Economy: Budget Statement

Baroness Jolly Excerpts

Tuesday 13th November 2018 Lords Chamber

[Baroness Jolly (LD)]

My Lords, I join others in thanking the noble Lord, Lord Bates, for tabling this timely debate and for his excellent speech. I also thank fellow Peers for their thoughtful contributions so far on this topic.

I shall use my time today to discuss the health of our population, a topic that goes hand in hand with a strong economy. There are clear links between good health and good economic performance. We know that when health and social care services are limited, it is the most vulnerable in our society who lose out. When services are strong and the Government fund progressive programmes to improve health, workers are more likely to stay in their jobs, children are more likely to thrive in school and the result is that the economy is made stronger. Not all health interventions need to be large or to take place at a clinical level. There is fantastic work being undertaken in public health by businesses, communities and local authorities across the country, which indirectly helps to support our economy by keeping people healthy and in work.

The headline figure of £20.5 billion by 2024 for the NHS in the recent budget, while welcome and laudable, is not enough to continue to grow this kind of upstream support, which helps keep individuals out of hospital and relieves pressure on primary care. Indeed, I was dismayed to note a cut of almost £1 billion in the non-NHS England parts of the Department of Health and Social Care budget this year, most of which will be felt in public health and social care services. I welcome the uplift to the national minimum wage, but regret the lack of funding for local authorities which have to pay for the increase in the wages of care workers.

The economic implications of Brexit are likely to add further strains to those services, which already face a funding gap far deeper than the most recent commitment will fill. Will the Government follow the Liberal Democrats in thinking strategically and on a cross-party basis about the future funding of help, including how it relates to our economy and workplaces?

To elaborate my point, consider for a moment an issue that affects all of us in our lifetime. One in four of us will have a mental health condition, and that means that someone well known to us or to our family will be affected. Mind estimates that 70 million work days are lost each year due to mental health problems in the UK. This costs employers billions of pounds each year in lost productivity and recruitment costs for those who ultimately feel forced to leave their jobs due to illness. Investing now to protect people’s mental health will pay dividends in future for employers and employees. Although I am pleased that the Government have highlighted this important issue in the Budget, I am disappointed by the funding allocation of £2 billion, which falls far short of the amount that experts say is needed to deliver vital improvements to services and achieve real equality between mental and physical health in future.

Mental health support is also crucial for younger people, who will soon be entering the workforce. The Budget recycles commitments set out in the coalition Government’s blueprint for children’s mental health, which pledged a named mental health lead in schools, as well as a dedicated professional in specialist NHS services. Will the Government consider investigating a similar programme for the workplace, perhaps along the lines of a mental health first aider? We are used to there being a first aider in all businesses above a certain size—I think it is those employing above 12 people. Perhaps we need to consider a mental health first aider. They need not be a professional, but rather someone trained to provide confidential advice and signposting for those who are suffering with their mental health who may not know where to turn. This is in line with existing efforts of employers to support the health of their employees. Let us consider some schemes that already exist which could be adapted.

Here in the Houses of Parliament, for parliamentarians and staff alike, the Parliamentary Health and Wellbeing Service offers mental health counsellors for anyone who needs them, away from their local GP and support network. Big White Wall, which provides emotional support for employees in the workplace, uses a virtual messenger service to provide advice. Fantastic work is being done by employers to encourage people to be open about their mental health and reduce stigma. It is surely also worthy of bolstered government commitment. There are plenty of lessons to learn about how we can improve our health in a cost-effective manner and save on lost work days. Do the Government support that view, especially considering the Statement of the Secretary of State for Health and Social Care on 5 November about prioritising prevention, including strengthening public health initiatives and local authority services to reduce strain on primary care?

We should remember that a lot of health conditions are caused or influenced by people’s work. To help keep individuals in their jobs and happy in those jobs, we need to be open to recognising that. In particular, it is important to fund research into conditions that are often exacerbated by the stresses of the workplace. The Migraine Trust quotes recent research by the Work Foundation suggesting that migraine is the least publicly funded of all neurological illnesses relative to its economic impact. It is estimated that absenteeism from migraine costs £2.25 billion per year in the UK, calculated on the basis of 25 million lost working days.

In addition, there is the phenomenon of “presenteeism”, in which workers attend their jobs, but are minimally productive due to their underlying and often unappreciated health conditions. Clearly, it is difficult under the Government’s current financing to fund some of these asks. But there may be other, creative ways to source funds. Possibly some health components could be funded in future by a system such as a citizen’s wealth fund—if you like, a sovereign wealth fund for the NHS. Under this system, the fund could be used to actively invest in stocks, bonds and physical assets. It would enable the country as a whole to benefit from the returns on investment typically available only to the wealthy. Once the fund became large enough to generate a substantial annual return, it would represent a new source of public funding, which could be used, for instance, to promote underresearched areas of health, or to bolster the much underfunded public health funding. This fund could also be used to raise awareness and identify conditions that are currently underdiagnosed—for example, structural heart disease, atrial fibrillation and bipolar conditions. It could help to normalise and prevent illnesses that affect thousands every year.

Overall, I see the state of the economy, and the state of our health, as closely linked. Tackling health in the workplace, and for the workplace, makes sense. It makes sense at a pragmatic level, a moral level and an economic level. I hope that the Minister can give me a positive response to guarantee the workforce, and so the economy, of the future.