Get better or die. How work and welfare institutions in the UK understand employee diagnoses of cancer

There are increasing numbers of older working age people in the UK experiencing long term health conditions, including cancer. Consequent of an ageing workforce, it represents a significant and ongoing challenge for individuals, workplaces and the labour force more widely.This paper draws on qualitative interview data from multiple perspectives; older workers (aged 50 years and over), employers (including line managers, occupational health staff and human resources staff), healthcare professionals and staff from a cancer support charity. Participants were sampled via their connection to a cancer-specific employment service in north east England. Analysis was informed by constructivist grounded theory.A key finding from this study was the observation of how both UK state welfare provision, and workplace policies and procedures employ a Parsonian model of illness which does not accommodate the material circumstances of older workers with cancer. In particular, data highlights the judicious use of ‘deservingness’ as a decision-making tool with regard to the support (financial or otherwise) offered to older workers with cancer. Conditions placed on being ‘deserving’ are increasingly difficult to meet as cancer transitions from an acute illness to a collection of longer term symptoms. Data highlights how long term ill health in the context of paid work is experienced as dynamic, exchange-based and nuanced.As such, this paper emphasises how current sociological models for illness have limited explanatory potential when exploring health in the workplace, despite pressing policy relevance, and offers new insight into how health might be reconceptualised in the UK workplace.