Welfare Reform Bill

Baroness Thomas of Winchester Excerpts

Wednesday 25th January 2012 Lords Chamber

[Lord Turnberg]

My Lords, in the absence of the noble Lord, Lord Layard, I would like to intervene briefly on his behalf. He spoke eloquently in Committee on this matter, and he is now busy saving the world in the economic forum in Davos, much to our dismay. I do not know exactly, but I have no doubt that he would want to point out that people with mental illness form a very high proportion of those who are out of work and seeking employment. They must be among the most difficult to place in work and among those we must strive harder to help. I recognise that the Government have put in place a system that aims to help with prime providers and so on but, as we have heard, this is of only modest benefit. It would be made so much more effective if, at the same time as being assessed for work and support allowance, claimants could be assessed medically for their mental illness and given the relevant treatment. A person whose mental illness is treated must be much more likely to get into work and to stay there. As the noble Lord, Lord Layard, pointed out in Committee, it makes no economic sense for the country, let alone for the people themselves, to leave them out of work because they are not gaining access to the relevant diagnosis and treatment that could make them fit for work. This is a marvellous opportunity when they are being assessed for work for them to be given the opportunity to get the treatment that would make them fit for it. I hope the Minister will look at this amendment as a valuable adjunct to the Bill and will accept it.

[Baroness Thomas of Winchester]

My Lords, I have a great deal of sympathy with this very practical amendment to a very real problem.

We heard a lot on Monday about taxpayers’ money, and particularly about how unfair it is for people on out-of-work benefits to be receiving more from the state for doing nothing than many of those who are in work, paying their taxes. However, we seem strangely passive about the problem of thousands of ESA claimants who are signed off work because of mental health disorders, thus costing the state millions of pounds, and who, as we have heard, are not required or even encouraged to seek treatment.

My noble friend the Minister sent us all a very interesting booklet entitled Models of Sickness and Disability Applied to Common Health Problems, written two years ago by Gordon Waddell and Mansel Aylward, a lot of which I have now read, he will be pleased to hear. We know that mental health problems now account for more than 40 per cent of long-term sickness absence, incapacity for work and ill-health retirement. We learn from the booklet that if current trends continue, within a few years they will be the majority; that the problem is mild to moderate conditions such as anxiety-related disorders, depressive disorders and stress; and, as we have just heard, that the cost of mental illness in the UK is estimated to be as high as £40 billion to £48 billion per annum, the greater part of which is due to sickness absence and long-term incapacity. Finally, we learn that about one-third of the working-age population have mental symptoms such as sleep problems or worries; one-sixth would meet the diagnostic criteria for a mental illness such as depression; but only about 6 per cent of the working-age population actually seek healthcare.

No wonder those who have made more of a study of these statistics than I have have tabled this amendment. However, the jury still seems to be out, according to page 39 of the booklet, on exactly which treatments improve work outcomes, although there is strong evidence that various medical and psychological treatments for anxiety and depression can improve symptoms, clinical outcomes and quality of life. Waddell and Aylward conclude that there is an urgent need to improve vocational rehabilitation interventions for common mental health problems, and that promising approaches include healthcare that incorporates a focus on returning to work, workplaces that are accommodating and non-discriminating, and early intervention to support workers to stay in work and so prevent long-term incapacity.

We now also have the report Health at Work: An Independent Review of Sickness Absence, by Dame Carol Black and David Frost, published in November last year. They mainly focus on those in work who might well be off sick without the right interventions, and make the point that people with health conditions too often do not receive appropriate early support to remain in work, especially those with common mental health conditions.

I am sure that the noble Lord, Lord Adebowale, will not divide on this amendment at this hour but perhaps he will instead seek a meeting with the Minister to discuss how to take forward this important matter, perhaps together with Dame Carol Black and Professor Waddell. I can quite understand why it is tempting to put something prescriptive into the Bill, but I do not believe this would be the right way forward.

[Lord Winston]

My Lords, I, too, also promised the noble Lord, Lord Layard, that I would chip in briefly on this amendment. As has been said, he is in a very different place—and I think they are probably all mad there anyway in Davos.

This is actually a very serious issue and I feel very deeply about it. It is a very good example of where there needs to be some joined-up thinking between what happens with welfare and the Health and Social Care Bill. This is one of the concerns that we have: more and more people with various mental disturbances—and of course it is a vast range of disease, much of which will probably not be helped by conventional treatment—becoming a particular problem in the workplace.

I support this amendment on the basis that a great deal can be done for mentally ill people, particularly those with anxiety disorders who are not necessarily severely incapacitated. The right support in the community—particularly, living in the community—is of immense importance. There would be a good chance of saving money for the Government if attention is paid to this area. I do not think that we would wish to press this amendment today but it still requires support even at Report stage.