Earlier this month, the UN rapporteur Philip Alston gave his statement on the widespread poverty and harm caused by nearly a decade of welfare cuts. Interpreting the damage, Alston proposed that the cuts were more about social engineering than managing state budgets. His statement referred to the government’s “desire to get across a simple set of messages”, namely, that the state is not responsible for your economic security, and “does not have your back any longer”.
Another message that welfare claimants have been forced to hear is the message that employment is good for your health – a view commonly held among politicians of many stripes. In a speech at the Confederation of British Industry last week, Theresa May said that having a job “can provide the sense of purpose and dignity on which a happy life is built”.
What was once a simple wisdom about the psychological value of work has now been converted into a scientific fact. In 2006, medical researchers published the government-commissioned review, Is Work Good for Your Health and Well-being – a report that would later be cited by politicians, mental health charities and psychiatric organisations as solid evidence that employment is not only good for health, but can even promote recovery among sick and disabled people. Duncan Selbie, the CEO of Public Health England, would suggest that our health, wellbeing and happiness are “inextricably linked to work” (defined as a paid job). In fact, the report itself took a broad definition of “work”, which included activities like volunteering, education, and caring for family.
Those who like to talk about the psychological importance of employment usually do so in an abstract way. This is perhaps the only way to sidestep the real issues of working poverty, insecure work, eroded employment rights, and what David Graeber refers to as a tidal wave of bullshit jobs: jobs which grind people down because, by the worker’s own admission, they contribute nothing of value to the world.
One of the maddening things about assumptions around the health benefits of employment is how often they are leveraged to depict welfare reforms as benevolent, or in the public interest. A government report from 2016, for example, ignored the controversies around forcing disabled people into employment, using a benign language of “supporting” and “helping” people into work for the benefit of their own well-being. In a 2017 white paper, the government pledged to double the number of “Work and Health Champions” embedded in hospitals and GP surgeries, redesign NHS evaluation measures to include employment outcomes, continue to gear state funded psychotherapy services towards employment, and force disabled people to discuss employment aspirations as a condition of their benefits.
These proposals are dogmatic, to say the least. The freedom of people to define their own ideas of health and recovery is being overridden. Productivity in employment, whether you agree or not, is being imposed as the ultimate symbol of health, and the only recognised way to make a social contribution. The researchers Lynne Friedli and Robert Stearn suggest that the latest policies amount to a kind of “psycho-compulsion”: a good old-fashioned brainwashing, which people are being forced to endure under the threat of sanction. Activist groups such as Disabled People Against Cuts and Recovery in the Bin are also pointing out the ethical problems with these policy developments, whether it is their trivialising attitude to long-term health conditions, or their failure to see the impossibility of giving meaningful consent to work-focused psychological interventions under the threat of destitution.
But perhaps the broader problem here is in presuming that objective science was ever equipped to answer questions about the relationship between employment and health. Such questions can never have objective answers, because they are always and unavoidably political. There may be an evidence base to highlight the psychological importance of having a job, but in what sense does this really say anything meaningful, in a social context where working a job is pretty much the only way to avoid social stigma and put food on the table? When confronted by the misery experienced by people without jobs, it is important to realise that this may say more about society’s political choices than human nature.
For this reason, we should resist leaving questions about work and health to the medical experts, and reclaim them as a topic for democratic debate. We should feel more disturbed by appeals to the psychological necessity of employment – an activity that is often exploitative, takes up our time and energy, and can be harmful to health in the long run. Recent statistics paint a bleak picture: 1.4 million workers in the UK now suffer from work-related ill health, and 13,000 workers died last year, as a result of exposure to dust or chemicals at work. For the first time, over 50 per cent of the work days lost in the UK have been linked to work-related stress, anxiety or depression, a fact which has prompted the general secretary of the Trade Union Congress, Frances O’Grady, to officially name the problem an epidemic. Rather than mindlessly re-stating the psychological importance of having a job, politicians should remain open to the idea that there might be other ways to define health and meet the need for security and dignity.
Perhaps a shorter national working week could shed light on the benefits of less work. Perhaps a new kind of welfare system, coupled with new public facilities, could aim at resourcing people to do something worthwhile outside of employment. Perhaps a new kind of ethics could see that people have an inherent dignity, irrespective of their economic contribution, and recognise that there are many ways to contribute to society outside the remit of a paid job. In this world of possible alternatives – many now being investigated – would we perhaps find that jobs are not quite so integral to health after all? Until politicians are willing to let go of the employment dogma, we will never know.
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