Musculoskeletal Conditions and Employment

(Limited Text - Ministerial Extracts only)

Wednesday 10th January 2024 Westminster Hall

[The Minister for Disabled People, Health and Work (Mims Davies)]

It is a pleasure to serve under your chairship, Dame Caroline, and I thank the hon. Member for Wirral West (Margaret Greenwood) for introducing today’s debate in a constructive, positive and very interesting way. As the Minister for Disabled People, Health and Work, it is an honour early on in my tenure to talk about the Government’s commitment to enabling people with musculoskeletal conditions to start work, stay in work, and importantly succeed in work, which is what today’s debate is about, and it was an honour to hear from Members on all those matters. As the hon. Member for Motherwell and Wishaw (Marion Fellows) said, the spirit and context of the debate is extremely important. I thank the hon. Member for Lewisham, Deptford (Vicky Foxcroft). We have always had a very constructive and positive relationship. I look forward to working with her on her challenges to us, and all her asks across Government; I note all of these. As hon. Members might note, I have a lot of material here. Whether I can get to all of it we will see, but I hope to share the Government’s ambition for this society as one where disabled people and those with health conditions can fulfil their potential when it comes to employment, and one where they have the fair rights and access that we all want for them.

My mum lived with osteoporosis and rheumatoid arthritis, and she worked with disabled adults; my dad lived with a head injury for more than 25 years under the Court of Protection, and I am a coeliac, so despite the height of my role, I want to reassure those in the Gallery and those listening to the debate that my convening power is no less and my commitment is no less, but I understand the asks from the hon. Member for Lewisham, Deptford—and on her advocacy for my promotion, one could ask for nothing else.

The joint Department for Work and Pensions and Department of Health and Social Care work and health directorate was set up in 2015 to recognise the extremely strong links between work and health and the importance for health of good work, which has been highlighted today. I pay tribute to those doing the “Better Bones” campaign. As the Minister who was predominantly responsible for the HSE for a number of years, I assure the right hon. Member for Hayes and Harlington (John McDonnell) that I have paid close attention to the issue, and I hope that the HSE’s representatives will come to Parliament shortly to give us all an update on their work. The responsibility sits with my noble Friend Lord Younger now, but I will be working very strongly with him.

I absolutely agree with my hon. Friend the Member for Gedling (Tom Randall) and others on the subjects of prevention, tackling stigma and keenly engaging with those who understand this matter. Supporting and empowering those with MSK conditions is very important to me—I hope I have outlined why—both in this new role and in my capacity as a local MP. In fact, in that capacity, I invited my ministerial predecessor, who is now the Minister for Legal Migration and the Border, my hon. Friend the Member for Corby (Tom Pursglove)— I pay tribute to his work and his commitment on this subject—to visit VIM Health. This gives me an opportunity to mention Tom from VIM Health and all his team, all his patients and the work done in this specialist neurological rehabilitation centre and MSK therapy service, which I have seen. My hon. Friend and I agreed that it was incredibly inspiring to see how innovative technologies can make healthcare more accessible, enjoyable and transformative. This gym helps with rehab, and also makes accessible exercise, and other things that many of us take for granted. We talked about the pools, and I will come on to that later.

I am looking forward to meeting representatives of Versus Arthritis later this month; I met them at the party conference. Like others, I extend my thanks to third sector organisations for the important work that they do, and the knowledge that they impart to us in Westminster, to raise awareness and to support people living with MSK conditions, helping them to fulfil their potential in the workplace. As we heard from my hon. Friend the Member for Gedling, this is about a change of mindset. Work is so much more than a pay packet. It increases people’s wellbeing; it increases their network and their confidence. At times when their health is perhaps failing or fluctuating, nothing is more important than having confidence, a network and support, and that very much comes from work.

[Margaret Greenwood]

I appreciate the tone that the Minister is taking in the debate. On that point about mindset, would she look at perhaps requiring employers to inform new employees about Access to Work when they start, to make it quite a routine thing, and so that people know about it and can have an up-front conversation about all areas of their health, but particularly MSK health? I ask because from the point of view of the person who is suffering, it can be extremely difficult to raise an issue that they know will cause bother for their manager, perhaps cost them money and so on.

[Mims Davies]

I thank the hon. Lady for that point. In fact, in preparing for this debate and seeking to understand the issue further, this was something that we discussed and I was interested in. Gatwick is not far away from my constituency, and many constituents work there, and some of them work in passenger assist, getting people on and off planes. Being able to talk to employers confidently and comfortably is really important.

When someone’s health changes, it is often a bolt from the blue. How do they manage that with their employer? That is something that I am very focused on, and it covers the Access to Work programme and the Disability Confident scheme.

I will come on to Disability Confident, but we need to move this from being a nice thing on a website to a reality for people working in whatever sector and with all employers. We have taken that approach with menopause and the debilitating impact that it can have for women of all ages, including in the workplace. All of this, in the round, is very important when it comes to staying in work and thriving in work, which is what we ultimately want for everybody.

For context, around a third of the UK population—over 20 million people—live with an MSK condition. As we said, we do not want people to feel that leaving employment is the only option, and the Government absolutely recognise that good work is generally good for health, as we heard from my hon. Friend the Member for Gedling and the hon. Member for Lewisham, Deptford. MSK interventions to improve workforce participation were key when it comes to the £400 million health package in the 2023 spring Budget.

Let me go through some what the Government are doing. We are introducing employment advisers within MSK services to support people with conditions to thrive in work, help them to have those conversations and, above all, assist with engaging with employers. We are developing and scaling up MSK hubs in the community. Building on existing local practice, hubs will offer people with MSK conditions access to physical activity interventions in leisure centre or community settings—as we have heard—and we will explore how to embed vocational advice too. We will also be making the most of digital health technologies to support people with MSK conditions to better manage those symptoms and remain in work, and that will include digital therapeutics.

The reality is we are all living longer, and long-term sickness is a common reason for economic inactivity among the working-age population. Therefore, the Government rightly have an ambitious programme to support disabled people and those with health conditions, including MSK, to start, stay and succeed in work. That includes variety of interventions, which we have heard about today: Disability Confident, the Access to Work grants, the Work and Health Programme, and a digital information service for employers in relation this. Employers knowing how to manage and to have those conversations equally with employees will make a real difference, and of course there are also our own disability employment advisers in DWP. I will be engaging directly with all groups and stakeholders to make sure this works, and I will be putting myself, as I always do, in the place of our claimants and of those people that that need help.

[Margaret Greenwood]

I thank the Minister for giving way; she is being very generous.

On helping people to engage in activities that will improve their health, the closure of swimming pools is really serious. In my constituency, we have lost the swimming pool in the Woodchurch estate. I met users there—we were fighting against the closure—and they were clear that they were using the pool to deal with two things: mental health issues and arthritis. That particular estate has a higher-than-average level of deprivation, a higher-than-average level of disability, and more older people living there. For them, the closure has been catastrophic. I recognise that that is not the Minister’s Department, but will she talk with ministerial colleagues and look again at the provision of sport and leisure facilities, particularly in areas of deprivation, so that those people can improve their own health?

[Mims Davies]

I thank the hon. Lady for reiterating that point for her constituents. These hubs in the community will deliver both that physical activity and those interventions. I understand her point, and I know that support for pools has come to councils from the Department for Digital, Culture, Media and Sport. What the hon. Member has said is very specific, and I will take that away in the cross-Government work that I am doing. I think, as well, that it is a lesson for many of our local authorities to think very carefully about the decisions they make and how they affect the whole community. It is vital that people understand that the wider impact might involve losing more than just swimming lessons—and that is not easy in itself. The hon. Member has rightly put that on the record for her constituents.

Employment advice and NHS talking therapies will be included in our interventions, along with individual placement and support in primary care and increasing work coach time in jobcentres. The hon. Member for Motherwell and Wishaw spoke about making sure that we listen to and engage with people, and do it in the right way, and I wholeheartedly agree with that individual approach.

All these investments are part of a much wider agenda to tackle inactivity due to long-term sickness. We also announced our Back to Work plan in the autumn statement. It includes doubling the number of universal support employment programme places; increasing occupational health take-up in businesses, including SMEs, which is absolutely key; testing new ways of providing individuals receiving a fit note with timely access to their key support; and supporting people with health-related barriers to work through the 15 WorkWell pilot areas that we are working on. WorkWell is accepting applications for funding from local areas across England, with pilot areas due to be announced in April and more details in the autumn. I will be working with the Minister for Employment, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) on this matter.

[Vicky Foxcroft]

I thank the Minister for giving way. She has pointed to a number of Government pilots and I know there are other pilots. In my contribution, I asked whether the Government would be transparent and publish data on those pilots. Does the Minister want to put on the record whether the Government would be willing to do that?

[Mims Davies]

I thank the hon. Lady for that ask. This is still being worked out. I am conscious that one of my predecessors in DWP warned about having “more pilots than easyJet” and about making sure that they work and are right. Once we have more details, I am sure we will be in a position to share them with her, so I will come back to her on that matter. It is early in my tenure, and I want to get to grips with this. When I am in a position to share, of course I will do so.

We have talked about the impact of poor MSK health on individuals and employers. We know that over 20% of employees and self-employed people have an MSK condition and that it is a leading cause of working days being lost through sickness and absence, accounting for over 23 million lost working days. My hon. Friend the Member for Gedling spelt that out strongly. Tackling these disparities and managing these conditions are absolutely key.

When it comes to women, the older population and certain ethnic groups, understanding the prevalence and the impact of the condition and doing more on prevention are key in terms of managing and supporting people. A predominant symptom is pain, which limits people’s mobility and dexterity. Living with pain is awful, managing it is incredibly stark, and it is very difficult for people to fully participate in society, so we need to make sure that people have a healthier home and working life.

We know that osteoporosis, which causes fragility and leads to fractures, disproportionately affects women. The Government’s women’s health strategy is key to understanding specific actions to improve women’s experiences and outcomes in relation to osteoporosis. I look forward to meeting Dame Lesley Regan, our women’s health ambassador, on this matter as soon as our diaries allow. I know she is very focused on this, and we will raise the profile of those issues. I have been very engaged with her in my work on menopause and employment action, and I will continue to do that.

I have talked about supporting employers and workplaces as key enablers for disabled people with health conditions to remain in work, so let me briefly cover prevention. Adults in employment spend a large proportion of their time in work. How we are engaged with in our jobs and workplaces has a massive impact on our health. Therefore, in 2022, the Government and the Society of Occupational Medicine published the MSK health toolkit for employers and further education institutions, which encourages employers to support adolescents and young adults with MSK conditions. We have also produced the MSK toolkit for employers, which has been developed in partnership with Business in the Community and provides practical information for employers of all sizes to address MSK conditions in the workplace for the working age population. We need to look at the adjustments and support there.

I thank Thriiver in my constituency, which is a brilliant group of people who deliver around £4 million to £5 million of support through the Access to Work scheme. They gave me a stark insight into what they feel should be done, which I fed back to my predecessor. We know that the grant scheme plays a key role in enabling people. The point about literacy and digital skills has been noted. I also note that the Chairman is looking at me, so I will conclude.

There are a few matters that I might write to Members about. I think we have all agreed that poor MSK health has a significant impact. The delays to Access to Work are improving—we have been forensic on that. People need support from employers, from Government, the wider economy and the NHS. We will continue to focus on good jobs to help everybody thrive and have fulfilling lives, with the benefit of health and wellbeing behind them. That is the best route out of poverty.