My Lords, I start by thanking the noble Baroness, Lady Thornton, for bringing about this important debate. She has held the Government’s feet to the fire—in fact, she held my feet to the fire—on this issue, and I absolutely commend her persistence.
Rehabilitation in general and post-viral syndromes in particular have a long history of being horribly overlooked in this country. I am afraid that this regrettable neglect has contributed darkly to the long-term poor health of many in this nation. However, before I speak about the consequences of this on long Covid, I will take a moment to recognise that Britain has done more than almost any other country to address long Covid. Professor Chris Whitty and the CMO’s office prioritised NIHR research, with £50 million going into 19 projects, giving a clear signal for other research. The NHS, and in particular the noble Lord, Lord Stevens of Birmingham, launched a welcome five-point plan, as the noble Baroness mentioned, and Amanda Pritchard has rolled out excellent long-term long Covid clinics. Treatments such as monoclonal antibodies and pulmonary rehabilitation are emerging as a result. I pay tribute to Dr Harry Brünjes, who pioneered the Breathe programme
at the English National Opera, which is a fantastic example of social prescribing that has produced some very promising clinical trial results. I thank the noble Lord, Lord Darzi, who kicked off the important REACT programme at Imperial College which has generated hefty longitudinal population studies. Lastly, I pay tribute to the patient groups, who are both vocal and thoughtful in their responses, for their testimony.
Despite these considerable collective efforts, I am sad to say that the long Covid story has become a parable for how the UK health system fails to protect people’s freedom from disease and illness. It fails to properly rehabilitate our sick, and we are paying a horrible economic price as a result. The scale of long Covid is enormous, as the noble Baroness rightly pointed out, but the clinical response I referred to is sadly inadequate. The ONS says that there are 1.5 million sufferers, yet the long Covid clinics can see only 60,000 patients per year. Patient groups are frustrated that, when they do get seen, clinicians do not have the latest pathways that might lead to positive outcomes. The NIHR agrees with patients that there are a lot of unanswered questions.
We are familiar in this country with the rationing of scarce health resources and the uneven distribution of the latest research—uncomfortable though that is—but I will focus a few words on the profound economic effects of this troubling British healthcare strategy. ONS data reports that 500,000 people have left the workforce over the last 18 months, and 75,000 of those are economically inactive due to long Covid. The Institute for Fiscal Studies has a slightly different figure of 110,000, and it says that the cost is almost £1.5 billion in lost earnings a year. Another IFS study suggests that there is an average of 2.5 hours of sick leave per worker being taken due to those who have long Covid. Either way, the OBR has recognised that Covid in the round could cost around £2.7 billion in welfare benefits such as incapacity and housing. That is an absolutely staggering sum.
My point is that we cannot shrug our shoulders about the impact of conditions like long Covid on the economy. We have to take on the challenge of making this country healthier and pivot towards prevention. Andrew Haldane, chief executive of the Royal Society of Arts, put it well in his recent speech:
“We’re in a situation for the first time, probably since the Industrial Revolution, where health and wellbeing are in retreat … Having been an accelerator of wellbeing for the last 200 years, health is now serving as a brake in the rise of growth and wellbeing of our citizens.”
Yesterday, Andrew Bailey, the Governor of the Bank of England, told the House of Commons Treasury Committee that part of the reason the country was being held back was the sharp decline in the size of the workforce since Covid.
Despite this, the Treasury plan for living with Covid makes no mention of investment in rehabilitation or major initiatives for getting the workforce back to work. Finances in the UK Health Security Agency and the Office for Health Improvement and Disparities, the main legacy public health organisations—