Long Covid: Impact on the Workforce

Debbie Abrahams Excerpts

Thursday 31st March 2022 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Forewarned is forearmed, as they say, Madam Deputy Speaker. It is a pleasure to follow the hon. Member for Oxford West and Abingdon (Layla Moran). I congratulate her not only on securing this debate, but on her leadership of the APPG, which she chairs exceptionally well. Today’s debate and the report that underpins it reflect that. I also thank all those who have provided evidence to the APPG, particularly on the latest report. Their stories are moving and quite shocking. In addition, I thank the secretariat, who do a fantastic job of providing support to the group.

This Covid pandemic is far from over. I am wearing my mask, and we know we have an outbreak in Parliament, with a number of MPs currently off with covid. It is far from over. We are seeing case numbers ticking upwards, hospitalisations also on the rise and, sadly, increased deaths. Once again, we have seen the burden of disease from this pandemic hitting the most deprived. Avoidable mortality is six times greater for women in deprived areas compared with the least deprived women and nearly five times greater for men. Yet we see a spring statement where the Government’s “levelling up” rhetoric has no substance. Just £1 out of the £6 from the Chancellor’s tax hike in the autumn was given back, but only 30p from that £1 went to those on the lowest incomes.

Despite the Government’s hype, their pandemic preparedness was woeful and their pandemic management in too many aspects was reckless, wasteful and even unlawful. We are now aware that, although many people may have fully recovered from the acute phase of covid infection, as the Member for Oxford West and Abingdon has said, for a significant number—ONS data estimates more than 1.5 million or 2.5% of the population, although the covid tracker identifies a larger percentage—there is a longer chronic phase. That chronic phase affects children, about 34,000 at the moment, women, particularly younger women of working age, people on low incomes, frontline workers who are more at risk of exposure, including NHS and care workers, and those with an existing activity-limiting health condition or disability.

As we have heard, symptoms vary but, in summary, they include fatigue, pain, reduced muscle strength, brain fog and so on. In my own case, I have experienced prolonged fatigue bordering on exhaustion, being awake but my brain being somehow disengaged from what I am doing and nasty bouts of nausea. I believe that covid has also exacerbated my already severe arthritis, which is partly the result of many years of running, but has got considerably worse with long covid. The pain is constant and sometimes completely debilitating, making it difficult to stand up.

What is shocking is the response to people who are experiencing long covid from their employers. The hon. Member for Oxford West and Abingdon mentioned some of these cases. I have also heard of those who have been disciplined by their employers. They were struggling with this condition and wanted to go about their everyday lives. They wanted to be at work and yet they were disciplined for not being able to be back at their desks, back in front of their class, or to see patients; we heard from a GP, as Members may remember. This very much reflects, unfortunately, the attitude of some, but it was particularly disappointing in public sector organisations, especially the NHS.

In December 2020, the National Institute of Health and Care Excellence brought forward its guidelines on managing long covid. At the time, I commended it on the holistic healthcare approach taken when assessing a patient with symptoms beyond four and 12 weeks, with the emphasis on empathy and acknowledging the impact the symptoms may have on the patient’s day-to-day life, including their ability to work. This was a major step forward from previous NICE guidelines on other chronic fatigue syndrome illnesses that are similar to long covid but also affect the nervous and immune systems. The NICE guidelines on long covid were updated earlier this month, and I note that they are to be regularly updated, which we recommended, because there is emerging evidence that we must make sure is incorporated at the earliest opportunity. I hope, because I have not seen evidence of this, that investigations into the range of immune responses to covid as well as immune therapies will also be incorporated.

As I mentioned last year, the British Society for Immunology and several others have suggested that in addition to long-term damage to multiple organs, the pain, muscle weakness, fatigue and even brain fog often associated with long covid may be due to inflammatory issues associated with our immune response rather than covid itself. Covid-19, like other viruses, attacks multiple systems—respiratory, cardiovascular, nervous and gastrointestinal—as it attaches to epithelial cells that are distributed throughout the body. Our bodies’ ability to fight the virus depends on our immune systems reacting appropriately and not overreacting.

We need adequate long-term funding for long covid clinics providing evidence-based therapies—evidence is the key. I pay tribute to my colleagues in Oldham for helping over 300 long covid patients. We need to ensure that long covid is recognised as an occupational disease. There has to be a societal approach.

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[The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Paul Scully)]

I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on opening the debate so incredibly well, and I congratulate her, the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) and my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter)—unfortunately he could not be here—on securing this important debate on the impact of long covid in the workplace. I thank the Backbench Business Committee and all those who have taken part in the debate for their thoughtful and insightful comments.

We heard about the ONS estimate that, in the four-week period ending 31 January 2022, 1.5 million people in the UK reported experiencing ongoing symptoms following covid. Of them, nearly 300,000 reported that their ability to undertake day-to-day activities had been significantly limited. It is therefore clear, as we have heard, that long covid presents a growing challenge for the workplace and more widely. The emergence of a completely new condition such as long covid is a real rarity and, much like our experience of the covid-19 pandemic itself, we must be and are constantly developing our understanding.

We have put support in place for those suffering from the condition. NHS England has invested £224 million to date to provide care for people with long covid. It has established 90 long covid assessment services across England, which are assessing and diagnosing people experiencing long-term health effects as a result of covid-19 infection, whether they have had a positive test or are likely to have long covid based on their clinical symptoms, regardless of whether they were admitted to hospital during their covid-19 illness. The services offer physical, cognitive and psychological assessment and, where appropriate, refer patients to existing services for treatment and rehabilitation. The hon. Member for Oxford West and Abingdon talked about the $1 billion in the States. Not all of that has been allocated yet, while the UK is already ploughing ahead, and we are quite far ahead of other countries, including the States, in our research in the area. Of course, there is always more that we can do.

It is clearly essential to get the right healthcare and treatment in place for individuals, for employers and for the wider economy. However, the theme of the debate is the impact of long covid in the workplace. People can suffer from many long-term health and other conditions that may affect their work. We have heard about ME, and we could talk about fibromyalgia, Guillain-Barré, Miller Fisher all those things. Indeed, there are other conditions that are not necessarily post-viral.

Earlier this month, I gave evidence to the Women and Equalities Committee on the impact of the menopause in the workplace, and in February I responded for the Government to a Westminster Hall debate on supporting people with endometriosis in the workplace. Those are different conditions, but, none the less, they are long lasting and we need to ensure that we can get people the right treatments and adjustments. Indeed, in the case of the hon. Member for Denton and Reddish (Andrew Gwynne), a simple, natural adjustment made his working life so much easier, and for so many of these other conditions there are examples of small things that employers can do to keep people in the workplace. They do not have to be complicated, and they certainly do not have to be expensive.

We believe that employers should play a significant role in supporting people with long-term health conditions to access and remain in work. That can certainly benefit individuals as well as bringing real bottom-line benefits to employers through, for example, avoiding recruitment costs and not unnecessarily losing experienced and valued members of staff.

However, it is not sustainable for every condition to get different or special treatment. For employers, that could lead to confusion and complexity; likewise for employees. That is why the Government’s starting position is that, specifically in the workplace and in the overall framework for providing health support to employees, long covid should be treated the same as any other long-term health condition. Let me set out that framework, which, as hon. Members would expect, is a cross-departmental effort.

The Government’s response to the “Health is everyone’s business” consultation, led by the Department for Work and Pensions, was published in July 2021. It sets out some of the measures that we will take to protect and maintain the progress made to reduce ill health-related job loss and see 1 million more disabled people in work from 2017 through to 2027.

[Debbie Abrahams]

I am listening keenly to the Minister, but the issue is that this is an infectious disease that is contracted partly as a result of exposure, and there is clear evidence that exposure happens in the workplace. It is therefore not the same as existing progressive or fluctuating illnesses; it is very much an infectious disease contracted in the workplace. That is the basis for our recommendations.

[Paul Scully]

I understand the hon. Member’s point. I am trying to set out the framework for managing long-term illness, but clearly, we still have support in the workplace for those with infectious diseases. I cited ME, fibromyalgia, Guillain-Barré syndrome and Miller Fisher syndrome, which are all post-viral infections—an infection beforehand typically leads to those other long-lasting conditions. That is why I am compartmentalising the framework, but none the less, I take the hon. Member’s point about the infections happening in the first place.

“Health is everyone’s business” did not consult on long covid, or any other specific health condition for that matter; it looked at system-level measures to support employers and employees to manage any health condition or disability in the workplace. The measures that we are taking forward include providing greater clarity on employer and employee rights and responsibilities by developing a national digital information and advice service; working with the Health and Safety Executive to develop a set of clear and simple principles that employers would be expected to apply to support disabled people and those with long-term health conditions in the work environment; and increasing access to occupational health services, particularly for small and medium-sized enterprises, which, as we know, are currently underserved.

As I said, although those measures are not long covid-specific, they are key steps in our effort to change the workplace culture around health and sickness management. That will benefit those suffering from long covid in the same way as those suffering from other longer-term health issues or disability.

As the hon. Member for Motherwell and Wishaw (Marion Fellows) said, we are also responsible for flexible working. We know that that policy can be incredibly helpful to those suffering from many long-term health conditions, including long covid, as they seek to manage the symptoms, some of which we have heard about today, such as extreme tiredness, insomnia, depression and anxiety. Although flexible working does not provide the whole answer, it can be an important tool for employers and employees as they have discussions about how better to balance the demands of work and life, particularly for those managing long-term health conditions.

The consultation on flexible working introduced plans for a future call for evidence on ad hoc flexible working; we want to explore how non-contractual flexibility works in practice. I discussed that with the Flexible Working Taskforce in February. We will ensure that the role of ad hoc flexible working to support those with long covid and other health conditions—such as the menopause and endometriosis, which I have mentioned—is part of its considerations.