Can you remember when climate change was a cost and not an opportunity? Sir Nicholas Stern (of the Stern Review) changed that. He showed that the cost of averting disaster was far less than the cost of living with the consequences, and that green energy represented a huge economic opportunity for the UK economy.
As Chair of Pain UK - a new alliance of medical charities - I took Stern as my point of reference last week when speaking about the societal impact of pain at a conference in Copenhagen.
Incredibly, I found that the depressive effect of chronic pain is so great that eradicating it would lift the country out of recession. Last year, for example, back pain cost the British tax-payer £12.3 billion - equivalent to 0.5% of GDP. Yet it was a 0.3% contraction in the economy that tipped the UK back into recession in March of this year.
That £12.3 billion is made up both of costs and lost profits. Most people who injure their backs at work will be off work for several weeks. During that time, the state will pay for visits to the GP, x-rays, physiotherapy and painkillers. Employers find themselves obliged to pay wages and either accept the lost productivity or hire in temporary staff to maintain output.
There are hidden implications too. Take, for instance, the example of a supermarket shelf-stacker who puts his or her back out while lifting a crate of beans. For the sake of simplicity, let us assume that the supermarket incurs costs of £1000 in covering the cost of sick leave, rehabilitation and compensation. Now assume that the profit margin on a tin of beans is one pence. Simply to recover the £1000 outlay, the supermarket now has to sell an additional 100,000 tins of beans on top of its original target. This is a huge burden to impose on companies that are already struggling to deal with the effects of recession.
Across Europe, 500 million working days are lost each year as a result of chronic pain. The economic effect is equivalent to paying half the working population of Portugal to sit at home doing nothing, while asking the rest to make up the difference via impossibly inflated sales targets.
The £12.3 billion (which, we should remind ourselves, describes only one type of chronic pain) also takes no account of the societal impact of pain. To understand what it is like to suffer from chronic pain, imagine having a toothache that will stay with you for the rest of your life, even after the tooth has been removed. Unsurprisingly, people living in chronic pain are more likely to lose their jobs, be divorced by their partner and die earlier than might otherwise be expected.
Part of the explanation is cultural. Our 'after the accident' approach to back care costs us around £5 in lost income for every pound we spend on treatment. In Germany, where they have just discovered that the annual cost of pain management is more than they spent bailing out Lehman Brothers, they are now starting to take the issue seriously. In their case, that means paying healthcare professionals by outcome rather than output. While it may not be to everyone's taste, tests conducted with 6000 patients in 41 centres showed a 52% reduction in sick leave and around 10% reduction in the cost of healthcare.
On a societal level, we already know that our present care systems won't work and can't be afforded. Meanwhile, our sedentary junk food culture is leading people to develop ill-health at an earlier age than ever before. Yet there are already 11 million people alive in the UK today who can expect to live to 100. If we do nothing, we may condemn millions of people to spend fifty years or more self-managing their pain.
Travelling back from the conference I recalled that, not long ago, heart disease was the number one killer in the western world. Today, advances in surgery, drug manufacturing and pace-maker technology have transformed the situation.
I believe that by working together, technology firms, designers, architects and the pharmaceutical industry could similarly define a new landscape in which people (starting at school) were given habits that would help them to avoid, delay, manage and hopefully recover from chronic pain.
As people entered into old age those same firms would enable them to live enriched lives, delaying the day when they required permanent residential care. The design of our streets would change to suit the needs of the elderly; the Zimmer frame would give way to low-profile exoskeletons that provided support and protected fragile hips; and a new type of doctor - the GPP, or General Pain Practitioner, would be on hand in every practice to help people control their pain and maintain their place in society.
These examples are the healthcare equivalent of the green economy. They may seem fanciful to some; others will see the export opportunities and rub their hands in glee. Wouldn't it be nice if the cure for economic pain turned out to be pain itself?
Sean McDougall is Chair of Pain UK - an alliance of charities providing a voice for people in pain.