Arthritis and Employment

Bill Grant Excerpts

Tuesday 21st May 2019 Westminster Hall

[Bill Grant (Ayr, Carrick and Cumnock) (Con)]

I beg to move,

That this House has considered arthritis and employment.

It is a pleasure to serve under your chairmanship, Sir Graham.

I am delighted that my application for a Westminster Hall debate has been successful, as it provides an opportunity to highlight arthritis, a condition with which we are all familiar. It is estimated that, in its various forms, it will affect approximately one in five individuals in the UK by 2050. Arthritis disrupts the body’s locomotor system, which is the bones, joints and muscles that facilitate a person’s movements. There are many types, and most people will have heard of osteoarthritis and rheumatoid arthritis, but there are other forms of inflammatory arthritis, and other inflammatory conditions such as lupus and polymyalgia rheumatica.

Arthritis is a frequently debilitating condition and does not, as some assume, affect only the older generations.

[Kevin Brennan (Cardiff West) (Lab)]

I congratulate the hon. Gentleman on securing this debate on a very important subject. Like many Members, I have constituents and family members who are affected by arthritis. Does the hon. Gentleman agree that when we consider people with arthritis and employment, and the benefit system as well, it is important to take into account the fact that some days people are able to work and on other occasions that is not the case? That needs to be reflected in how we treat people with arthritis.

[Bill Grant]

Those three elements are indeed linked. Flexibility is the key. Employers and managers have to understand that those suffering from arthritis have good days and, as I will come on to later, bad days. We need to adapt the workplace and be flexible.

The symptoms may be identified in very young children or occur at any time in a person’s life. More than half of the 17.8 million people in the UK with arthritis and related conditions experience daily pain. The condition severely impinges on their lifestyle, whether it be their ability to live independently, to care for family, to work, to travel or to take part in sports and hobbies, all of which, in some instances, may lead to social isolation. I recall at an event trying on a tight-fitting gauntlet with the purpose of experiencing the restrictions caused by arthritis of the wrist and hand. I was concerned to note how I lost my fine motor skills for even the simplest of tasks. It must be so frustrating to be faced with such difficulties on a daily basis.

[Mary Robinson (Cheadle) (Con)]

I congratulate my hon. Friend on securing this debate on such an important subject. He speaks about social isolation; many people who suffer from arthritis have not been able to work for years, such as my constituent Russell, who came to my surgery. One of the things he does is volunteer: he is an ambassador, who goes out and helps other people in his community in a really positive way. However, he and potentially others have found that when they get expenses for helping out, they are charged as if they were in employment. Does my hon. Friend feel it is important that we make sure that people who want to volunteer when they can are able to do so without that fear?

[Bill Grant]

I thank my hon. Friend for that intervention, and I wholeheartedly agree with her. The modest expenses of somebody who makes a special effort to go and volunteer should not affect any other income that individual may have.

In my constituency of Ayr, Carrick and Cumnock, the second most common reason for awards of personal independence payments was musculoskeletal disease, including osteoarthritis, inflammatory arthritis and chronic pain syndrome, which accounted for some 20% of awards in the constituency. That is similar to the UK average of around 21%. Those of us who attended Versus Arthritis’s recent event in Parliament heard about new research, illustrating that some 43% of people with arthritis struggled with tasks at home, and some struggled for in excess of two years before sourcing equipment that could assist them.

[John Howell (Henley) (Con)]

It is not just about struggling at home. About a quarter of people with disabilities who are employed said that they did not get the right sort of support: their employers had not got advice from Access to Work to try to make their lives easier. Does my hon. Friend think that is something we can tackle?

[Bill Grant]

I thank my hon. Friend for that intervention. Access to Work is important, but as I will come to later in my speech, it is not widely known about. The Government and Departments have more to do to promote that scheme and make people aware of it, so that workplaces can be made that bit more acceptable to individuals with particular disabilities.

Versus Arthritis’s “Room to Manoeuvre” campaign has been set up to improve access to aids and adaptations in the home and—I would hope—in the workplace, as my hon. Friend the Member for Henley (John Howell) has suggested. Apparently, a remarkable 94% of people with arthritis said that those aids and adaptations had immensely improved their life. That independence is valuable to a person’s overall wellbeing, and reduces the strain on our NHS and local authorities.

[Hugh Gaffney (Coatbridge, Chryston and Bellshill) (Lab)]

I congratulate the hon. Gentleman on securing this debate. What Versus Arthritis is doing is fantastic, but does he agree that workers are now having to work longer, which they cannot do because of arthritis? This is not only about adaptations; there is a financial burden on them. What will this Government do for the people who have been forced to work longer for their pension?

[Bill Grant]

I thank the hon. Gentleman for that intervention, and to a degree, I accept his criticism. Consecutive Governments have made pension adjustments in 1995 and 2011 to reflect the equalisation of the pension age and people living longer, although I think we have plateaued in that regard. However, those who have disabilities and conditions such as arthritis will be impacted that bit more. For those who plan to continue a career but are impacted in extreme cases by disabilities such as arthritis, I agree with the hon. Gentleman. Maybe we need to think about how we can assist those people’s allowances more when they have to retire early, before their planned retirement.

The MPs who attended the “Room to Manoeuvre” event heard from Maureen, who suffers from rheumatoid arthritis. She said:

“I use aids at home, they help to keep me independent. However, I didn’t realise I could get them through the local authority and it’s not clear what to do when you need support. It’s important that MPs learn about the problems people with arthritis have accessing aids and adaptations, so they can make sure the right help is available.”

Arthritic conditions can be a drain on medical resources, requiring regular medication, blood checks, bone scans, and occasional time off work to attend appointments. They are often lifelong conditions, and remissions or flare-ups may occur. As was said earlier, we need to be flexible in our places of work to host and accommodate the issues that affect these individuals.

Being able to work is often seen as beating the challenge that such a condition presents: a person taking control of their condition, rather than the condition being in control of them. It allows that person to have dignity and pride in their personal achievements, which I think we would all agree they are entitled to. Versus Arthritis includes in one of its publications a quote from Dr Carol Black, the expert adviser to the Government on health and work:

“The evidence is clear that most people with these disabling conditions want to work. Indeed, with the right support and working arrangements, usually with modest adjustments, they can do so and be valued employees”

or continue to be valued employees in a company.

Let us endeavour to ensure that we do not unnecessarily lose talented and hard-working people from the workforce. The Equality Act 2010 requires an employer to make reasonable adjustments to support job applicants and enable an employee with a disability, or physical or mental health condition, to in effect wholly fulfil the duties of their post. I am aware that the Department for Work and Pensions has published guidance on employing disabled people with health conditions, and the Equality and Human Rights Commission has provided, or cited, examples.

Additionally, the Government’s Access to Work scheme affords an opportunity for funding extra assistance, bespoke to an individual’s specific needs, to help that person start work, stay in work, or move into self-employment. I will refer later in my speech to the work, health and disability Green Paper that resulted in the announcement of the personal support package, through which people with health conditions including arthritis will be able to receive employment support that is more tailored to their specific or individual needs. Such funding is available to both employees and the self-employed, and may be provided for specialist equipment, support workers, transport needs, or training for colleagues to ensure that they fully understand the needs of their fellow employee and how best to assist them with their day-to-day workplace activities. There is a maximum amount, which is uprated annually. The Government’s “Improving Lives” White Paper stated that the Access to Work scheme would be “significantly enhanced”; hopefully, the Minister will provide an update on that point.

It is certainly of concern that employees may not be aware that assessments under that scheme are free, and some people may not even be aware of the qualifying criteria. Although I am not overly well informed, I am aware of some of the available support and of the employer’s responsibility, as I have signed up to the DWP’s Disability Confident scheme. That scheme improves how employers attract, recruit and, importantly, retain disabled workers. I am pleased to note that some 5,000 businesses in the United Kingdom are already on board.

I employ a person with osteoarthritis, osteopenia and polymyalgia rheumatica. Reasonable adjustments feature in my constituency offices. New chairs were purchased to ensure appropriate lumbar support, and a document stand for copy typing was subsequently purchased at a low cost, for occasions on which stiffness restricts movement—a stiffness that, when untreated, my staff member describes eloquently as

“at times, a living rigor”.

Other staff are observant, supportive, and undertake heavy weight-bearing tasks; in other words, they are collaborative and work as a team. That involves permission, sharing information about the condition, and—as I said—teamwork. My staff member also has fantastic support from her general practitioner and practice nurses.

People with arthritis and related conditions can often experience a greater than normal degree of tiredness, stiffness, or the side effects of medication for the condition. Indeed, certain necessary medication such as steroids may deplete the calcium levels in the body, putting people at further risk, in that they may potentially develop osteoporosis in addition to their existing condition. It is also important to note that symptoms will often fluctuate, with the sufferer having good days and bad days. I understand that even the weather may have an adverse effect on an individual, particularly temperature changes.

Arthritis and related conditions are the biggest cause of pain and disability in the United Kingdom, and result in over 30 million working days lost per annum. The British Society for Rheumatology highlights the need for multidisciplinary teams, and the considerable cost of rheumatoid arthritis to the UK economy. I am pleased that as part of the work, health and disability Green Paper, Ministers have explored ways to improve support for people with conditions such as arthritis, so that they can find and remain in work.

The ministerial foreword stated:

“This government is determined to build a country that works for everyone. A disability or health condition should not dictate the path a person is able to take in life—or in the workplace. What should count is a person’s talents and their determination and aspiration to succeed…We are bold in our ambition and we must also be bold in action. We must highlight, confront and challenge the attitudes, prejudices and misunderstanding”.

That message is still relevant today, and I hope this debate will reinvigorate discussion and capture the wider public’s attention.

The work, health and disability Green Paper proposed a 10-year plan to remove employment barriers for disabled people, and the Fit for Work scheme is being reformed to focus on what people can do, not what they cannot. I welcome the fact that the Access to Work scheme is being expanded to help more disabled people into work. However, at present there appears to be a lack of knowledge about the scheme and it is crucial that the Government proactively promote that valuable opportunity. When Versus Arthritis conducted a survey between May 2018 and June 2018, it found that of those who responded, 59% had never even heard of the Access to Work scheme. A proactive promotion of the scheme would, I am certain, assist the Government in meeting their ambitious and commendable aim of having 1 million more disabled people in employment by 2027.

There is a degree of comfort in knowing that since 2013, some 600,000 disabled people have moved into employment. We must build on that with a sense of urgency. In addition, according to Versus Arthritis, it has been discovered that many of the people who qualify for assistance from the Government’s Access to Work scheme face problems with how it is operated. Administration processes can on occasion be cumbersome, and it may be that the Government could carry out a review to ensure that things are more user-friendly. I am sure the Minister will take note of that. That is a concern with a number of issues with the DWP.

One of my constituents felt that the DWP did not fully comprehend the consequences of her osteoporosis when asking her to attend a course, particularly as she relied on others for transport. I for one appreciate that the DWP has been increasing its advisers, including its community partners, small employer advisers, disability employment advisers and work coaches, as well as providing training for them. It may be that that needs to be further enhanced to provide greater awareness among some of the DWP’s frontline staff of the various arthritic and associated conditions and to adequately address the needs of service users. I do not say that with any intention to be unkind to those staff, because they do a wonderful job on our behalf on a daily basis.

[Hugh Gaffney]

The hon. Gentleman is doing a great job. We are talking about helping people, but can we not also help health and safety in the workplace by working with young workers to prevent arthritis later in life?

[Bill Grant]

I am not a medical expert—arthritis may or may not be related to the workplace—but where issues can be identified, such as repetitive work that might affect the musculoskeletal system of an individual, we can change it. We can automate it without losing the job, but we need to be conscious of what staff are subject to through 10, 20 or maybe 30 years of work. I agree with the hon. Gentleman: if those issues can be identified, they should be removed and we should mitigate the risks as best we can. Where possible, we should assist employers in doing so.

Spending on the Access to Work scheme has increased by 8% in recent times, supporting more than 25,000 people. Around £54 billion per annum is spent on benefits to support people with disabilities, equating to some 6% of all Government spending. Nevertheless, I make a plea to the Treasury to consider further increasing the allocation of funding for the scheme and introducing incentives to encourage employers to consider health and wellbeing initiatives to assist those with arthritic conditions. The benefits of physiotherapy have been recognised. In Scotland, the public may self-refer, but that may not be the case throughout the whole United Kingdom.

Finally, there is a problem that action does not always follow post-assessment recommendations. Will the Government consider what they can do to address any negative attitudes on the part of employers or managers, whether that be by further legislative provision or some other means? By sharing and encouraging best practice and putting the right support in place, we can make it easier for people with arthritis who want to work, helping to achieve the Government’s laudable ambition of getting 1 million disabled people into work.

[Several hon. Members rose—]

--- Later in debate ---

[Bill Grant]

I thank the hon. Members for Strangford (Jim Shannon), for Ellesmere Port and Neston (Justin Madders), for North Ayrshire and Arran (Patricia Gibson) and for North Tyneside (Mary Glindon), and my hon. Friends the Members for Moray (Douglas Ross) and for Stirling (Stephen Kerr), for their valuable contributions to the debate. Clearly, hon. Members understand the challenges we face and the need for means to mitigate them.

I thank the Minister for listening intently and responding to the concerns that have been raised, and I thank the shadow Minister for his welcome contribution. I also thank the charities that campaign tirelessly for, and offer support to, my constituents and people throughout the United Kingdom who suffer arthritic conditions. I thank people in science, medicine and the care services who undertake research and treatment and provide care packages—in doing so, they greatly assist and support people to live their lives. Last but not least, I thank the Commons staff, who worked behind the scenes to enable the debate to take place. I give special thanks to the Library staff.

Question put and agreed to.

Resolved,

That this House has considered arthritis and employment.