Health, work and the economy: can tackling waiting lists get Britain’s economy moving again?

New analysis from the Office for National Statistics (ONS) and NHS England explores whether reducing waiting lists could help more people return to work and boost productivity. In response to this analysis, Siva Anandaciva outlines three wider policy issues at play.

Not all jobs are good for our mental or physical health. And being healthy doesn’t guarantee you’ll get a good job. But our health and our work are still closely related, and new research produced by the ONS and NHS England is a further demonstration of how national policy is starting to explore how data analysis and policy action can be more co-ordinated across these two agendas.

In their analysis – available on our website – the ONS, working in partnership with NHS England, have for the first time linked millions of pseudonymised patient-level data on hospital waiting lists with individual-level data from HMRC. Their analysis explores the economic impact of tackling long waiting lists for planned NHS consultant-led care – and in doing so, achieving the NHS’s 18-week target. This is the latest step in exploring how linking datasets can improve our understanding of the drivers of health and unemployment or underemployment.

This analysis also updates and extends previous related work on this topic. In 2023, the IPPR and LCP Health Analytics estimated that significant reductions in NHS waiting lists could lead to direct economic benefits (eg people returning to work) and indirect benefits (eg people being able to do more childcare or volunteering). However, separate analyses from the IFS suggest that long waiting lists for NHS care are associated with (at most) a small share of the increase in health-related benefits for working-age adults in recent years.

The potential prize on offer is clear in theory. If the nation was healthier, we might be able to work more (because we can take on more contracted hours, reduce absence from work, or move from part-time to full-time work); work more productively (because we can produce more when our work-limiting health conditions have been tackled) or be able to work at all (because we can take up jobs if our health conditions are resolved).

And the government has been consistent in its push to bring its ‘health’ and ‘economic growth’ objectives together. In his first conference speech as Health and Care Secretary, Wes Streeting announced that crack teams of top clinicians would be sent to tackle waiting lists in hospitals that had the highest numbers of people off work sick. The government has also created three ‘health and growth accelerators’ that are trying to boost health and local employment in parts of Yorkshire and in the North East. In the early steps of this programme, local areas are exploring how better occupational health and identifying and preventing ill-health could stop people falling out of the workforce. And since the start of the year, the Mayfield Review has been exploring how the government and businesses can do more to recruit and retain people with disabilities and people with ill-health.

This growing body of work to connect the health and economic agendas highlights three wider policy issues.

The first is whether the 18-week target can be achieved at all. The 18-week target has been elevated from being one of many NHS promises in the Labour manifesto, to being one of the three top government priorities – even before a wider economic case was built to tackle waiting lists. Nevertheless, serious doubts still remain over whether the target will be achieved by 2029 in the face of industrial action, winter crises and wider pressures on the NHS.

The second issue is the clinical and ethical issues that come from linking health and economic growth agendas. At a national level, and even at the level of local regions and communities, you can see how targeted action to maintain our health and employment status could benefit from being more co-ordinated. But more thought will be needed before these agendas are brought together at the level of individual patient care. For example, by our economic potential being used as a criterion when prioritising treatment, or in asking clinicians to make social value judgements rather than clinical judgements.

The third issue is around maintaining a focus on how wider cross-government policy – beyond the ambit of the 18-week target – could help get people back into work.

Continuing the work on the health and growth accelerator programme, and recommitting to a mission-based approach to improving the nation’s health that would help, for example, break the links between smoking status, obesity and health-related economic inactivity.

Better health is about more than the 18-week target. Better health is about more than having a job. And as the New Zealand government once tried to show – economic growth should not be the only goal of societies or governments. But what the government is trying to do, and should keep trying to do, is to increasingly think of linking data and linking policies together to reflect that these three important agendas are all part of a bigger picture.