Bone and Joint Health
Debate between Jim Shannon and David Reed(2 weeks, 4 days ago)
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David Reed (Exmouth and Exeter East) (Con)
It is a real pleasure to lead this evening’s debate during Bone and Joint Week, raising awareness of an issue that affects millions of people, but receives nowhere near the attention it deserves. I start by thanking Arthritis UK and the Arthritis and Musculoskeletal Alliance, known as ARMA, for their work raising awareness of these conditions, for the information they have provided ahead of this debate and for the parliamentary event they put on today.
Musculoskeletal conditions or MSK conditions affect our bones and joints and the muscles and tissues that hold them together. They include arthritis, osteoporosis, chronic back pain and joint injuries. For some, these conditions are manageable. For others, they are utterly debilitating, leaving people struggling to walk, to work or to carry out basic everyday tasks.
More than 20 million people in the UK live with an MSK condition. Some 10 million have arthritis, including an estimated 15,000 people in my constituency. Such conditions are the single biggest cause of pain and disability in this country, accounting for around one in seven GP consultations, yet I fear that we underestimate their seriousness, perhaps because they are rarely immediately life-threatening. While they may not kill people, however, they can slowly rob them of their mobility, independence, ability to work and quality of life.
I want to explain why this issue matters to me personally. Six years ago this month, my life changed significantly, although I did not know it at the time. It is something that I have avoided talking about publicly, and if I am honest, I have struggled to accept it. However, I believe we should draw on personal experience in this place, particularly when it might help improve our country.
In October 2020, I was an extremely fit and physically robust former regular Royal Marine with multiple operational tours behind me. I was also competing at the highest level of wingsuit skydiving as a member of the Team GB squad. I can see Members thinking that those activities and MSK injuries are natural bedfellows, and they are probably right, but nothing prepared me for the debilitating consequences of what happened that October.
On a grey and windy day in Devon, I decided to go parachuting, which was a near weekly occurrence. As a reservist member of the Royal Navy parachute display team, I needed to keep current for the following season. I had completed around 700 jumps, and I was not frightened—this was like any other day—but I had something far more dangerous: complacency. The winds were strong and the parachute centre had restricted jumping to experienced parachutists only. I was practising precision landings and convinced myself that it would be good training. I also chose to wear trainers, rather than my usual military boots that provided ankle support. The plane took off and we climbed to 15,000 feet. The green light came on and I jumped.
Everything went to plan until the landing. Rather than landing in the middle of a muddy field away from obstacles, I decided to land closer to where I would be picked up. It was a lazy decision, and it was a stupid one. As I approached the ground, gusting winds caught my parachute, lifted me and slammed me into the side of an aircraft hangar. My left foot took the initial impact, before the rest of my body smashed into the building. My parachute went over the roof, leaving me dangling from the hangar. Fortunately, I remained conscious, managed to release my harness and fell the remaining 5 feet or so to the ground. I remember lying there in shock, checking everything was still attached. Then came the searing pain in my left ankle. My wife came and picked me up and drove me straight to accident and emergency. After examinations and scans, I was told that I had suffered a severe sprain. I was advised to get the ankle moving and seek physiotherapy, because timely NHS support was unlikely to be available. Having had little experience of the NHS, I trusted that advice.
Over the following months I worked hard at rehabilitation. Gradually, I regained strength, but I remained in considerable pain. I took the classic Royal Marine approach: crack on and hope it gets better. Having served alongside men who lost limbs in Afghanistan, I considered myself lucky, and I certainly was not going to complain about a sore ankle, but six months later, something was clearly wrong.
My physiotherapist recommended an MRI scan, which I paid for privately—again, I was advised that the NHS process would take too long—and, when the results came back, I had to catch my breath: my ankle had been broken the entire time. The fracture had been missed at A&E and I had spent six months rehabilitating an injury that had never been properly diagnosed.
I was advised to see a private consultant—again, because of the time it would take to access specialist help through the NHS. This is where I was incredibly fortunate. By complete chance, the consultant whom I went to see happened to be ex-forces himself. Having discussed my injury and background, he suggested that I see him through his NHS practice, where he could continue to oversee my treatment, and I am enormously grateful to him for doing so. After months of uncertainty, pain and frustration, I finally felt that someone understood the problem and could help me to work out what came next. I want to make an important point here: my experience has left me deeply frustrated with parts of the NHS and particularly with the difficulties in accessing timely diagnosis and treatment, but it has also shown me that there are some outstanding people working within it who go above and beyond for their patients.
Jim Shannon (Strangford) (DUP)
I commend the hon. Gentleman for raising this issue. I spoke to him this morning to ensure that it would be okay for me to intervene in the debate.
Arthritis UK has said that there is an “escalating musculoskeletal health crisis”. In Northern Ireland, some 550, 000 people—nearly a third of the population—are now living with arthritis or a similar condition. Those living in chronic pain face long, painful waits—the very thing the hon. Gentleman referred to—with some reporting having to wait for up to eight years for a rheumatology appointment. Many are unable to work or live independently as a result, and almost 80% report that their mental health has deteriorated significantly, so it is not just a physical problem. Does the hon. Gentleman agree that while more must be done to reduce waiting lists, we must also ensure that, in the interim, patients living with chronic pain have timely access to appropriate mental health support?
David Reed
I will come on to the points that the hon. Gentleman has made, but he is completely right. We must look at these problems in the round, because this is an issue of not just physical but mental health. People who were once fit lose that fitness, both physically and mentally, and then they become a bigger burden on the state.
Let me return to the subject of the surgeon who helped me out. I have been fortunate to benefit from that care, but I recognise that I was lucky. At the time, I had the means to access private treatment, and through that process happened to find a consultant who could help me back into the NHS system. That should not be a matter of luck, and it certainly should not depend on someone’s ability to pay.
Six years on, despite the excellent care that I now receive, I am left with osteoarthritis that can, at times, be severely debilitating. I can no longer run. I avoid activities that cause my arthritis to flare up, and I face the prospect of eventually having the bones in my ankle surgically fused. For the first few years I held on to the hope that I would recover and return to the active life that I once had, but I have now accepted that it is likely that I will not. That is difficult when physical fitness and independence have been such an important part of one’s life. At times, it has been an incredibly lonely journey. My current NHS consultant gives me hope that advances in medical technology may offer better options, but because I limp, other bones and joints are now beginning to suffer. I know that I am likely to place increasing demands on the NHS in the decades ahead.
My experience has shown me a health service that can be brilliant at dealing with life-threatening emergencies, but pretty poor when it comes to conditions considered less serious, even when they fundamentally change someone’s life. I was fortunate enough to be able to afford private care, but millions of people cannot. They are left waiting, living with pain and sometimes watching manageable conditions develop into lifelong disabilities. That brings me to the wider purpose of this debate. People living with musculoskeletal conditions are about one and a half times more likely to experience mental health problems, and I understand why. When pain becomes part of everyday life and you can no longer do the things that you enjoy, it takes a toll. However, there is another dimension that we must urgently address in the House: the economic cost of doing nothing.
In 2024 alone, 26.5 million working days were lost to musculoskeletal conditions. Arthritis UK estimates that working days lost to osteoarthritis and rheumatoid arthritis cost £2.58 billion in 2017, with the figure projected to reach £3.43 billion by 2030. About 646,000 working-age people claiming sickness or disability benefits cite a musculoskeletal condition as their primary reason. I am not suggesting that they can all return to work, or that every disability is preventable, but I do believe that too many people deteriorate when early intervention might have kept them healthy, independent and economically active.
Let us consider someone working in construction, hospitality or healthcare. They develop a back problem or knee injury but cannot access timely treatment, so they carry on through the pain. Eventually, they cannot carry on. They fall out of work, their health deteriorates and they become increasingly dependent on public services. The taxpayer potentially picks up the bill several times over through NHS treatment, welfare payments and lost tax revenue, and the individual pays an even greater price. We focus too much on the immediate cost of treatment, without considering the potentially much greater cost of failing to treat someone early. Surely that is economically illiterate. If timely physiotherapy, imaging or specialist intervention can prevent lifelong disability or someone losing their job, we should see it as an investment, not simply another NHS cost.
However, it is not all doom and gloom, and there is reason for optimism. In my constituency, the Royal Devon University healthcare NHS foundation trust held its first MSK community appointment day in Exmouth. More than 100 people attended, accessing clinical assessments, rehabilitation advice and community support together. Patients particularly valued being listened to, and early results suggested fewer unnecessary follow-ups. One pilot does not provide all the answers, but it does show what can happen when services are organised differently and patients receive joined-up support.
That brings me to my questions for the Minister. First, where is the national leadership on MSK health? The previous Government recognised MSK as one of six major conditions in their major conditions strategy, yet we have not received a firm commitment that the current Government will develop a dedicated modern service framework. Will the Minister commit to establishing such a framework, with clear accountability and measurable outcomes? Will the Minister also commit to a national approach, with clear responsibility and measurable outcomes, and meet the Arthritis and Musculoskeletal Alliance to discuss it? I thank the shadow Health Minister, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), for tabling an amendment to the recent Health Bill that calls for just such a framework.
Secondly, what more can be done to improve early diagnosis and timely access to rehabilitation to prevent avoidable deterioration while patients wait? Thirdly, will the Government work across the Department of Health and Social Care, the Department for Work and Pensions, and the Treasury to properly assess the economic case for early intervention?
Lastly, as a veteran, I want to raise veteran issues. MSK injuries are a major reason for medical discharge from the armed forces, and their consequences can follow people long after they leave service. Will the Minister work with Defence colleagues to improve access to rehabilitation for veterans, and examine whether the armed forces covenant properly addresses their long-term MSK needs? It cannot make sense for any one part of Government to save money by delaying treatment, only for another part to spend considerably more in dealing with the consequences.
I will finish where I began. Six years ago, I was able to soldier. I could run for miles, jump out of aircraft and represent my country in sports. Today, I have to think about every physical activity and the associated cost in pain. I do not share that to seek sympathy; I share it because I understand how profoundly an MSK condition can alter someone’s life. Millions of people across this country are living with far worse circumstances than mine.
National Resilience
Debate between Jim Shannon and David Reed(4 months, 3 weeks ago)
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David Reed (Exmouth and Exeter East) (Con)
It is a privilege to lead this evening’s Adjournment debate on improving national resilience. I am also glad that the Security Minister is responding. He is a man for whom I have a great deal of respect. As we have both served in what is now the Special Forces Strike Group, albeit at different times, I know he is one of the few people in this House who has seen the sharp end of national insecurity at first hand.
It has sadly become commonplace to say that we are living through unprecedented times. The international system we have all lived under has fractured, war has broken out across multiple continents and technological upheaval and a warming planet compound to create an increasingly volatile world.
We hear repeatedly across this House that the first duty of any Government is the defence of the realm. It is repeated so often that it risks becoming a platitude, but here is the hard question: are we actually living up to that duty here in the UK in 2026? This evening, I will set out why I believe we are falling short and, more importantly, what we might do about it and how we might build a country and citizenship resilient enough to meet the growing and interconnected number of threats to our homeland.
Jim Shannon (Strangford) (DUP)
I commend the hon. Member. Resilience is about not just defence but health. To cast the mind of the hon. Gentleman and that of the House back to the national emergency of covid-19, the report of the UK covid inquiry mentioned “fatal strategic flaws”. The NHS did not collapse, although it came close and patients often did not receive the standard of care that they were due, and that led to delays in diagnosis and treatment. Does the hon. Member not agree that serious concerns about the lack of the health service’s effective surge capacity need to be addressed in anticipation of another national health emergency and to secure national resilience in the face of medical uncertainty?
David Reed
The hon. Member raises a serious points, which I will come on to, on interconnectedness. We saw how covid-19 affected so many different parts of society—it closed down industry and the economy. We have to start to think about these things cross-departmentally.
The Government’s definition of national resilience is a society’s ability to anticipate, withstand, respond to and quickly recover from severe crises, whether natural disasters, pandemics, geopolitical shocks or deliberate attacks. It rests on a whole-of- society approach in which Government, business and the public work together to protect critical national infrastructure and maintain vital services.
Last year’s strategic defence review made precisely that point. One of its central recommendations was a national conversation on defence and resilience built on that whole-of-society approach and premised on a simple idea: that defending the nation is no longer the job of the armed forces alone. A year on, however, I think it is fair to say that that conversation has barely begun.
One critical central challenge, both to having that conversation with the British public and, more importantly, to making the preparations to be resilient, is that living memory of needing to be resilient in this country is fading. I often speak to my father about this. He was born in 1942 in Plymouth during the blitz. His generation is the last with a direct lived experience of national insecurity on home soil. The contrast is stark. To the young people I speak to about the risks we face, the idea that we might have to defend our homeland, our democracy and our way of life, remains abstract—something that happens to other people in other places.
We are in a more vulnerable position still, however, because beyond the fading of that memory, resilience is no longer woven into our national story. In Taiwan or Finland, the people I speak to have a geographical proximity to the threat, which they feel in their bones: the Chinese dragon across the strait and the Russian bear across the border. Those threats are real and they are close, and that is precisely why those countries do resilience well: their people and their institutions understand in their core the need to be strong. A quotation that has stayed with me since my Royal Marines training puts that well:
“You cannot dream yourself into a strong character: you must hammer and forge yourself into one.”
As a country, we must wake from that dream, and it is incumbent on the Government to have the hard conversation with the public about how we fund our national resilience.