Long Covid: Impact on the Workforce

Layla Moran Excerpts

Thursday 31st March 2022 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

I beg to move,

That this House has considered the impact of long covid on the UK workforce.

I thank the Backbench Business Committee for allowing us to hold this updated debate on long covid. I also thank my co-sponsors, some of whom, I am sad to say, are at home ill with covid and very much wanted to be here today. Also the fact that the debate has moved weeks has not helped. For those watching at home, I have been contacted by several Members who are very sorry that they are not able to be here. I also want to put on record my thanks to the many hundreds of people who, over the years, have contacted the all-party group on coronavirus with their personal stories, many of which are very heart warming, but also moving and worrying because it is a debilitating condition. What I say to all of them is: “We hear you, you have not been forgotten and we will continue to fight for you.”

I want to recognise the actions that the Government have taken so far. I was pleased that, after the first debate we had on the issue in January 2021, the Government made some £18.5 million available for research into long covid, including treatment, and delivered even more funding in the summer, which is incredibly welcome. In that debate, I also welcomed the new dedicated long covid clinics and the publishing of guidance to medical professionals by the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network and the Royal College of General Practitioners. However, despite that welcome action, it has felt, over the past eight months, that long covid has totally dropped off the radar and, on this issue, there has been very little debate.

I thank the Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Sutton and Cheam (Paul Scully) for coming to the Chamber to answer this debate. I believe that it is the first time that the Department for Business Energy and Industrial Strategy has answered in the Chamber on this. I will focus my remarks on the effect that long covid has had on the workforce because our belief is that this is a looming crisis that we need to think ahead about and that it would be wrong for us just to focus on the medical side— there are broader implications here.

Although there are many understandable reasons why this matter may have dropped off the radar, including the cost of living crisis and the war in Ukraine, I argue that these things are very much linked. How are we going to have a strong and productive economy if large swathes of our workforce are struggling to do the jobs that they are meant to be doing? How can we help them to recover?

Over this past year, we have had more information and learned more about long covid, although it is worth saying that there is still no cure. There are treatment plans that can help with symptoms, but the past year has been awful for many, including Andrew, a headteacher whom I spoke about in the debate a year ago, who received multiple written warnings about his inability to do the job in the day. I went back to him and asked how he was. He said:

“I made the difficult decision to resign from my post as a headteacher, so my limited energies could focus on coming to terms with my illness rather than continuing to face dismissal from a career that I had committed the past 25 years to and one that I dearly love.”

I also got an email from Nell, one of my constituents, who is a doctor. She said:

“I adore being a hospital doctor. I love my patients and I trained for years to do this. It’s been nearly two years of struggling with my health after covid, and while I continue to slowly recover, I don’t know if I can do this much longer. I’m so very sorry—I feel that I have let you down writing this.”

To Nell, I say that I do not believe that she has let anyone down, but I think that, to an extent, the Government have let her down.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

I thank the hon. Member for giving way and for her excellent speech. I also thank the Backbench Business Committee for granting the debate. She has raised a couple of cases that she has heard about. I have been in touch a lot with Sam, a carer in my constituency. At the very beginning when she had long covid, people did not understand the condition and it was not taken seriously, and it has affected her ability to work ever since. Does the hon. Member agree that, as well as dealing with the health side and getting more research on how the condition affects people so differently, it is important to have guidance for employers—she will probably come on to this—on how to deal with this and how to support those who may have long covid through that very difficult period? As we do not know how long the condition lasts, we need a proper long-term strategy for those who are affected and for their families.

[Layla Moran]

The hon. Member hits the nail on the head. People can recover, and very often do, but the way to help them do that is very badly explained to employers right now. Indeed, I will come on to talk in some detail about that.

Many people were told, especially at the beginning, that long covid was something that they were making up. They were told that it was all in their head. I have a research paper here that shows that scans have been done on people’s chests and the reason they were suffering from breathlessness was that the tissue was fundamentally damaged. This is very much a real disease, which now needs a real response.

It is not just public sector workers who have dealt with this. I spoke to Rebecca, who gave evidence to the all-party parliamentary group. She was a fitness instructor, Madam Deputy Speaker. You would think that a fitness instructor would be very healthy and would have very good lungs—before the pandemic, anyway. She used to teach 14 high-intensity classes a week and ran her own business. Now long covid means that she is in bed 60% of the time and describes being

“unable to return to work, and to be the mum, wife or friend I once was”.

It is utterly heartbreaking. We now need to accept that, if we are going to live with covid, we also have to live with long covid. In the evidence sessions that the APPG took in December and January, we heard how the condition is still severely impacting the lives and livelihoods of people across the country. They described how the condition has left them unable to work, sometimes unable to move, forcing them into long periods of absence from work, dipping into their savings and doing anything to stay afloat—something that is much more difficult now with the cost of living crisis.

A study released this month by Queen Mary University concluded that becoming infected with covid increases the risk of economic hardship, especially if the individual develops long covid. Those individuals describe a patchwork of uneven availability when it comes to long covid clinics and many are desperate for treatment. We heard from one nurse, for example, who has spent thousands of pounds going to Germany to get treatment that she is not able to access here. Public sector workers gave their lives for us. When we were all allowed to be at home, they went in, and they are the ones, according to Office for National Statistics surveys, who have the highest prevalence of long covid. I believe that we owe them so much more than they have had so far.

Unsurprisingly, though, it is not just about public services. We have 1.4 million people across the country experiencing self-reported long covid symptoms. That is 2.4% of the population and that cuts across every single sector, not just the public sector.

In the hospitality sector, which, as the Minister will know, is already struggling, 2.6% of workers have long covid. If we take the 3 million workforce estimate from UKHospitality, that equates to 70,000 workers unable to do their jobs as they did before. In retail, it is 2.3%, which equates to just under 70,000 workers; for personal service, such as beauticians, it is a bit less at 6,000, but still 2.1%. Those are big numbers in sectors that are already struggling post pandemic and struggling with workers’ visas following Brexit. They do not need this.

[Mary Glindon (North Tyneside) (Lab)]

I congratulate the hon. Lady and her colleagues on securing this important debate. Does she agree that it is not only the people who have had long covid who suffer, but their family members who have to care for them? My constituent Julie Wells has had a working life of nearly 40 years. Her teenage daughter, on a second dose of covid, has been left with totally debilitating symptoms and now needs constant care. Julie hopes at best to get back to part-time work, but she may not. That is a full-time person lost to the workforce because of caring for a family member.

[Layla Moran]

I thank the hon. Lady for her intervention. The caring responsibilities are greatly increased, as is the prevalence in children. I was alerted by my hon. Friend the Member for St Albans (Daisy Cooper) to a case of a parent who is asking for dispensation for her child from taking examinations because she has missed so many days of school. I am talking to the Education Secretary separately about that point, but long covid affects the entire family, not just the workforce.

Some 1.5 million people have long covid, but 989,000 people say that those long covid symptoms adversely affect their day-to-day activities and 281,000 people report that their ability to undertake their day-to-day activities had been “limited a lot”. That often means they must take part-time instead of full-time work, and sadly it often means they are unable to recover well because they are pushed to try to get back to work.

The effect on business is now being better documented. The Chartered Institute of Personnel and Development found that a quarter of UK employers cited long covid as one of the main causes of long-term sickness absence among their staff. For small businesses, the effects can be devastating. The Federation of Small Businesses has shared guidance on how to help with statutory sick pay and arranging for temporary staff cover.

However, I am concerned that the ACAS guidance right now is pretty sparse; I hope the Minister might take that up. The guidance signposts to other websites but does not make it clear that one of the most important things to do with long covid is often to let someone rest. People say “listen to your body” when it comes to medical things; I am afraid that with long covid that is actually the treatment plan.

If someone is forced or encouraged into work by their employer—often inadvertently, if they do not have proper guidance—it can set them back and cause even more problems down the line. One of our main calls is for employer guidance, but I also urge the Government to look at the ACAS website, for example, and ensure that it is clear to employers how they can help and support their employees to stay at home and rest as long as they need to, so that they come back and we do not unnecessarily lose people from the workforce.

A legal expert speaking to the APPG described the lack of access to financial support and said,

“lots of people with Long Covid find themselves starting for the very first time to be involved in the obstacle course which is our benefit system”.

It is clear that long covid is having a serious impact on the ability of our workforce to do their jobs, and we can only expect that to get worse as the virus spreads through the population again and we get more cases of long covid.

What can we do? The all-party group has released a report on long covid this week; if the Minister has not seen it, I would be happy to give him a copy. In it, we make 10 recommendations, but I will highlight just a few. First, the Government need urgently to prioritise research treatments for long covid patients. We welcome the money already committed, but we would contrast it with the United States, for example, where $1 billion has been earmarked for this, because the US recognises the effect long covid could have on its economy and sees this as an investment. I urge the UK Government to find similar ambition.

Secondly, we call for employer guidelines, set out by the Department for Business, Energy and Industrial Strategy in conjunction with the Department of Health and Social Care, to help all businesses to help their employees back into work. Thirdly, we call for the UK Government to launch a compensation scheme for all those frontline workers currently living with long covid, similar to the armed forces compensation scheme.

The Minister will perhaps be aware that the process for the designation of an occupational disease is ongoing; we are hopeful that that will report back soon, and we are discussing that with the Department for Work and Pensions. That designation could be game-changing, particularly in those public sector areas where prevalence was incredibly high, such as education, the health and social care workforce and public transport, which had some of the highest prevalences of covid, particularly at the beginning.

The Office for National Statistics survey points to where we need to look. However, I urge the Government not to wait for that designation. Many of those workers, as in my examples, have already left the professions. They are leaving the sector or deciding to take early retirement, and this is a time when our economy needs a boost. It needs those experienced workers. At the moment, we are not paying any attention to that.

The main reason we secured this debate was to urge the Department for Business, Energy and Industrial Strategy to look ahead and take this seriously. The best thing we can do right now is to help hard-pressed people in the UK in our fight against Putin, against the cost of living crisis and all the rest. If we are to get our economy back on its feet, we must get our workers back at their desks. If those workers have long covid, there is currently very little out there to support them or those businesses that desperately want them back.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I think we can get everybody in with a reasonable amount of time, if everyone limits their comments to a maximum of eight minutes.

--- Later in debate ---

[Andrew Gwynne (Denton and Reddish) (Lab)]

I sincerely thank the hon. Member for Oxford West and Abingdon (Layla Moran) for all the work she has done on this issue, and for the way she opened this debate. I also thank the Backbench Business Committee for granting it and the Members who have taken part. I thank in particular my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), and I sincerely thank my hon. Friend the Member for City of Chester (Christian Matheson) for his kind words. It is nice to know that my experiences have helped somebody else with theirs, and I wish his family member well for the future. I also thank the hon. Member for North East Fife (Wendy Chamberlain), and my hon. Friend the Member for Putney (Fleur Anderson), who is absolutely right to draw parallels with ME both in some of the symptoms and in how that community has been treated over a number of years. I thank my hon. Friend the Member for Strangford (Jim Shannon)—because he is my friend—for his kind words, too.

As colleagues will know, not least because it has been mentioned in this debate, long covid is an issue very close to my heart. Back in March 2020, I first caught covid. That was 107 weeks and four days ago, and I am still struggling with some of the symptoms of long covid all these weeks and days later. Back then, I felt rough with covid, but to my relief I avoided a lot of the more serious symptoms we were seeing on the news and hearing from friends and colleagues at that time. It was not great, but the fact that I was not hospitalised was a blessing.

However, when my self-isolation period ended and in theory I should have been fine to return to work, I found that I could not. I found that I was perpetually exhausted, and I could not catch my breath. I would be talking to my wife, and suddenly the words would vanish. I would try to pick them out, but I could not find the right ones. I would forget things and lose track of why I had come into a room. I would sweat as though I had run the London marathon just doing routine day-to-day things such as making a cup of tea. I felt completely terrified. My symptoms were not going anywhere, but instead evolving into something different and seemingly something permanent.

In May 2020, Elisa Perego coined the term “long covid” to describe these persistent and wide-ranging symptoms, and I felt like a bright light had been shone on what I had been going through. We now know that over 1.5 million people suffer with long covid in the United Kingdom, and that the majority of these—989,000—say it affects their daily activities. It certainly affected mine. I am very fortunate to have a brilliant team across Westminster and in my constituency of Denton and Reddish, and they stepped up on my worst days, when getting out of bed felt like running a marathon. They made sure that my constituents were still well represented, and that I was given sufficient time to rest when needed. Listening to my body was a hard lesson, too.

However, millions of people in this country are not as fortunate as I was. We have some of the worst sick pay provision in the OECD, and we are in an age of precarious work. In that context, long covid becomes an economic as well as a health emergency. The fact of the matter is that there has been an acute failure on the part of Government to take long covid as seriously as perhaps they should, because it is not just a health issue, but an employment and a DWP issue. The Government could and, I believe, should be doing more to encourage workplaces to better support those suffering from long covid and to enable employers to understand precisely what long covid means for their workforce.

For December 2021 to January 2022, the most recent period we have access to, it has been shown that, of the 1.5 million people currently suffering from long covid, only 2,869 had attempted to access the post-covid assessment service. Of that tiny number, 34% had been waiting for longer than 15 weeks. Something is going very wrong. Almost 1 million people are reporting long covid symptoms that are adversely affecting their day-to-day lives, yet just a fraction are attempting to access care and only a fraction of those are actually getting it. I would be grateful if, in his response, the Minister set out what conversations he has had with colleagues in the Department of Health and Social Care about these figures, and what action the Government will be taking to ensure that those who have long covid can actually access the care they desperately need.

This is actually quite crucial because, with the right rehabilitation package, work can become viable again for a proportion of those people. I want to share with the Minister some data I have received from Nuffield Health. Operating a free 12-week programme, it has so far helped over 1,900 people from across the UK to recover from the prolonged effects of covid-19, including breathlessness, anxiety and fatigue, and I am one of the 1,900 who have taken part in that free programme. Its results to date show that for 64% of people the programme improved mental wellbeing, for 39% it improved their functional capacity and for 39% it improved their breathlessness, while 35% saw an improvement in fitness and 30%—not an insubstantial number—were absent from work but felt they could return. This is not a silver bullet for all, because those are still minority figures, but I think that 30% being able to return to work with the right rehabilitation programme is quite encouraging.

As has been pointed out on numerous occasions, 4% of the UK workforce currently have long covid. That is an extraordinarily high number of people, and it will no doubt be having an impact both on workplace productivity and on wider employment outcomes. The Chartered Institute of Personnel and Development has found that a quarter of UK employers cited long covid as one of the main causes of long-term sickness among their staff, yet those living with long covid have had very little in the way of workplace protection.

In my capacity as shadow Minister for public health, I have been inundated with stories of employees facing an uphill battle to have reasonable adjustments implemented in their workplaces. I have heard from doctors unable to return to work and NHS staff who have been sacked or had contracts terminated because of long covid symptoms. They are the people who carried us through the pandemic—we stood on our doorsteps for them and applauded them. We can do much better than that.

I turn to the help that I had in returning to work. I pay tribute to Mr Speaker and the staff in the Speaker’s Office, because I am lucky enough to work in an environment where reasonable adjustments were made. When I first returned to the House in person after the summer recess, I found that I could not bob in the Chamber without becoming incredibly fatigued, and that would trigger my brain fog. After almost collapsing during a ministerial statement on Afghanistan—I had been bobbing for almost an hour—I arranged for a meeting with Mr Speaker on the basis that I could not do my job and, if I could not do a simple task like bobbing up and down, I might as well pack up and leave. Mr Speaker and his brilliant staff advised me that instead of rising on each occasion, I could simply hold up my Order Paper. That simple solution made a huge difference to my health and wellbeing. I sincerely thank Mr Speaker, and indeed you, Madam Deputy Speaker, and the staff in the Speaker’s Office for being so understanding.

However, reasonable adjustments should not just be made for Members of Parliament. The Government need to do much more to empower employees to approach their bosses and have these conversations. The problem is that, with practically zero workplace protections in place for long covid, they become incredibly difficult to have.

The Opposition recognise the threat that long covid poses both to the health of this nation and to the British workforce. That is why we would end the postcode lottery of long covid care provision, fix the shameful state of sick pay and engage with employers to support those living with long covid. Covid has not gone anywhere, and it is profoundly irresponsible to stick fingers in ears and pretend that 1.5 million people are not still struggling. Free lateral flow testing will end tomorrow and, as a result, covid cases will rise. It will make it much harder to track the level of covid in the UK and, by extension, the number of people who may go on to develop and live with long covid.

[Layla Moran]

I am glad that the hon. Member has brought up that point. He will have heard about the difficulties that people have in accessing benefits and proving that they have long covid. People get long covid from covid, but, if they cannot get a test, how do they know if they have had covid? That makes it so much more difficult for people to prove long covid down the line and access the benefits that they deserve.

[Andrew Gwynne]

The hon. Lady is absolutely right. That is a real concern of mine, not least because I have experienced it. I was in the first wave of covid, having caught it in the weeks when the Government said, “If you develop symptoms, you no longer need to test; just go into self-isolation.” I knew that I had covid, and I know that that led to long covid, but to this day I cannot prove it because there was no routine testing available to show it. That is a real issue.

I am incredibly worried that getting rid of free testing is a short-term decision that will have major financial and public health implications for the foreseeable future. The Government cannot turn a blind eye to a problem that is having a devastating impact on the people of this country. One of the defining lessons of the pandemic is that we do not have the luxury of dithering and delay when it comes to public health. We urgently need a cross-departmental long covid strategy. I would support that, work on it and gladly give my experience and advice to Ministers to help develop it. We need a long covid strategy, we need proper sick pay, and we need the Government to understand that they have an important role in working with business and industry to ensure that reasonable adjustments and support in the workplace become a thing for all, not just for me.

--- Later in debate ---

[Paul Scully]

Our manifesto committed to consult on this issue. Within that consultation, we looked at a day one right to request flexible working. That is key, because it will attract people to and keep them in a good workplace. We might as well start as we are set to carry on.

Another significant part of the cross-departmental framework is the Government Equalities Office, which is responsible for the Equality Act 2010. That is an important part of the matrix, because it may protect those with long-term health conditions from discrimination. That Act ensures that any person with a condition that meets the definition of a disability is protected, so it should not be stigmatised. The Act describes disability as

“a physical or mental impairment”

that

“has a substantial and long-term adverse effect”

on a person’s

“ability to carry out normal day-to-day activities”.

We heard about that not least from the hon. Member for Denton and Reddish and during the incredibly passionate speech of the hon. Member for City of Chester (Christian Matheson), who cited the example of his family member. By the way, I know how difficult it is for an hon. Member to describe a family member who is suffering from something that we are debating, and I thank him for his personalised experience, which has informed the House and positively contributed so much to the debate.

As I said, the disability should not be stigmatised, though some may do so. This is simply about the impairment, as we have heard loud and clear. “Long-term” is defined having lasted, or being likely to last for, at least 12 months. “Substantial” is defined as more than minor or trivial, as we have heard strongly in Members’ examples today.

The Act makes it clear that it is not necessary for the cause of the impairment to be established, nor does the impairment have to be the result of an illness. A disability can therefore arise from a wide range of impairments. That means that any person who falls within that definition will already be protected as having a disability. That can therefore encompass some of the emerging effects of long covid, but every case will be different and should be considered on its merits.

As well as paying tribute to the hon. Member for City of Chester, I thank the hon. Member for Oxford West and Abingdon and ask her to pass on our regards to Andrew, Nell and Rebecca. We also heard about Julie Wells and her daughter and the caring responsibilities involved. The examples that we have had really add colour and inform the debate.

The hon. Member for Motherwell and Wishaw talked about statutory sick pay. We have discussed the fact that we need to look at statutory sick pay, but this is not the time to do so, particularly while we are in the middle of the pandemic. However, we also need to look at statutory sick pay in the round. She mentioned people earning under £120 a week, but many in that situation are already in receipt of other benefits. That is what I mean about not just concentrating on one issue; we need to look at the whole person and their whole personal finance.

In summary, we are supporting people with long-term health conditions, including long covid, by working hard on the general approach to work and health, through our response to the “Health is everyone’s business consultation”, and taking steps to make some of our employment rights work a little harder to support those balancing work with other issues and challenges. All that is underpinned by the protections against discrimination provided by the Equality Act. We must also showcase the good employers, as was mentioned by the hon. Member for City of Chester.

[Layla Moran]

If I understand this correctly, the consultation is happening and guidance will be provided more comprehensively for all longer-term illnesses. The issue particularly with long covid is that it is so new that many employers do not have a clue what it is. Will he consider suggesting a public health information campaign particularly targeted at businesses so that they know that it exists and where they can go for such guidance?

[Paul Scully]

I often talk about ACAS guidance, which, obviously, is available in this area. The hon. Lady mentioned what she saw as shortfalls in that guidance. We will always look at that to make sure that guidance is up to date, especially with an evolving condition such as long covid. I keep citing the example of ME, which, like fibromyalgia, is one of those diseases that is very poorly understood by so many people in the workplace and even, frankly, by health professionals. It will evolve and I am sure that we will able to push that information out to employers.

I hope that hon. Members would agree that there is a wide-ranging set of actions to address long-term health issues in the workplace, whatever those health conditions are. We want to encourage a better culture around work and health, including for those suffering from long covid. I firmly believe that it is an important principle to have a single, consistent and clear approach to managing health in the workplace. It is unsustainable to have a number of different approaches for different conditions. I close by thanking everyone once again for this helpful and informative debate.

Question put and agreed to.

Resolved,

That this House has considered the impact of long covid on the UK workforce.