Occupational Health Services

Lord Freud Excerpts

Thursday 1st March 2012 Lords Chamber

[Lord Harrison]

To ask Her Majesty’s Government what they will do to encourage co-operation between the Department for Work and Pensions and the Department of Health to improve access to occupational health services including early intervention physiotherapy.

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)]

My Lords, the Department of Health and Department for Work and Pensions work closely together on improving the link between health and work, including helping to improve access to early intervention services for people at work with health problems. It is the responsibility of local and national health service and public health organisations to commission services to meet the needs of their community, including the provision of physiotherapy services.

[Lord Harrison]

My Lords, given that this country loses some £7 billion each year because of back and neck pain suffered, and given that some half a billion pounds is lost through NHS staff suffering in the same way and that the proper and timely application of physiotherapy would help enormously in returning people to work, can the noble Lord ensure that physiotherapy services are well funded and provided for in a timely fashion and that, in the development of government policy, the left hand of the DWP knows what the right hand of the NHS is doing?

[Lord Freud]

My Lords, I share the noble Lord’s concern about having adequate physiotherapy services. We are making quite a lot of strides in the combination of helping people to stay in work and getting them back to work and good health. There have been a lot of pilots, which I could go through if there were time. A lot of work has been done on this and it is right at the forefront of our concerns. We will be trying to optimise the position as we look at our response to the sickness absence review.

[Lord Addington]

My Lords, my noble friend spoke about the link between the Department of Health and the Department for Work and Pensions. Will he ask the Department of Health to make sure that if somebody has a soft tissue injury, which is usually what we are talking about, not only are they allowed to see a person who is qualified to assist them with it—usually a physiotherapist—but they are encouraged to do the exercises they will be given? If you think that treating any injury and stopping it becoming chronic can be done by somebody prodding you once a week, you are mistaken.

[Lord Freud]

I will not talk about the prodding too much, my Lords, although we get plenty of that here. One of the most valuable developments has been the self-referral process. There has been a lot of experimentation and piloting in relation to self-referral to physiotherapy and it has all been found to be very valuable. Patients have been empowered and highly satisfied with the results, with a lower level of work absence. The service provision has reduced costs and has substantially reduced the quantity of medicines prescribed as a direct result.

[Baroness Finlay of Llandaff]

Do the Government recognise that, given that on average 17 days’ sickness absence can be related to musculoskeletal disorders, the placement of physiotherapy in the workplace, as has happened in Rhyl in North Wales, can result in a decrease in sickness and the maintenance of people in work? Rhyl’s experience is of 82 per cent of people being able to remain in work, but that requires joined-up thinking between employers, health services and the benefits system.

[Lord Freud]

My Lords, that is absolutely smack on what the sickness absence review is looking at and whose recommendations we will be examining. The noble Baroness mentioned Rhyl. There have indeed been some quite remarkable improvements in this area. The project with which I was most impressed was in Lincolnshire, where triage was available on the same day. Advice, triage and signposting dramatically reduced the level of absence from work and, indeed, reduced the number of sessions of prodding that were required.

[Lord McKenzie of Luton]

My Lords, one of the long-standing issues around occupational health services and intervention physiotherapy, particularly those which are accessible through the workplace, is the tax treatment of the cost, and in particular, whether it is an assessable benefit on individuals. I imagine that the likes of Barclays Bank have a way round this, but can the Minister say what the Government’s general approach is?

[Lord Freud]

As you know, my Lords, I always find it difficult to say what the Chancellor may or may not do at any time in the future, so I will avoid that. However, I will point out that there was a recommendation in the sickness absence review to have some of those services tax-allowed by the employer. The recommendation is there and we will clearly look at it.

[Baroness Fookes]

My Lords, my noble friend will, I am sure, be aware of the pioneering work undertaken by Tomorrow’s People in putting employment advisers into doctors’ surgeries entirely on a voluntary basis. Is he happy with the extent to which this now exists, or could more be done?

[Lord Freud]

My Lords, various pilots, in particular those around putting employment advisers into improving psychotherapy services—the IAPT—seemed to go very well indeed. Clearly, having obtained that intelligence, we will be moving in that direction. I have talked a lot about pilots and trials in this area. It is rather recent that as a state we have begun to look at helping people to stay in work as part of the solution rather than keeping them out of work. That is why some of this is quite new and we are finding our way in this area.