being propelled by big increases in the number of people out of work due to long-term illness and disability. 2.3 million working age people are "inactive" due to long-term ill-health, a figure at its highest level in almost two decades.

Speaking at a Reform event on Thursday, Secretary of State for Work and Pensions, Thérèse Coffey, identified this as a key priority for the DWP. But, as the Secretary of State highlighted, this will require a cross-government effort, and a recalibration of our health system to provide support to those who have fallen out of work. Let's hope that the consultation on the Disability Green Paper leads to some concrete policy commitments in this area.

Speaking of areas in need of a fundamental rethink: this week saw the publication of new data from NHS Digital on childhood obesity. These statistics, already scandalous before the pandemic, have deteriorated even further. One in seven children in England are already obese when they begin primary school and that number climbs to more than a quarter of Year 6 students. Once a disease of affluence, obesity (both in children and adults) is now concentrated among the disadvantaged — more than a third (33.8 per cent) of students in the most deprived communities are now obese when they leave primary school.

The response to these shocking numbers? A re-upping of the NHS commitment to open specialist childhood obesity clinics throughout the country. While no doubt useful for addressing complex health conditions for children living with obesity such as Type 2 diabetes — a condition virtually unheard of in children two decades ago — clinical solutions can't address socially determined problems. Getting on top of obesity in all age groups requires changing our relationship to food and exercise and tackling the causes of unhealthy weight, not opening the NHS cheque book. This will be a clear test for the newly launched Office for Health Improvement and Disparities...

Finally, social care made it back into the news this week after a brief hiatus. Though a raft of recent reports document ongoing crises in the social care workforce, discontent among users over the way our current system squeezes out innovative approaches, and high levels of unmet need, public debate remains fixated on the cap and floor proposals.

Government documents released on Wednesday reveal that payments from local authorities that help those with assets under £100,000 meet the cost of their care will not count towards the care cap, contradicting plans laid out in the 2014 Care Act. The rub for most seems to be that those with moderate assets will be hit hardest, whilst those with substantial wealth will not.

But yet again, we're having the wrong conversation. If you really wanted to build a more equitable system — one in which those with substantial assets pay their fair share — you would set the capital floor at a higher level and abolish (or set a much higher) upper cap. That way those with the broadest shoulders would pay most and those needing social care with the least assets would be better protected. Unfortunately that doesn't seem to be on the cards any time soon...