The Mayfield report ignores how work is damaging our health in order to keep up the attack on the sick and disabled, argues Lee Humber

Sir Charlie Mayfield’s report ‘Keep Britain Working’, published at the beginning of November has a liberal sheen. In fact, the report, and the ‘task force’ Labour want him to lead, is the next phase in their long-running series of attacks on sick and disabled people. Sir Charlie argues for a coalition of employers and employees to ensure healthier workplaces, overseen by a hands-off government, to address what he calls an ‘economic inactivity crisis’, which the report argues is costing the UK £85bn a year. An additional 800,000, the report claims, are unemployed or under-employed and drawing on state benefits due directly to sickness. For Sir Charlie, these people have a responsibility to be at work, not off sick undermining UK Ltd.

In passing, Mayfield refers to ‘barriers’ in the way of, in particular, disabled people finding work. Barriers there most certainly, despite the introduction of the requirement of employers to make ‘reasonable adjustments’ to job roles and work tasks, a responsibility included in the original Disability Discrimination Act of 1995. Then, around half of disabled people were in employment. Today, around half of disabled people are in employment: no change after thirty years. More employers have been taken to court for refusing to enact reasonable adjustments over the last ten or so years, starkly highlighting the environment of discrimination that persists. A recent ACAS report concluded that discrimination is rife ‘at the point of recruitment, during employment and at the end of employment’. This last point is an awkward way of saying disabled people are likely get the boot more readily than others.

Meaningful, and menacing, content in passing reference is the report’s forte. ‘Over 1 in 5’, the report says ‘are out of work and not looking for work’. This seemingly innocuous sentence is in fact of central importance and a continuation of a government strategy already in place to shift people on disability benefits, like Disability Living Allowance, Personal Independence Payment and others, on to the lower-paying Universal Credit. Only those on UC are considered to be actively looking for work. For this calculated piece of callous admin, those on DLA need to be shifted on to UC, losing income in the process, in order to be considered to be looking for work and no longer part of the ‘economic inactivity crisis’.

Mayfield concludes that government and employers can’t solve this crisis alone, we employees also have ‘responsibilities’ which, if left unaddressed, can lead us to ‘detachment and dependency’, a well-worn trope with which to stigmatise ill and disabled people. ‘Health and work’, he tells us are ‘mutually reinforcing’. Until 2020, Mayfield was Chairman of the John Lewis group. In 2015, he cut staff bonuses to their lowest level for twelve years and ended the final-salary pension scheme. In 2020, as a parting gift, he closed just under 20% of John Lewis stores, making redundant over 1300 staff, saving the company £80m. Seems to be little ‘mutual reinforcing’ going on there, and little concern for the health issues arising from the stress of job loss and deteriorating work conditions. That said, we probably couldn’t call Mayfield a health expert. His direct, health-related employment seems to have been the twelve months he spent with Big Pharma giant SmithKline Beecham as assistant product manager for Horlicks Instant.

The economy makes us sick

‘Keep Britain Working’, despite itself, highlights a number of issues UK capital is attempting to come to terms with which are undermining its performance, but in no way does it make any substantial argument to support the idea that worker ill health is at the root of them. Neither does it offer any insight into why ill-health in the UK is, as is generally accepted, rising. The reasons for that lie elsewhere and are fairly obvious. Perhaps if Mayfield had consulted a little-known body called the World Health Organisation, he may have offered us something more useful.

Since 2011, the WHO has argued in support of an approach to health encapsulated by their Social Determinants of Health framework. In a nutshell, this insightful and thoroughly well-researched framework shows health to be the collective and cumulative effects of the natural, social, cultural and political environments in which we live. They don’t actually state it, of course, but health is about class. The framework considers the impacts of differing experiences of education, diets, housing, our extent of political and social rights, our access to healthcare, as well as the nature of our employment and many other things, and how all of these combined set a context for resultant health outcomes.

All of the above have deteriorated, in the UK and globally over the recent past and in particular, I would argue, since the onset of what Michael Roberts describes as the ‘Long Depression’ of falling or stalled profitability in the years since 2008. Global capital continues to fail to resuscitate its general rates of profitability despite on-going attacks on workers, and in the process, our health suffers. The much-vaunted growth of life expectancy, a constant topic of largely doom-laden Malthusian debate in the early part of this century, has stopped, while health inequality continues to grow. Studies in the UK show a severe deterioration of income across working-class households in the 2020s. Food insecurity has grown from affecting five million to seven million by 2023, material deprivation from ten million to thirteen million people. Those unable to adequately heat homes rose from two million to seven million. These, and many other factors, form the material basis of increased levels of ill health and the disability that can arise from it.

As Marxists have long known, thanks to Engels’ monumental The Condition of the Working Class in England, and as anyone who’s ever worked has instinctively known, working in conditions of industrial capitalism – and the relentless process of alienating exploitation at its heart – can be lethal. Today, as a result of capital’s increasingly desperate search for a return to profitability, work conditions are worsening. Reports in the UK suggest Gen Z and Millennials spend all of their monthly income on basic living costs. More people are taking on additional work, more are delaying retirement while general social morale is low and stress levels are at unprecedented highs. Stress, depression, musculoskeletal syndromes, virus-related diseases – often provided with powerful disease vectors as a result of so-called ‘presenteeism’, with staff pressured into turning up for work when infectious – combine to turn an economically sick society into a physically and mentally sick one. Without radical social change, it’s difficult to see how this worsening trend can be halted.

The scurrilous piece of charlatanism that ‘Keep Britain Working’ is has nothing to say about UK health, UK employment or little else. At its core, it is yet another mealy-mouthed attack on the most vulnerable in society.