My optimism for spring, change and transformation (see April 2024 Legal Action 7) has come back to bite me this month as I’ve found myself transformed into a croaky mess thanks to a nasty bout of tonsillitis. I’ve been forced to take some time off.

Coming back to work, I’ve found myself telling people, as I apologise for my absence: ‘I hate being ill, I’m rubbish at it.’ What an odd thing to say. No one likes being ill. Who is good at it? If I’m honest, what I really dislike, and fail miserably at, is taking my own advice. And, speaking to colleagues managing other services, I know I’m not alone.

In any small charity, staff are our greatest asset. Working on the front line with people in distressing situations, the need to take care of colleagues can’t be overstated. ‘You can’t pour from an empty cup,’ I tell people when they’re unwell, run down or just plain exhausted. I’m adamant that staff use all their leave, take time off sick when they’re not well enough to work, and aren’t under pressure to return before they’re better. Sometimes, practicalities make leading by example difficult (as I discovered while running the payroll from under a blanket on the sofa). And yet being ill always comes with a side order of guilt.

The Health Foundation, in its report, Health inequalities in 2040: current and projected patterns of illness by deprivation in England, published in April 2024, points out that ‘good health is an asset to society’ (page 47). All the more alarming, then, that its authors found that the number of people living with major illness is set to increase by 2.6m by 2040. Most stark is the rise in health inequalities, with 80 per cent of that rise predicted to be among working-age people in the more deprived 50 per cent of areas. It’s almost as though health and inequality are linked … On the same day that I read the Health Foundation report (19 April 2024), the prime minister appeared in my newsfeed decrying the UK’s ‘sick note culture’ while simultaneously threatening to further empty the cups of people most likely to be ill, disabled or unable to work. Perhaps he hadn’t had a chance to read the report.

Advice agencies see more than most the links between poverty and ill health (every single person coming to us for housing advice in the past six months has had health issues). Our clients also know this – a private tenant coming for advice recently told us: ‘Our landlord only lets to people on benefits. They know we’ve all got disabilities, mental health problems, too much going on to be able to fight them, and we can’t afford to move out.’

So, too, does the Bevan Foundation, which responded to the Health Inequalities report with a call for decent housing, fairer conditions, and a social security system with benefits above destitution levels in Wales (Victoria Winckler, ‘Health warning for Wales’, 18 April 2024).

Thankfully, I was lucky enough not to need a sick note. Having tonsillitis as my most pressing health concern is a privilege – as is having a decent home to recover in. I’ve resolved not to tell anyone else that I hate being unwell as it suggests needing time off work because of sickness is a weakness to be resented rather than an inevitable human reality. I’ll keep making sure our team are supported when they need time off. I might even start taking my own advice.