World Arthritis Day

Debate between Jim Shannon and Tom Randall

Wednesday 25th October 2023 Westminster Hall

[Tom Randall (Gedling) (Con)]

I beg to move,

That this House has considered World Arthritis Day.

It is a pleasure to serve under your chairmanship, Ms McDonagh. This House was in recess on 12 October, but that date has been celebrated—if that is the right word—as World Arthritis Day since it was established by Arthritis and Rheumatism International in 1996. Its aim is to raise awareness across the world of the existence and impact of rheumatic and musculoskeletal diseases, and to educate people about symptoms, preventive measures and treatment options. I thought it might be helpful to bring this debate to the Chamber today—the closest date to World Arthritis Day that we could arrange—to raise awareness, to highlight the extent and impact of arthritis and musculoskeletal conditions in Britain today and to continue the debate on what we can do to mitigate the impact of arthritis.

What is arthritis? Arthritis refers to painful, stiff or restricted joints, which are common symptoms in conditions that cause joint damage or inflammation. They include osteoarthritis, which happens when the body can no longer maintain and repair one or more joints; autoimmune inflammatory arthritis conditions, including axial spondyloarthitis; crystal arthritis such as gout; or symptoms of inflammatory connective tissue diseases, such as lupus. Arthritis is used as an umbrella term for a range of conditions, and that is how I will use it in this debate, although there are certain issues specific to particular conditions that I will mention later.

The subject is worthy of debate for three reasons: first, to recognise the inherent issues in living with arthritis, and how widespread it is; secondly, to highlight the wait for diagnosis and treatment; and thirdly, to understand the economic costs of not dealing with musculoskeletal conditions effectively. We might think that arthritis only affects old ladies, but it is more widespread than that. More than 10 million people in the UK—one in six of our constituents—have arthritis. One in six of our constituents is in pain and experiences fatigue and often restricted mobility.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward this debate. In Northern Ireland, where we have a population of 1.95 million, there are 525,000 people living with arthritis or another musculoskeletal condition. That gives some perspective— it is more than one in four. The scale of the issue is massive.

Does the hon. Gentleman agree that for those in the early stages, help in dealing with pain and strengthening the muscles can prevent further untimely deterioration? We should ensure that people stop classifying arthritis as an old person’s disease, so we can allow younger people to determine what they have and how to manage the progression that the hon. Gentleman wishes to achieve.

[Tom Randall]

The hon. Gentleman is absolutely right. When we have debated this subject in the past, he has raised the issue of arthritis in Northern Ireland; I am so pleased to see him raising it again. He is right in the perspective that he takes on the breadth of the issue, which affects a wide variety of people. I will come on to that point shortly.

One of my Gedling constituents puts it this way:

“Living with arthritis changes you and turns your world upside down. Things you took for granted become obstacles and daily challenges to be overcome. On a good day, you might not look like you’re living with a chronic condition but it never goes away. It’s hard to plan ahead because you don’t know if you’ll be up to going out or meeting up. Arthritis doesn’t only affect the person with the condition but their family too. I have watched Rheumatoid arthritis rob my mum of a life and now I have it too. It makes me frightened for my daughter’s future.”

Early diagnosis and prompt treatment can improve the futures of people living with arthritis and musculo- skeletal conditions, but not always. In the case of axial spondyloarthritis, in which I declare an interest as chair of the all-party parliamentary group on axial spondyloarthritis, a key challenge remains timely diagnosis. In this country, the condition currently takes an average of eight and a half years to diagnose, which puts us behind most comparable nations in Europe.

The latest report of the national early inflammatory arthritis audit, which is run by the British Society for Rheumatology, found that patients are experiencing diagnostic and treatment delays, with 44% of patients still not referred within the target of three working days and 48% of patients experiencing symptoms for longer than six months prior to referral. Although the average time to treatment has improved in England, having been reduced by three days, delays are an average of 12 days higher than the quality standard of 42 days.

The impact of arthritis is ultimately a human story, but the economic cost is also worth mentioning. According to the Office for National Statistics, 23.3 million working days were lost in 2021 due to musculoskeletal conditions. I have thought about how to put that figure in a way that politicians and politicos can understand. Think back to the winter of discontent in 1979, when 29 million working days were lost due to strike action. That was a politically pivotal year, which was notorious for how many working days were lost, and we are facing the equivalent of 80% of that figure—not just in one year but every year because of musculoskeletal conditions.

People with arthritis are 20% less likely to be in work than people without arthritis. Twelve per cent of sickness absence in the NHS between September 2021 and August 2022 was due to back problems and other MSK conditions. The National Axial Spondyloarthritis Society estimates that

“A patient aged 26 who waits 8.5 years for a diagnosis is likely to lose around £187,000”,

the majority of which derives from a loss of productivity due to reduced employment. The average patient also incurs costs of around £61,000 in out-of-pocket expenses while waiting for a diagnosis. That includes the cost of medication, travelling to appointments and private healthcare appointments, including visits to chiropractors.

I first praise the Government for making musculoskeletal conditions part of the major conditions strategy. Making MSK one of the six major conditions signals the importance of this issue, and I believe that it demonstrates that the Government are serious about tackling it. I hope that it will be understood that there are a range of measures that can be taken to improve matters. The Government have made reducing waiting lists one of their top priorities to improve the lives of those with arthritis and musculoskeletal conditions, including those waiting for joint replacement surgery, but I would welcome clarification that it will remain a key Government priority and clarity on how that will remain the case in the face of likely future winter pressures.

According to the British Society for Rheumatology, growing the rheumatology workforce would reduce the health and societal costs of newly diagnosed rheumatoid arthritis by £50 million, so I welcome clarification from the Minister on plans to grow the rheumatology workforce.

Everyone recognises the valuable role that primary care can play. Raised public awareness can help to encourage early presentation in primary care, but there is also work to be done to help GPs and other healthcare professionals to recognise conditions. I spoke earlier of the delay to the diagnosis of axial spondyloarthritis. Fifty-six per cent. of that delay time occurs in primary care, with GPs often failing to identify the symptoms of axial spondyloarthritis and thinking that the patient may have mechanical back pain or back pain associated with injury. That can lead to repeated primary care visits and causes patients to be bounced around in the system, placing further burdens on the already stretched system. I welcome any opportunity to follow up with the Minister separately on that point, particularly on what can be done to improve public and primary care awareness of these conditions.

World arthritis day only comes once a year, but for those living with arthritis and musculoskeletal conditions it is a constant issue. While they might dream of a world free of pain and discomfort, that is not yet a reality. I am grateful for the opportunity to raise this issue on the Floor of the House today and I look forward to hearing further contributions on how we might make that the case.

Axial Spondyloarthritis

Debate between Jim Shannon and Tom Randall

Thursday 17th September 2020 Commons Chamber

[Tom Randall]

The hon. Lady is absolutely right. What I and her husband have experienced is sadly not a rare phenomenon.

The name axial spondyloarthritis will be unknown to many, if not most, people, but it is not uncommon. It affects about one in 200 of the adult population in the UK, or just under a quarter of a million people.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing forward this debate. I spoke to him this morning to seek his permission to intervene. He is aware of the massive eight-and-a-half-year delay in diagnosing this awful illness. I read an article in my newspaper back home in May about a young mum in Northern Ireland and her battle. We must all be determined to secure extra funding so that early diagnosis can happen, for adequate research into this life-changing debilitating disease, and for more support groups. In Northern Ireland, we have only two—one in Belfast and one in Londonderry—for a population of 1.8 million spread across the whole Province.

[Tom Randall]

In last night’s Adjournment debate, the hon. Member for Pontypridd (Alex Davies-Jones) said that she felt like a proper MP after the hon. Gentleman intervened on her in an Adjournment debate, and I echo those sentiments. He is completely right about the delay, which I will come on to in a moment, and about the role that support groups can play in showing that people are not alone in having the condition and in providing moral and practical support. I hope that now awareness has been raised, there will be more than two groups in Northern Ireland in due course.

As I was saying, there are a quarter of a million people with AS, which makes it more prevalent than multiple sclerosis and Parkinson’s combined. Hon. Members may say, “Well, so what?” AS is incurable and it can be managed through medication, physiotherapy or exercise, but what makes it worthy of particular concern and debate is, as outlined earlier, the delay to diagnosis.

The symptoms of AS can be difficult to diagnose. I was passed between neurologists, geneticists and other specialists as various conditions were ruled out, before a rheumatologist finally diagnosed AS when I was about 20. I was very lucky that I had to wait only a couple of years before getting my diagnosis, but on average, there is a delay of eight and a half years between the onset of AS symptoms and diagnosis in the UK.