The new Keep Britain Working review puts occupational health centre stage – but the real cure for economic inactivity lies in reshaping the nature of everyday work. It’s time for government and public authorities to lead the way on Good Work.

The Government’s Keep Britain Working review, published today, puts occupational health back on the agenda – and that’s a good thing.

Prevention and early intervention matter. Helping people stay in work or return after illness is vital. But this review, for all its good intentions, still skirts the bigger question: what kind of work are people being asked to stay in?

Let’s face it shit work is precisely that. It’s bad for health, bad for public services and bad for the economy too. For too long, the UK has subsidised poor work. Public authorities have awarded contracts to employers who pay low wages, rely on insecure hours and offer little support when people fall ill. The state then carries the cost in welfare, lost tax and growing NHS demand. That’s not an economy in recovery; it’s a system quietly paying to sustain bad practice.

The review estimates that ill-health and economic inactivity cost more than £130 billion a year. The numbers are staggering, but they tell a simple story: bad work costs everyone. When people are undervalued and unsupported, productivity falls, health deteriorates and communities lose strength.

The deeper problem is institutional disadvantage. The labour market is designed to reward people who can work full time, without interruption or caring responsibilities. It locks out millions who could contribute: disabled people, older workers, parents who need flexibility, people with criminal records, care leavers, refugees, and those with limited qualifications. These barriers aren’t accidental; they’re built into the way work is organised and rewarded.

If we want to keep Britain working, the answer lies not just in occupational health services but in reshaping the labour market itself. Jobs need to be secure, fairly paid and designed around real lives. That’s what Good Work means – and government and public authorities can make it happen and lead the way

They already have some tools. Every public contract could require Real Living Wage pay and recognised Good Work Standards, as a default condition.  Section 32 of the Procurement Act allows public bodies to reserve contracts for social enterprises and inclusive employers that create fair, supported jobs for people who face disadvantage. Used properly, these powers could build a national network of Good Work providers — employers who pay fairly, train locally and give people the support they need to stay in work.

This is not charity; it’s good economics. When work is decent, people are more likely to stay healthy, spend locally and strengthen communities. When it’s not, we all pay the price of a broken economy.

Keep Britain Working is one step forwards, but the next steps need to focus on transformation – creating a labour market that values people properly and uses public spending to set the standard.  Good work doesn’t just improve lives; it rebuilds the economy. And if we’re serious about keeping Britain working, we have to make good work accessible for everyone, not just a chosen few.