Episode 58 · 28 September 2023 · 55:54

Why the Health Gap is a Silent Saboteur of Business Success

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What is the health gap — and why should business care?
other#health-gap #business #economics
The gender health gap: conditions men don't know about
other#gender-health-gap #women-health #menopause
Equity vs. equality — explained simply
other#equity #equality #explained
Why isn't the NHS the solution?
other#nhs #healthcare #uk
The silent exodus: nearly a million people have left the UK workforce
other#workforce-exodus #covid #employment
Dame Carol on why Zumba classes and water bottles aren't enough
other#dame-carol #workplace-health #zumba
The C-word: COVID's lasting impact on workplace health
other#covid #workplace-health #culture
Menopause at work: 15 years of discomfort for some women
other#menopause #workplace #perimenopause
What leaders must do — the panel's calls to action
other#leadership #action #workplace
Digital health solutions: Syrona and Peppy
other#digital-health #syrona #peppy
What would it look like if we got this right?
other#vision #success #health
Final reflections and resources
other#reflections #resources #closing

Show notes

Why the Health Gap is a Silent Saboteur of Business Success

Episode 58 — Al Elliott and Leanne Elliott (Chartered Occupational Psychologist) are joined by a panel of distinguished experts — Lord James Bethell, Dame Carol Black, Kathy Abernethy, and Chantelle Bell — to uncover the hidden consequences of the health gap on workplace productivity and employee well-being.

Most businesses think they know their people. They have the attendance data, the engagement scores, the wellness perks. But beneath the surface, a silent saboteur is eroding performance, retention, and culture: the health gap.

In this special panel episode, Al and Leanne bring together four leading voices in health, policy, and workplace innovation to explore what the health gap really means — and why it's not just a social issue, but a business-critical one. From the gender health gap and menopause support to the exodus of older workers and the limits of the NHS, they ask the uncomfortable question: are we building workplaces that keep people well, or just plastering over the cracks?

🔥 Key Themes

1. The health gap is a business problem, not just a social one. When we talk about the health gap, we usually mean economic inequality. But as the panel reveals, the gap between who gets good health support and who doesn't is quietly shaping your workforce — from productivity to retention to recruitment.

2. The NHS can't fix this alone. Free healthcare is a British luxury, but the system is overloaded. From long waiting lists to drugs tested primarily on male bodies, the panel explains why employers can't wait for the system to catch up — and why digital health platforms like Syrona and Peppy are stepping into the void.

3. Nearly a million people have left the UK workforce. The stats are almost unbelievable. Post-COVID, the 50-plus workforce has diminished hugely — and even if you hold on to your key employees, a large percentage of them are struggling with health issues they don't talk about.

4. Wellness perks are plastering over the cracks. Dame Carol is blunt: Zumba classes and water bottles are nice-to-haves, but they're not the fundamentals. Empowering leadership from the top, who show they care and talk about it, is where real change starts.

5. Menopause is a workplace issue. With early onset perimenopause typically around 43, some women face a good 15 years of discomfort — often in silence. Kathy Abernethy explains why one-on-one support matters more than training, and why leaders need to normalise the conversation.

💬 What Would It Look Like If We Got This Right?

The panel shares their visions — from a nurse in every school to leaders who recognise that employees are not disposable. Lord Bethell offers a rebuttal to those who call this a "snowflake" issue: these are management priorities now, whether you like it or not.

Connect With Us

Get in touch, book a call, or find Al and Leanne on LinkedIn — all in one place: truthliesandwork.com/connect

Mental health support: findahelpline.com — UK: Samaritans 116 123 · Mind 0300 123 3393 — US: 988 — Australia: Lifeline 13 11 14

Truth, Lies & Work is part of the HubSpot Podcast Network.

Full transcript

Expand full transcript

Al ElliottThe dirty little secret is that most businesses think they know their customers. They have the data, the records, the history, but it's scattered across 3 teams and 4 systems. And in our case, it's about 216,000 spreadsheets, which means nobody can actually use it.

Leanne ElliottWhat you should be doing is using HubSpot, because why? HubSpot connects it all— every interaction, every support ticket, every conversation— into one platform every team can work from. So when sales talks to a customer, marketing already knows the full story. And when you know more, you grow more. Nice.

Al ElliottCheck out hopspot.com, the agentic customer platform for growing businesses. And she died in the bath, slipped under the water in a, in a, in a drink and drug haze.

Leanne ElliottHello and welcome to the Truth, Lies and Workplace Culture podcast, brought to you by the HubSpot Podcast Network, the audio destination for business professionals. My name is Leanne. I'm a business psychologist.

Al ElliottMy name is Al. I'm a business owner.

Leanne ElliottWe are here to help you simplify the science of people and create amazing workplace cultures.

Al ElliottYeah. Hello again. Episode 58, I think. Yeah, episode 58. This one's going to be a good one. It's a beefy one. We probably have around about 45 minutes of clips to play you. So we're not— we're going to do a very reduced news roundup, aren't we, Lee? I didn't think we were doing one at all.

Leanne ElliottI haven't prepared one. Is it reduced?

Al ElliottDon't worry, there's no quizzes or anything. All we want to do is basically just tell people that we're going to be at the Mad World event on the 13th of October. Does that sound right?

Leanne ElliottNope, it's October the 12th.

Al ElliottDon't come on the 13th, we won't be there.

Leanne ElliottIt's October 12th, 2023, at 1111111 at 133 Houndsditch, which if you're not from the UK or indeed London might sound a bit strange, but it is a very fancy conference centre apparently. Um, but yeah, it's a Mad World. This 6th Summit. We are the official podcast partner of the event. There is loads of cool speakers there, people from all sorts of corporate organizations, small businesses, providers, government. It really is going to be an incredible event for anybody who cares about workplace well-being, mental health, and culture and wants to see a shift in how we work. Uh, yeah, it's going to be ace. Tickets are still available. It's very reasonable price for the huge amount of content that they are going to pack in in that one-day event. So yeah, do come down, go to madworldsummit.com, um, and you can book your tickets there.

Al ElliottAnd as Leanne said, the added bonuses that will be there, you'll have a greet and meet for us, or a meet and greet. That's probably the way to say it.

Leanne ElliottOr indeed a greet and meet.

Al ElliottOr you can do it whichever order you want to do.

Leanne ElliottWhichever, we're not fussy.

Al ElliottTechnically you do greet and meet, you say hello and then you meet them, don't you? So anyway, either way, so you'll see us and that will be zero pro— we won't charge you any money for that. It's going to be free to come and say hello to us. If you want a photo, it's 100 quid a pop, but you know. So that's the Mad World Summit, link in the show notes. If you'd like anything to do with mental health, wellbeing, corporate wellbeing, you have to be there. We're coming over from Bosnia, flying out there to, uh, to be there. So if you live in the UK, you've got no excuse. Get yourselves down there. Link in the show notes. We'll see you there. Oh, by the way, just get on your LinkedIn and tell us if you are coming, because we'd love to arrange to see you. Okay, so this episode is all about about the health gap. Now you might be wondering, what on earth has the health gap got to do with me as a business owner? Turns out quite a lot. We won't go into it right now because we separate this up into sort of 5 major sections. So I'll quickly go through those with you there. So there's 3 sort of impacts of this health gap. The first one is around productivity. What's it doing if someone doesn't— isn't 100%? They're clearly not going to give you 100%. The second one is around retention and recruitment. If people are If people aren't coming in looking for jobs, then it's more difficult to find the right people. And if people are leaving because of due health, due to ill health, then it's hard to retain them. And the final one is the role of leadership. What should leaders actually be doing? We're gonna go into that in a second. We'll tell you the 5 questions we've asked our panel, but we've got a panel of 4 incredible people. Leanne, do you wanna start with guest number 1?

Leanne ElliottYes, we have some incredible guests today. Our first panel member is Lord James Bethell. Yes, my US friends. You heard me correctly. We have a lord on the podcast this week. Lord Bethell is a huge advocate for a healthier and happier workforce, having held numerous ministerial posts such as a Minister of Life Sciences and building and selling several businesses. He's definitely on the side of business owners.

Al ElliottJust in case you didn't know, and I don't think Leanne knows this, and I wanted to surprise her with it, um, Lord Bethell actually also was one of the founding, founding people behind this brand and also was the managing director of Ministry of Sound. Yes, the nightclubs. Yes, all the DVDs, all the CDs. Yes, that guy. He was one of the founding team and he was the managing director for a while there. Isn't that cool?

Leanne ElliottSo is Lord Bethell a bit of a raver? Is that what we're saying?

Al ElliottI think so. I think it's MC Lord Bethell, I think, is his full name. Really cool guy. Yep. So let's go and meet Lord Bethell. Yep. My name's James Bethell. I'm a member of the House of Lords, and I was Minister for Life Sciences in the Department for Health and Social Care, and I remain a champion for innovation and for, well, really making Britain a healthier place. Our second guest is Chantal Bell, who's one of the founding partners of Sirona Health. It's a platform that provides gender-inclusive benefits. Now, we're going to go through that in a second, what that actually means. Chantal did a master's at Cambridge and is named as one of the top 50 women in a European list. Let's go meet Chantal.

Leanne ElliottMy name is Chantal Bell. I'm one of the co-founders of Sirona Health. Serona Health is a digital healthcare platform supporting people going through various life transitions, as we call it. So supporting people going through different phases of healthcare conditions. Our next guest, we have a lord, it is only fair that we have a dame. Dame Carol Black. She is a physician, a government advisor, and was president of the Royal College of Physicians for 4 years. She's also a world expert in scleroderma. I think I'm very well known for health, work, and wellbeing because I've written 3 reports for government and it has changed, I think, the way people think about health and wellbeing in the workplace.

Al ElliottAnd last but certainly not least, Kathy Abernathy, who is a nurse who specialises in menopause. She worked for the NHS for 25 years and then became the founding clinician at Peppy Health, which is an employee wellness platform. Let's go meet Kathy.

Leanne ElliottI'm Kathy Abernethy. I'm the Chief Nursing Officer at Peppy, Peppy Health. We're a healthcare app, and we offer employers an innovative way of offering support to their people through a digital app with real human experts like me. So now we've met our panel, let's ask them some tough questions. There are 5 themes that we will be quizzing our guests on this week. Number 1, what is the gender health gap and why does it matter? 2, why isn't the NHS the solution? 3, how does this affect business and employees? 4, what can owners and leaders do? And 5, how can we create a healthier future for everyone? It is a jam-packed episode. Let's get started. So first up, what is the health gap and why does it matter?

Al ElliottYeah, so most people talk about the health gap in terms of economic terms, so, uh, poverty, Wealth. That's the health gap. I know we are talking specifically the UK here because I know that in America the health system is very different. Also, UK people, British people can't really understand how it works across there. You have to pay for things, but over here it is free. But it still means there is this gap. So the economic health gap is certainly a problem, as Lord Bethell explains. Some, you know, if you are poverty itself, lack of access to health support, The pressures of life and bad environments, living in an environment where there's dirty air or lack of access to public spaces. These are all the cycles of tough lives, of poverty and of living in environments that don't support healthy living. So that's the macro environment in the UK at the moment. It's really hitting us hard and it's cost the NHS a lot. It's costing our workforce a lot. It means our welfare bills as a nation are really high. Despite her current status, Dame Carol Black actually had a really, really modest upbringing. And so she can totally relate to the connection between poverty and poor health.

Leanne ElliottYou need health to be an asset. You need a healthy population. And I think you've gotta start pretty early in life. Child poverty in our country is a huge problem. And the government puts the same amount of resource into a wealthy child as a poor child.

Al ElliottAs an advisor to the government, she definitely feels that the government could be doing more to help those who come from lower socioeconomic backgrounds.

Leanne ElliottWell, I think you would think possibly you need to compensate for poverty in childhood because children have no choice, do they? And you don't want children growing up in poverty. It affects Their physical health, their mental health, their educational potential, their potential in life. I don't like to see that. But it's not just economics that leads to a health gap. There's also a very clear gender health gap, as Lord Bethell explains.

Al ElliottSo overall, you know, since the beginning of history, we have always overlooked women's health. So we— this takes several forms. We, we don't listen to women. Very well. When they say they have a problem, we tend to brush it off. And this is particularly heard in mental health, where we tend to put things down to, well, we just have an institutionally patronizing approach and don't listen to it. And the current focus on both menstruation and menopause would be really good examples of that. We don't put women into— we don't research women's problems. So the classic example of that is a heart attack. So the way in which a heart attack presents itself in a man and/or a woman is really different. For a man, it is typically a sort of quite a violent sort of heart-based problem, and for a woman, it will be a feeling of tiredness. So in other words, the basic diagnosis of something as common and big as a heart attack—we just take a man-centric approach, and therefore a lot of women. get overlooked. Autism is another good example. The statistics seem to suggest that autism is as common in women as it is in men. We just don't diagnose it because it takes a different form.

Leanne ElliottThere are conditions that a lot of men might not know about, and often women won't be willing to talk about. Let's hear from Chantal. So I think everyone should know about these conditions. You know, endometriosis, just for those of you who don't know, is a condition where the lining of the uterus Uh, grows in other parts of the body, or lining similar to the lining of the uterus, I should say. And, um, yeah, it affects 1 in 10, uh, women or, or people with, um, uteruses. And it's extremely painful. I think a few years ago, Google listed it as one of the top 10 most painful conditions to have. So, you know, 1 in 10 women are going through this in the workplace and, um, with no support, quite frankly. It takes 8 to 9 years to diagnose. And there really is no treatment or no cure for this condition. So it's more kind of around surgery and management of removing the affected parts and then managing the condition. Um, so from a male's perspective, you know, just at least understanding what the kind of symptoms are of these conditions and how you can support your, your fellow colleagues in the workplace, I think it's super important. But when it comes to mental health, men are often guilty of doing the same. Women quite naturally, uh, access healthcare, ask questions, and quite, you know, open to that. But men Typically kind of hide a lot of these issues internally. And unfortunately, you see kind of higher suicide rates, etc., when it comes to kind of men and mental health. So what we've done, we spend a lot of time actually working on our men's health proposition. We work with someone who was a GP in the Royal Navy, so a male-heavy organization, to help shape the men's health offering, as we realize that, you know, men access healthcare quite differently. And we've provided support in a way in which men can easily access. These, these things on the app. So for example, we have a discreet kind of health coach, as we say, or health physicians. So instead of having to go to a doctor or see someone in person, on video, for example, you can just ask a discreet question on the, on the health chat, and they will answer that for you and help you with your, your treatment pathway.

Al ElliottSo it seems like, is the solution that everyone gets the same access to and levels of healthcare? The real issue is something which Cathy calls Equity versus equality.

Leanne ElliottYes, so it's about treating everybody fairly but not necessarily the same. So we believe that people of all genders deserve specific individualised healthcare, and that's what we offer. We offer specialised men's health, specialised women's health, baby care support, fertility support, menopause support, and that will differ according to each individual person. So that's equity rather than just offering everybody the same and saying just Take the bits of it that suit you.

Al ElliottI've heard this term before, you've used it before, still don't think I fully understand what equity versus equality means. Can you explain it for us?

Leanne ElliottI saw a really good explanation on LinkedIn, actually, the difference between equality and equity. Let's imagine that everybody wanted a bicycle, but you have men, you have women, you have children, you have people with disabilities. They're going to require a different size of bike. If we were focusing on equality, you'd give everybody the same bike regardless of their specific circumstances or needs. Equity would be about adjusting the bicycle to meet the individual needs of each person. That makes sense?

Al ElliottThat makes perfect sense.

Leanne ElliottBrilliant. So Lord Bethel points out that a lot of drugs are tested for the male and not the female body, and this caused a huge problem during the COVID vaccine rollout.

Al ElliottAnd then lastly, in terms of researching drugs, drugs that help men are very heavily researched, and drugs that help women are often overlooked. And drugs that help both, they tend to be researched for men and not for women. And I was very frustrated in the pandemic that yet again we didn't do clinical trials for pregnant women. Why didn't we do it? Because of an anxiety that if there was a problem with the clinical trial, it would have massive consequences, because who the hell wants to try out a drug on a pregnant woman and that to lead to some kind of problem. But that lack of courage and lack of thoughtfulness does mean that a whole bunch of women who have children can't then take the vaccine in the knowledge that it's been passed for its safety tests.

Leanne ElliottYou may think that we're lucky in the UK, and to a large extent we are. We do have free healthcare through the NHS, the National Health Service. But it's not quite that simple. So why is the NHS not able to fix this problem?

Al ElliottSo this brings us on to the second part, which is why isn't the NHS the solution? The problem with the NHS, it was founded in 1948, so just after World War II. It was designed for this population who'd been through 2 world wars in like 20 years. It wasn't designed originally for today's complex problems, which might They might be physical, they might be mental, they might be emotional. Let's hear from Lord Bethell. We have a wonderful asset, a massive national achievement in the NHS and the principle that the NHS will pick you up and put you back on your feet when you've taken a hit. And that access to the NHS creates a secondary impression that somehow the NHS will fix all the problems of the country when it comes to physical and mental health. But I think there's only so much the NHS on its own can do, and it does come back to others— individuals, employers, communities, civic groups— to try to make a contribution to health. The determinants of health are much wider and broader than the government Or the NHS can look after. In fact, the NHS is a sickness service, really. It looks after you when you are ill, and it should be able to give you access to the tools like vaccines and diagnostics that help you on your health journey. But the determinants of good health are much wider than that.

Leanne ElliottChantal's platform, Sirona Health, is built on providing this kind of service. that the NHS can't realistically fulfil. It's not just the strategy that requires updating. Some of the methods are pretty archaic too. We love it. We love the NHS. It's great at what it does, but equally, it's a big old organisation with some archaic ways of working. I think the one thing I would say is ensuring that data is accessible and can be transferred back and forth. A lot of NHS trusts still use paper. for example, to kind of store their notes. So, just updating that and moving more into the digital world, I think, would help make the patient experience a lot better. But, I think we're a little bit of a long way away from that. So, yeah, I'm not too sure how quickly that would happen, but fingers crossed soon. Kathy from Peppy Health agrees with Lord Bethell, but as you'll remember, she spent 25 years in the NHS, so she has an inside view. I'm still a strong advocate for the NHS, even though I don't work in it anymore. And I still pay my dues to the NHS. I sit on the Menopause Guideline Group, and I work with NHS England to try and improve care in menopause within the NHS. But I think what's happened is that the NHS is under immense pressure, and the staff are therefore under an immense pressure. They're doing an almost impossible job. Now, could I fix the NHS? I would not like to be the person to have to do that. But does it need fixing? Yes. At its best, it's amazing. That's why apps such as Peppy are so important to complement, not replace, the NHS. At the end of the day, that we're people who want to be treated like people, so we want to treat people the way that we would be treated. And we've seen that, that this is a real gap, and the areas that Peppy are areas which the NHS don't support very well at the moment due to the pressures that we've been talking about. So Peppy is stepping in not to replace the NHS, But to fill that gap. Yeah. So a good example is endometriosis, where if a person has endometriosis, it takes a very long time to get a diagnosis. If somebody joins our women's health service, our specialised women's health service, they have access to an experienced and qualified endometriosis nurse who can take them through the pathway of diagnosis, telling them the options so that when they do go to their healthcare practitioner, they're really well equipped for that consultation. And it can save time enormously, and they know their options. And Peppy can even do testing for some of the conditions as well.

Al ElliottChantelle, the founder of Serona Health, agrees.

Leanne ElliottWe've had a few patients kind of reach out to us saying, oh, you know, I'm struggling to get an appointment on the NHS, for example, or it's just taking so long, I'm in so much pain. So we've helped connect them with some of our physicians on the platform. They've gone on to actually receive, um, a diagnosis, uh, much quicker than they would've done on, on the NHS, um, had they had waited. So, um, the good thing about what we do is that we can refer back into the NHS, but also help people go private if that's something they would, um, like to do.

Al ElliottSo it seems clear that there's no gonna— there's gonna be no quick solution from the NHS to this health gap. It's not gonna happen overnight. And more and more business owners and leaders are seeing the impacts of this poor mental and physical health in the workplace. So we're gonna go on to section 3, which is all about how does this health gap affect businesses and leaders? The first one is a problem of retention. Your key people are leaving work early, as Dame Carol explains.

Leanne ElliottAfter COVID, you'd have seen a lot in the paper of people leaving the workplace. They were mainly people who were 50+, our experienced workers. who we need in the workplace, they were leaving. And probably the most important reason is long-term ill health. So chronic conditions, you know, their diabetes has got worse, their arthritis has got worse. They perhaps need a knee replacement, but it means they can't be in the workplace. And that has caused an enormous problem. Everywhere you look, there are vacancies. People are looking for skilled people because so many people left the workplace that there are vacancies. Uh, skills are greatly needed. So I think you have to look at the balance, but the biggest worry for me, it exposes that we are an unhealthy population. Lord Bethell is the Commissioner for Health and Prosperity, and one of the biggest problems he sees is that although we are living longer, We are able to work less.

Al ElliottIn other words, although the total amount of time people spend on the earth is getting longer, the amount of time, the proportion of that time that they spend actually healthy is reducing in many demographic groups. And that's just a heartbreaking and economically depressing fact. And in the time that they are at work, their productivity is not increasing in the way that it has historically climbed. And there are a number of reasons for that. Some of them are monetary, for instance, inflation. Some of them are about investing in infrastructure and training. But one of them is about the health of the nation, the physical and mental health of the nation, how much time people can spend working, the state they're in when they are at work. And also their resilience to adversity, which is an inevitable part of life. Adversity isn't a bad thing, but when people can't cope and their work suffers, then that's not just bad for them personally and for their families, it becomes in aggregate a real problem for the nation's economy.

Leanne ElliottThe stats are almost unbelievable. In the UK, nearly a million people have left the workforce force in the last 3 years, and we don't really know what they've left to do.

Al ElliottNearly a million people have left the workforce. For what? We don't quite know why they have left and what they are now doing. What we do know is that in the mix are mental health pressures, physical pressures, and for some, just a desire to leave the workplace and to spend more time smelling smelling the flowers and hanging out with their families. And for some of those people, hanging out with the families is not a relaxed thing. It's caring for someone who is already quite poorly. What we also know is that the people who leave the workforce for one reason or another quite often then go on to develop quite serious chronic disease and then become disabled. So people aren't leaving the workforce because they're disabled, they leave the workforce and then become disabled. So I had to ask Lord Bethell, why do we think they're leaving? For some people, I think there's just an enormous amount of frustration that their skills haven't developed, their salaries have gone sideways, and for them, the benefits— when they look at the effort-benefit analysis of working, they're just not feeling very inspired by it. For some people, they have found the workforce, the workplace, really quite a traumatic space to be in, and I was very moved listening to the testimony of nurses who have found that the management of their work environment is just so chaotic that they feel that they are put under undue pressure, that the hierarchical and sometimes racist and sometimes sexist environment within the NHS is something that has led them to feel very bruised and like they want to be somewhere else. So there is in some workplaces a toxic element that's literally pushing people away. And then lastly, there seems to be a problem with the support we're giving people just to conduct the everyday realities of life, to be able to get their kids to school on time, to have the childcare to support their families, to have reasonable amounts of time off for maternity and paternity leave, to be able to learn new skills and have the financial and practical support to progress their careers in the right direction, and to live in and to work in an environment where they feel safe and supported. So it would seem the solution would be that we just recruit younger, fitter people to replace those that are leaving. Dame Carol Black seems to think it's not quite as simple as that. We haven't got people for jobs because for many, many years, the sad truth often not talked about is our young people, our 16 to 24-year-olds, have been having worse health, mainly mental health. And they have been increasingly not going into the workplace.

Leanne ElliottSo the young weren't in the workplace, but the older worker was holding it up, if you like. The whole— the older worker was the pillar that was supporting the economy.

Al ElliottCOVID came, and after COVID, that 50-plus workforce has actually diminished hugely.

Leanne ElliottAnd even if we do manage to hold on to our key employees, there's a good chance that a large percentage of them are disengaged due to health issues. Menopause and perimenopause affect women between 40 and 55. So even if they don't leave, it's reasonable to assume that productivity is affected. The menopause, um, some people might not even know what the menopause is, but it's when your periods stop. If it was just that, it would be fine, but it's because The menopause is associated with what we call the perimenopause, and that's the symptoms. And it's the symptoms that affect people at work, things like flushes and sweats, brain fog, memory issues. If someone's going through the menopause, they will know those symptoms. And if you're experiencing those symptoms at home, then you take them to work with you. So they have a real impact. And when you consider that women of a menopausal age, so women around 50, we're the fastest growing demographic in the workplace.

Al ElliottSo we're painting a bit of a grim picture here, and it's one that is likely gonna be replicated across the world. So as business owners, as business leaders, is there something we can actually do about it? So we asked our panel, what can owners and leaders actually do?

Leanne ElliottDame Carol knows exactly where the blame lies. So let me say straight up front, Zumba classes, water bottles, and fresh fruit, um, and mindfulness.

Al ElliottTraining is nice, nice to have, but it, it, it is plastering over the cracks.

Leanne ElliottSo the fundamentals are really empowering leadership from the top who show they care and who talk about it. It's a board that is interested if you have a board in your organization, um, or your top managers. Really talking about this, taking it seriously, being interested in the health of your workforce. Harsh but true. Fruit in the break room will not a difference make if we don't look at the bigger picture. As we've always said, great managers are one of the 3 cornerstones of an amazing workplace culture. A bad manager, as Lord Bethell explains, is worse than no manager.

Al ElliottAnd good leaders deliver that. And bad leaders are destructive and leave a bad taste in the mouth and a feeling that one wants to kind of not do another meeting like that. And that used to be okay in the old days where you just wrote lists and ticked off when people had done their tasks, but very rarely these days does that actually lead to, you know, the completion of the objective.

Leanne ElliottAnd of course, no conversation about culture would be complete without the C-word. Not that C-word. COVID.

Al ElliottWe all know a lot of people at the moment who have been through the financial crisis, been through COVID, who have been through life's attritional traumas, who just feel a bit overwhelmed. And it just makes sense for thoughtful employers who want to create the best environment for people to work in and to hold on to their workers for as long as is reasonable, to have a think about how they can support them and therefore to get more out of them for their shareholders and fulfill their fiduciary duties. So you'd think probably that the more complex the organization, the better the leaders will be. Well, one of the most complex organizations in the UK is the government, and it's no different there. Here's Lord Bethell to explain his experience. I've just done 2 years in pandemic government. I can tell you not all the meetings were high-fiving and body bumps. You know, they were— there were some really tough moments, but the good managers somehow managed to deliver the message but leave a sense of positivity on the table, that people leave the room, the Zoom, thinking that, you know, that the world's going to be all right. And you need that in a collaborative environment. You know, the world is much more complicated. We don't have single roles. We don't perform tasks in a sort of by-sequence basis. In order to get anything done in the modern world, you have to work in teams, and everyone has to trust each other and have quite a lot of non-verbal communication and And belief in the, in the, in the ability of others to deliver.

Leanne ElliottI don't want to get political, but I think even, you know, that a very simple example of, of the disruption that inconsistent leadership can have, maybe look at the UK in the past 4 years and how many prime ministers have we had now? 3?

Al Elliott94 prime ministers in 3 years.

Leanne Elliott184.

Al ElliottOne thing that Lord Bethel does say, though, it is down to the leaders to create great places and to fix this health gap wherever we possibly can. Now, being a supportive employer during such times is something that I think most employers would regard as the traditional role of a thoughtful, kind, and pragmatic employer who's trying to retain a skilled and cohesive workforce. But I think that there's also an additional element that's really become important in people's minds, and that is creating a workplace that endeavors to support strong values and in which celebrates the kind of environment that people can really thrive in. What we've become more aware of is that the pressures on people from their social interactions with each other can become much more debilitating and much more a barrier to peak performance than perhaps we had once given appreciation for. If you have an environment where people are not respectful of each other, where values of equality are not upheld, where personal behaviors can be coercive or dominating, then that can create a culture and an environment which leaves people feeling quite traumatized and hurt and feeling like they can't get through the working week in the way that they could. Now, going back to this gender health gap, the menopause and perimenopause affects women generally sort of around the age of 50, although I I'm pretty sure, Leanne, menopause, perimenopause can start at like 38.

Leanne ElliottEarly onset perimenopause, typically around 43.

Al ElliottThere we go. So we're talking about a good potentially 15 years of discomfort for some women. And these are often our most experienced employees. They have the skills and the potential to be able to mentor younger people if they're not at their best, if we are not catering to them as business owners, as leaders, if we are not doing all we possibly can to make their lives better, it just doesn't bode well for the organization. Traditionally, this would be a relatively difficult— going back maybe 30 years— relatively difficult conversation, I think, to bring up at work. But these days, Cathy and Shantelle and everyone is saying that it needs to be more in the conversation. So I asked Cathy, all right, we have to, we have to do this. How do us leaders broach the subject? And particularly in the context, if you're a male leader?

Leanne ElliottWell, menopause is private, and there will certainly be some people who don't want to talk about it, and that's fine. And that's where it differs from some other health issues. But actually, if you're experiencing these symptoms and they're really impacting you, then it means that you're taking time off work, or maybe you're coming to work but not doing your job as effectively as you'd like to. It could mean that you're not going for that promotion. And we know that 1 in 10 women actually leave work because of their menopause. And part of that can be addressed because these people are senior women, they've been long-established workers, they're good people to keep in the business. So it's very definitely a business issue as well as a personal one. So first of all, get the conversation going. That means having things like menopause cafes or champions in the workplace to make sure it's an easy conversation. That's the first step. I think the second step is to make sure that your leaders are trained. So they need to know what menopause is, how it happens, what happens, the way that people might be affected in the workplace. And that might mean a programme of education, perhaps incorporating it into your mandatory training, for example. Every aspect of your mandatory training will have a menopause aspect to it, if you think about it. And then I think finally, particularly for me as a clinician, it's about coming alongside and offering people personalised support. So it's great to talk about it.

Al ElliottYeah.

Leanne ElliottIt's great to train people, but actually people want one-on-one help, and that's what we do at Peppy. If you do want to hear more about menopause, perimenopause, and what you can do as a leader to support the women in your business, do go back to our previous episode on women's health, a guide for male leaders. I will leave a link in the show notes. But of course, it's not just perimenopause or the menopause that affects women differently. Lord Bethel has a heartbreaking story about his mother who suffered from postnatal depression.

Al ElliottI have a lens for this because my mother was really the victim of this syndrome in a big way. She had postnatal depression, which was completely brushed off as a condition when she was a young woman, and she was just considered to be insane. She was given electroshock treatment, which is an incredibly brutal treatment for something that required a completely different approach. Her marriage broke down. She fell into addiction with drugs and alcohol, for which she was very heavily derided and basically abandoned by, by the family. And her GP ended up having an affair with her and was going to leave his wife, but guess what? Never did. So she was literally abused by the medical professionals who were meant to be looking after her. And she died in the bath, slipped under the water in a drink and drug haze when she was 35. I was 10 years old. Basically, she was a victim of being a woman.

Leanne ElliottAs business owners and leaders, we have an obligation to not only make our workplace places a better place, but wherever possible, the world a better place. So how can we create a healthier future for everyone?

Al ElliottSo let's hear from Lord Bethell first. We should be recognising that employees are not disposable, that they're not easy to replace, and there isn't an endless supply of them. And therefore, if their health, both mental and physical, is going to be one of the reasons why they drop out of the workforce and leave your country, your company, then for goodness' sake, have a think about what you can do to support them. So when I interviewed Lord Bethell, I kind of challenged him a little bit on this. I was like, you know, as business owners, our budgets are stretched, inflation, fuel costs, everything's going up. It's a tough, tough time to be in business. I kind of said in a very polite way, what the hell do you know about running a business He's already said that he's a self-confessed public schoolboy who's got a hereditary peer. Seems very far from us actually at the coalface. Turns out Lord Bethell knows quite a lot about running a business. And I used to run an SME. I ran 3 or 4 of them, and most recently I built up a consultancy and sold it before I went into the House of Lords. And I, yeah, all right. I used to despair. I used to have my head in my hands sometimes at the sheer cost of all the additional benefits and support and investment that was required of my people. The only thing that I also found though was that people leaving my business was even more expensive. I mean, the biggest cost was a really valued employee who had a big impact on the work, who was loved by colleagues and clients. When they left and you had to recruit someone else and bring them in, oh my goodness, that cost a lot of money. And I used to weigh it up in my own mind as just being a diff— just creating the resilience of my own business. How do I— it was a people business, and if they weren't happy, then the business didn't work. And it was quite refreshing to hear him say that the solution isn't always just to throw money at the problem. It's more difficult than it used to be. You used to be able to, I think, you know, be a sort of old-fashioned, brash, leading-from-the-front type, and people were prepared to jog along with that. But now I think you have to be a lot more thoughtful. And it's not just money, it's not just extra maternity leave and free yoga. It is the way in which people are managed. I think it comes back to basic good management, that you're giving people an overall mission, a role within that mission, the tools to be able to complete the task, And the interactions necessary to make them feel like they are working in collaboration with management and are valued and making a contribution to life. So I think most of it is about good management rather than opening the checkbook and just spraying cash around.

Leanne ElliottUnsurprisingly, Dame Carol takes a very sensible approach approach to all of this. She suggests that we start preparing the current generation for the workplace. But I think we've got to start to think of health as an asset from when we're very young, a capital. You know, we talk about human capital, we talk about knowledge as a capital. So to start to think about how do we build that human capital, that resilience, so that we can do far more in the community.

Al ElliottI would be old-fashioned enough to think I'd have a nurse in every school.

Leanne ElliottI'd start to go back to some of the things that hopefully would stop the NHS being so loaded. And I think we put up with a lot. And we just thought that somehow if you had a mental health problem, you were a weak person.

Al ElliottAnd we've had to change that.

Leanne ElliottIt is not true.

Al ElliottMental health is just as important as physical health.

Leanne ElliottLet's go back to Kathy Abernethy, who's one of the UK's leading menopause experts. She says it's okay if leaders don't know exactly what to do, but instead of guessing, try asking. Um, it is an issue that affects everybody. I mean, everybody's got either a partner or a sister or a work colleague, maybe a daughter who is going to go through menopause one day. So we have to see this being something which just affects the whole workplace. And if we can get that conversation to such a degree that actually everyone's open and talking about it, it becomes much easier for all genders to talk about it. So it doesn't become just a male or a female issue. If somebody, if a company was to put out a survey, for example, and ask their people what they want in a workplace in relation to menopause, you'd get some surprising answers. The most obvious is access to things like fans on desk, air conditioning. Hybrid working has been really good for some people going through the menopause. They can sit in their own home at whatever temperature they want to be, but for others it's very isolating and they want the support of their colleagues. So it is coming and asking the individuals what they want. There has been a flurry of platforms and apps released recently under the broad term EAP. EAP is an employee assistant programme and can help with anything financial planning to healthcare. Lord Bethell is very supportive of this approach.

Al ElliottThere's definitely a role for digital mental health support of the kind that many companies are now investing in, and many companies, particularly white-collar companies, who are trying to find ways in which to support their employees are using the latest apps and algorithms to give their employees another way of thinking through their issues, of finding forms of mindfulness, of bringing discipline to their physical regime and programs, talking through their issues, and also at times asking for help. And the science on that is developing, but I am hopeful that some of those will provide an interesting layer of support.

Leanne ElliottDid you know that the UK's number 1 management podcast— that's us, by the way— and the UK's number 1 marketing podcast are both on the same podcast network?

Al ElliottWe actually have a lot in common. We both use behavioural science to help people do better at work.

Leanne ElliottAnd we both had to wrangle Rory Scott. Sutherland on episode, and two out of three of us are devilishly good-looking.

Al ElliottAnd you're not gonna say which. Phil, host of Nudge, UK's number one marketing podcast. It's brought to you. We need to do this in threes.

Leanne ElliottThe HubSpot Podcast Network, the audio destination for business professionals.

Al ElliottSeamless, seamless. Tell us about your latest episode, Phil. We've just done an episode on fake fandom and how new. New York indie bands are paying agencies to create fake TikTok videos about how much they like their work. And we talk about the behavioural science behind fandom and how that encourages people to enjoy the music and all of that good stuff and do some big things about how this affects the world of politics, business, and brands as well. It is.

Leanne ElliottIt's such, it's such a good show. Of course, you'll hear all the stuff you want to hear about how to grow your business by using behavioural science in your marketing. But there's also just some really interesting episodes that'll be right up your street. Personally, I enjoyed Can Balsamic Vinegar Make Beer Taste Better?

Al ElliottIt can.

Leanne ElliottAnd Are We All Just Status-Seeking Monkeys?

Al ElliottI am. Go and listen to Nudge wherever you get your podcasts.

Leanne ElliottBut come back.

Al ElliottYeah, come back. Definitely come back because Nudge isn't as good as this.

Leanne ElliottSo come back.

Al ElliottI'll cut that out. Keep that in. Chantelle is one of the founders of Sirona Health, which is exactly one of these apps which are designed to help with health. She explains that she kind of sees this platform as essential for organizations.

Leanne ElliottSo this is kind of where I guess tools like kind of Sirona come in, come into play. So this is kind of how we support people. Um, we discreetly, uh, support people going through conditions such as endometriosis, helping them out with their treatment pathway, diagnosis pathways, etc. Um, and, uh, yeah, our tool is very much applicable for all workplaces. We support all organisations, big and small. And yeah, I think it's super important to support your workforce, as what we see is a lot of these people going through these chronic conditions actually end up leaving the workforce, and the cost to replace them is actually quite significant. So supporting your workforce whilst they're working is the priority here.

Al ElliottKathy Abernathy from Pepi Health totally agrees. So Pepi is there to provide one-to-one health advice to employees, which is paid for by the employer, but totally confidential, and the employer knows nothing about what goes on in these discussions.

Leanne ElliottSo you access Pepi through your mobile phone. So it's a digital app, and it's entirely confidential. So as an employer, you sign up to Pepi, but then when your people sign up with Pepi, your employer doesn't know that you signed up. They know a certain number of people have, but it's entirely confidential. So when you're talking to me and my team of practitioners, you're talking to us privately about your health issues, things that are important to you, and it's all paid for by your employer. But in the NHS, I was able to support a handful of people in a clinic a day. What I love about the vision of Pepi is that I can support thousands of people through the content that we have, the events that we have, and the one-to-ones with my nurse practitioners. And so it's such a broad service that can just meet so many more. And that, for me, with my menopause hat on, is what I really would like to do. Although Lord Bethell grew up with a very different background to most of us, as we've heard, he does have a lot of experience in industry and consulting, and he genuinely believes that training managers and leaders is key.

Al ElliottListen, I'm a hereditary peer and a public schoolboy. You know, I was brought up to sort of, you know, in a sort of Victorian, uh, with Victorian values. Which were extremely old-fashioned and just not relevant in the modern digital age. And I went on to work in tech companies and in consulting and service companies, which have got a completely different approach. So over the years, I've had several rounds of training on how to learn to work much more collaboratively, much more thoughtfully, and in a much more positive way. And I think that's a really good thing.

Leanne ElliottLord Bethell and his literal peers— that's a UK joke— they had some mandatory training recently in the House of Lords. Some of his peers did not take to it well. Lord Bethell, on the other hand, really got something out of it.

Al ElliottEven in the House of Lords, we have done training on interacting with colleagues, and it hit the headlines when some peers didn't want to do it, but I for one found it incredibly helpful, because although I regard myself as a reasonable person, we all have to accept that we don't have a monopoly on wisdom, and having someone come in and just giving you a bit of an update on changing work environments, I think, is incredibly helpful. I think the 2 areas that we've all had to adjust a bit on is the old-fashioned idea of leadership put a great emphasis on directional alpha-type behaviors where the senior hierarchy imposed strong, strong direction on junior members and led from the front in a sort of quasi-military kind of way. And we've learned that that doesn't get the best out of people. And actually, it can lead to people feeling quite hurt and traumatized if their views are overridden and trampled on. So I think we've all had to learn to be a little bit more consensual and to use our ears as much as our mouths when we're trying to lead groups of people. Now, Dame Carol totally agrees, but she feels that education needs to happen before we even hit the workplace. I've seen my own generation My cousins particularly die before me due to poor health, due, I think, to poverty, poor education, and a lack of resources.

Leanne ElliottSo I was the lucky one, but it doesn't make it okay for the rest.

Al ElliottSo one of the questions we always ask anyone on a panel is, What would it look like if we got this right? Lord Bethell feels the employer has a very, very important part to play. What I would like to think is that there would be a feeling of consideration and thoughtfulness, and that the employer would have the resources, either through private insurance or through some kind of referral mechanism, that if the person, the lady involved, did turn to the employer for help, they would know how to guide them to the right place. And I think that that would be a valuable thing. If it had been my mother and she had gone to her employer, I would hope the employer would at least have the expertise and the network to be able to walk her over to someone who could help. Kathy, our menopause expert, has got a very specific example of when she realised that Pepi Health were doing great things.

Leanne ElliottIt's the one, the lady who had brain fog, memory issues. She was struggling at work. Her manager directed her to Pepi. She sat with us chatting to our practitioners, and then eventually, after a few months of intense support, she said to me, you know, my daughter said to me last night, I've got my mum back. That's what really touches me.

Al ElliottSo should the government be doing more? Well, let's go and ask someone who's in the government. Here's Lord Bethell. The government has an important leadership role, partly to indicate what the new norms are and partly to create a level playing field to reduce competitive advantage around sort of non-alignment. What I mean by that is on things like maternity leave, paternity leave, bereavement leave, timeout for what used to be called duvet days for people who are feeling a bit overwhelmed. The kind of support that individuals need in very highly pressured modern digital workplaces is something where I think the government can provide a degree of regulatory guidance and tramlines. I kind of feel sorry sometimes for people in the government because it feels like no matter what they do, there's one half the country saying that's a great idea, one half the country saying it's a really bad idea. I think that we need to have this sort of like even approach to it. Lord Bethell says, yes, we don't want to be wrapping people up in red tape, but we still do want to be providing some kind of guideline. I think we're all conscious of not drowning employers and entrepreneurs in red tape and onerous costs that create a lack of competitive— competitiveness. On the world— in the world markets. On the other hand, resilient workforces are essential to maintaining productivity and competitiveness. So I think, I think there is an area there where businesses and government can work together.

Leanne ElliottFor those that say this is a generational thing, this is a snowflake thing, Lord Bethell has a rebuttal.

Al ElliottThese all should be now management priorities. You wouldn't think, you know, 20 years ago we didn't worry about cybersecurity, we didn't worry about data privacy, and now they are all absolutely fundamental parts of most businesses, and it's high up on the C-suite responsibilities, whether that C-suite is, you know, the small business owner or the big corporate. And I'm arguing that health is now Whether you like it or not, on the list. And you need— anyone running a business needs to be thinking about how they preserve the mental and physical health of their workforce. Well, it's been a bit of a bumper episode. We had 5 main questions we wanted to ask. We've asked the panel each one of those. I think they've been answered pretty well. What do you think, Leanne?

Leanne ElliottYeah, I think they've been answered pretty well. I think what I would maybe wonder if there are some business leaders that are now kind of thinking, Oh man, this is something else I need to think about. I think it's more that these are probably things you're already thinking about because you have processes in place, you have your EAP in place. It's maybe just building your awareness of these inequities perhaps that exist in your workforce, or indeed the specific needs that, that the people in your business, depending on their demographics, are going to experience over the next few years. And I think women's health is a really easy place to start. But of course, there is— there are many different areas of, of health, of health gaps. Uh, we've not even delved into a lot of them. So I think really it's just about being mindful, being aware, so that if somebody in your business does experience this type of challenge, it's not going to be completely novel or unexpected.

Al ElliottIsn't it nice as a business owner for someone to go, do you know what, you don't have to be all across this, you don't have to be like experts at it yet. But as long as you're thinking about it, as long as you're asking what peop— what your employees want and what support you can provide, you're probably about 70% of the way there.

Leanne ElliottYeah, I agree. And of course, our guests offer some incredible resources that you can check out to learn more. If you would like to learn more about menopause and how you as a leader can be supporting your employees through this, go to Peppy Health or check out Kathy's links in the show notes.

Al ElliottIf you, like us, believe that healthcare should be gender inclusive, not gender exclusive, then go to syronahealth.com, S-Y-R-O-N-A, syronahealth.com, or check out Chantelle's links in the show notes.

Leanne ElliottWe'll also leave links to Dame Carol Black and Lord Bethell, including their pages where you can find all the different things they are currently working with in terms of health within the government. Uh, so yeah, go and check it out. I think if you're looking for a bit thought leadership there and what's gonna happen over the next few years, it's a good place to start.

Al ElliottI'll also leave a link to my favorite Ministry of Sound album on Spotify. So thank you for putting that together, Lord Bethel. That's it.

Leanne ElliottWhat is your favorite?

Al ElliottOn a popular music playing streaming app, I have a playlist for Ministry of Sound, which I've just called MOS. But, uh, yeah, I'll leave a link to that.

Leanne ElliottI had it. I had a CD. It's one of my favorite CDs in uni. It was a Ministry of Sound funky house.

Al ElliottThat's the one I— that's, that's mine. Oh yeah, we had the same one. So thank you, Lord Bethel, for all of your—

Leanne ElliottThank you for your service.

Al ElliottYeah, thank you for your service. Right, we will see you next week for yet another episode. If you're on YouTube, do us a favour, click the subscribe button. We're probably up to about 20 subscribers now.

Leanne ElliottRing that bell.

Al ElliottRing— we're not doing that. We're not doing that. All right, so we'll see you next week. Bye for now.

Leanne ElliottBye.

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Why the Health Gap is a Silent Saboteur of Business Success

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💬 What Would It Look Like If We Got This Right?

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