When you undergo cancer treatment, the knee-jerk reaction of many people is to encourage rest. In theory, advice like ‘don’t overdo it’, ‘prioritise your healing’, or ‘take it easy’ is all good, particularly as the bone-wracking sickness, hair loss, and other grizzly side effects of chemotherapy make it clear that you’re fighting for your life.
Yet rest is the antithesis of capitalism, a system which relentlessly prioritises and glorifies work as both necessary for the continuation of the market and a symbol of one’s own virtue. Practically speaking, how can one rest when forced into debt and living with the threat of losing their home because this country’s sick pay doesn’t cover the bare essentials?
This is the reality for many diagnosed with cancer, who are also in low-paid or precarious work. At £96.35 per week, Britain’s sick pay system is the lowest in the industrialised world, with the former Health Secretary Matt Hancock even admitting that he would be unable to live on such a meagre amount.
When coupled with an economy built on increasingly precarious labour, being a worker means living under the constant threat of severe financial hardship after simply becoming ill. In 2021, the TUC found that 3.6 million people work in low-paid, insecure employment, with a University of Cumbria study noting that these are factors in working while ill.
These circumstances are uniquely cruel, particularly when contrasted with similar European countries: Germany covers 100 percent of an employee’s wages for the first six weeks. Moreover, the Office of National Statistics reported in 2019 that millions of low-paid workers don’t even qualify for SSP due to not meeting the Lower Earnings Limit (LEL) of £118, wherein ‘you don’t qualify for SSP or any financial support from your employer when you go off work sick.’
In my research as an academic, I have spent time in food banks to explore the impact of Universal Credit and austerity. I’ve met people who could barely afford food, who were working, and were one step away from homelessness. As the United Nations reported, the British government’s austerity programme has meant ‘great misery’ for its own people, in what UN rapporteur Phillip Alston called a ‘political choice’ and ‘driven by a political desire to undertake social re-engineering rather than economic necessity.’
When I was at the Royal Marsden Hospital receiving my treatment for cancer, I would think about the people whom Alston mentions may ‘end up visiting the food bank, or forgoing food jut to stretch a very small amount out over an entire month’, and what would happen if they were in my situation. Would they lose their jobs from going to appointments or being too ill to work? Who looks after their kids?
Previously, I’d worked on a temporary contract and had been casually employed. While I was sick, I often thought how my life could have spiralled out of control had I fallen ill earlier in my life. I could have suffered from the dreadful Statutory Sick Pay, I could have not finished my PhD before my funding ran out, I could have struggled to afford rent and would have been forced to move back in with my parents. It would have destroyed my independence and would have been detrimental to my mental health, if not my physical chances of recovery.
The fears of illness penalising you are real, but so too are the anxieties over going back into work following treatment. It’s been reported that cancer survivors have difficulty finding work, with thirty-seven percent of patients experiencing workplace discrimination. Although cancer is classed as a disability under the Equality Act 2010, and employers are ‘required to make “reasonable adjustments” to the workplace’, there is no cast-iron understanding of these adjustments, and recent changes to employment tribunals means that hearings could now cost the pursuant as much as £1,200. One cancer survivor wrote in the Guardian that he sometimes thought that ‘had I known how difficult things would be to get a job, I think I’d have opted not to have the treatment.’
Likewise, in a survey of 201 cancer survivors, all of whom were unemployed and looking for work, sixty-one percent of respondents said that they were ‘at least somewhat concerned’ that potential employers wouldn’t hire them if they discovered they had cancer; and whereas only four in ten said they felt well enough to work, they knew they had to in order to survive financially.
Recently, Rishi Sunak’s spring statement did little to support people weathering the storm of soaring inflation and stagnating wages, with the Resolution Foundation warning that people will ‘see the biggest drop in living standards on record’. The pandemic caught Britain at a point where its health had been in slow decline for the past decade; now the cost-of-living crisis will see these catastrophic inequalities deepen even further.
Poverty dramatically impacts the ability to live healthily—not least because it restricts access to amenities like food and safe housing, but also because it is mentally draining. People in poverty are consumed by fear of survival, which is true for cancer survivors. In 2020, Cancer Research UK noted the stark disparities in both the diagnosis and treatment of the disease, pointing out that people from deprived areas will be more likely to get cancer, but will also be more likely to be diagnosed at a late stage, or have trouble accessing services.
What does this mean for cancer patients and survivors as we head into a crisis? If a person is in long-term precarious employment, unemployed, or struggling on SSP, how do they balance physical and financial survival?
In my secure job, I found solace in experimenting with my style and treating myself to wigs. It left me wondering how you make yourself feel nice when all your hair comes out in clumps and you don’t recognise your own face, but you need to spend whatever money you have on bills. Likewise, the plan set by my personal trainer alleviated many side effects, providing me with mental clarity and a sense of connection to my body that had been disrupted by cancer.
Liz O’Riordian, an ex-breast cancer surgeon and survivor, emphasises that exercise is essential for cancer patients, referring to it as a ‘fourth’ form of treatment. But how many people have the funds for a personal trainer or gym membership—or even the luxury of leisure time?
In 2009, Mark Fisher published Capitalist Realism: Is There No Alternative? A year after a catastrophic global economic collapse, Fisher spoke to a chink of light that streamed through the gloom. Here was an opportunity to pave another way which drew on new possibilities outside of capitalism’s cut-throat logic.
Today, as ‘business as usual’ returns to Britain, Fisher’s writing haunts us. Millions lose their jobs while millions more are forced to continue working in the face of a deadly virus. Low-paid, precarious workers—often classed as ‘essential’—feature higher in the Covid death toll. While Jeff Bezos became the world’s first trillionaire, GMB members at Amazon warned of their colleagues’ fear that if they self-isolated they’d be made homeless, but if they did go to work, they may die.
This gaping chasm of inequality is surely enough for us to step back and ask what is going on. But today, ‘sensible’ politics is understood as taking a centrist, middle path.
For instance, Labour’s current approach is to win an election by not rocking the boat. Rather than build upon the current resurgence in workers’ self-organisation, Keir Starmer has distanced Labour from the industrial wing of the labour movement to present Labour’s distance from calls for economic justice. The lack of imagination is bleak, particularly as working people are—yet again—forced to pay to cover damage to a market that would replace them while their body is still warm.
My experience of cancer has further confirmed to me that life’s best aspects stem from care, support and community. The NHS and my loved ones are what saved my life, not my own ability to hustle or manoeuvre situations. We currently live under a system at odds with what makes us human. This is encapsulated by our sick pay system, wherein the extraction of human labour is valued over the very existence of that human.
This is set to get worse. And as we head into another economic crisis that will hit the most vulnerable the hardest, we need to carve out space for a more caring way of being. With that comes conversations about how to think beyond capitalism. Collectively rejecting the penalisation of the chronically ill is a good place to start. We can—and must—demand more from life than simply existing to work.