The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)
My Lords, the Independent Review of Sickness Absence by Dame Carol Black and David Frost has provided a valuable contribution to the evidence base about the issues facing individuals, employers, healthcare professionals and the state. The Government will carefully examine the findings and respond later this year. Given the complexity of the issues raised and the work needed to consider the recommendations, it is too early to speculate on whether and how individual recommendations may be implemented.
Lord Luce
My Lords, I welcome the Minister’s response. Does he agree that the report is full of recommendations that are designed to help those who suffer from long-term diseases such as chronic pain to get back to work or indeed to stay in their jobs? Since sickness absence costs the economy something like £15 billion in output and £13 billion in health-related benefits, does he agree that the early implementation of these recommendations would do a great deal to boost both the quality of life of a large number of people and the economy?
Lord Freud
Yes, my Lords. This initiative, which I am proud to have commissioned and sponsored, is really very important for improving the quality of life for a lot of people. With this review we are talking about a way of intervening much earlier so that we stop people start falling out of the labour market. The present system allows them to drift on for months, if not years.
Lord Harrison
My Lords, does the Minister agree that there is a connection between a healthy economy and a good health service? Given that back problems are the most important reason for sickness absence, early intervention by physiotherapy services is important for those who fall foul of that problem. Will he ensure that we have a service for physiotherapists that is able to match the need in order to return people to healthy work as soon as possible?
Lord Freud
My Lords, one of the reasons why this is quite a challenging report that implies quite a lot of work is that we need to reshape the provision for people. I shall give your Lordships a statistic that I find truly shocking. We have one occupational health professional in this country for every 34,000 people. In the Netherlands, there is one for every 4,000 people. That just shows how far we have to go to get provision for people in that position.
Lord Kirkwood of Kirkhope
Does my noble friend agree that general practitioners have a critical role to play in the health-at-work policy area? Is it too early to say whether there has been any flow-through from the recent introduction of the fit note certification process on absence rates? Will he give sympathetic consideration to the idea in this very welcome report that we should have an independent assessment service? That would be of signal assistance to general practitioners, who are trying to persuade their own patients that it is often in their own interests to go back to the world of work earlier rather than later.
Lord Freud
Yes, my Lords. The recommendations in the report were very supportive of maintaining the GP’s role. The independent assessment service could be a supplement to that, which a lot of GPs would find very welcome in helping to get people back into the workplace.
Lord McKenzie of Luton
My Lords, if we are going to prevent people becoming ill at work and accidents at work, should we not do more to promote and applaud the health and safety system that we have in the UK? Would the Minister have a word with his right honourable friend the Prime Minister to ask him to stop making ill informed comments that undermine the system?
Lord Freud
My Lords, in practice there has been a lot of emphasis on the safety aspects of work and too little on health in work. One of the things that we are trying to encourage is the ramping up of health support, both in work and as people fall out of work. That is why this set of recommendations is so interesting.
Lord Brooke of Alverthorpe
I welcome the report and the update that the Minister has given us on the process for its implementation. He mentioned early interventions in this context, and in the debates on Monday he spoke frequently about the need for early interventions with certain families to try to get them on the right track. That is a lot of additional work coming the way of the Civil Service. Is he confident that his department has the resources to address these issues adequately? Can he say whether his department will increase or diminish in size between now and 5 April?
Lord Freud
My Lords, the department has an enormous workload; I am absolutely conscious of that. It is driving through one of the biggest social changes that this country has seen for many decades. At the same time, we are decreasing the numbers in the department at the centre. That does not mean that it is happening at Jobcentre Plus, which is the client-facing area. We are confident that the department, which I have now been in for some time and genuinely find admirable, is able to fulfil these objectives.
Baroness Masham of Ilton
My Lords, does the Minister agree that it is sometimes easier for GPs just to write a sick note, rather than find the real cause; and that this is very difficult for employers?
Lord Freud
One of the things that the sickness absence review did was to look at the mismatch in what people were trying to do. The worst of the mismatches was that GPs were signing people off on their sick notes because they could not do a particular job, while the work capability assessment later looked at whether they could do any job. It is those mismatches that we need to stop and sort out.
Lord Campbell-Savours
I suffer from ankylosing spondylitis, which the noble Lord will know is a long-term disease. Does he have any provisional views on the recommendations in the report on physiotherapy services?
Lord Freud
My Lords, I think I tried to deal with this a little earlier. There is inadequate support across a whole range of occupational health therapies, including physiotherapy. We are taking our time to do this properly, but one of the important implications is the question of what provision is needed for people who are of working age and in danger of going out of the workforce. We seem to have far too little provision generally, and we will probably need to bulk it up.