Mental Health: Access to Work Support Service

Lord Kirkwood of Kirkhope Excerpts

Monday 18th June 2012 Lords Chamber

[Lord Kirkwood of Kirkhope]

My Lords, I am very pleased to follow my noble friend Lady Browning. She is an expert in these things, and I agree with what the noble Baroness, Lady Bottomley, said earlier about the expertise available to us in this House.

I do not consider myself to be a great expert in this subject, but I want to say in passing to my noble friend Lady Thomas that I do not know how many sessions of cognitive behavioural therapy Richard III would have needed, but it would certainly have spoilt the plot. She should stop going to literary book festivals, because this is all above my literary pay grade.

Reading up for this debate, the subject really took me back. Some of these statistics are quite startling. I did not realise that the trends had been so dramatic. I think, therefore, that it is something that we as a House and as legislators need to keep a careful eye on, which is why I am so pleased to take part in the debate this evening, brief as it is.

I agree very strongly with Liz Sayce’s report. Liz Sayce is an excellent person. She did an excellent piece of work for the Government, and we are all in her debt, but the bit of the report that captured my imagination and which picks up on what my noble friend Lady Browning has just said is the bit that says that what we really need is confident, well-informed disabled people with confident well-informed employers and an enabling state. That was the essence of where Liz Sayce started from, and I agree with that. Confidence is a very important element in all this.

I perfectly understand that we have come a very long way since the mid-1990s on the role of work, the support that is necessary and the active labour markets. Provision and support for people with disabilities going into work is much more accommodating than it used to be. Of course, there is still a huge amount to do. I just want to point out in passing that we have to be doubly careful about mental illness because we are putting greater pressure on people to go into work. I say that neutrally. We have to be careful because we get into conditionality and there are some real problems with that, because if we do not acknowledge and deal with mental illness we can suddenly find we are penalising people in ways that are contrary to natural justice. There is a real necessity to get this right.

One other point that I would like to put on the table is that I am still not confident we have enough capacity—broadly defined as occupational health experts, the medical profession, specialist services and employment support services—to deal with the explosion of need that we may face if some of these assessments are right. We must think very carefully about that.

I also agree with the point about co-ordinating commissioning services. The noble Baroness, Lady Meacher, rightly said that £400 million is being spent in the health service. The health service people need to talk to the skills people, to employers and to Jobcentre Plus—to all of them. If we do not do that, people will fall through the gaps.

I was interested in what my noble friend Lady Browning said about the public service. The Minister will put me right about this but I do not think that Access to Work is capable of being deployed in the public service. I may be completely wrong about that. If I am right, however, I do not begin to understand why that is not the case if it is true. People in the Civil Service may, the argument runs, have enough employment support and capacity in their own departments to be able to provide an equivalent service anyway, but the Minister would help me enormously if he could clear that up. I may have misunderstood, but if I have not I join my noble friend Lady Browning in saying that public service absence rates are far higher than they should be. We really need to address them as soon as we can.

I will make two final points in the two minutes left available to me. Everyone has said this, but I hope that the Minister takes this message back to the department: raising awareness is key and has to happen. If we are short of budgets, as we always are on these things—no one finds it easy to find money in these straitened financial times—I do not understand why the professionals in Jobcentre Plus and indeed in Remploy, or any others who are actively engaged in this important area of public policy, do not engage employers and deploy the business case for supporting mental illness and reducing absence rates. I have talked to employers in my time who think that absence rates are nothing to do with them. They said that it is for doctors to sort out, which is so old-fashioned as to be positively dangerous. There is a business case, which again the Sayce report clearly makes, that if we get this properly done, well-being can be increased and the public purse can be better off.

My test for the improvement suggested by my noble friend Lord German was whether more Jobcentre Plus people were engaged with more business people—particularly managers, if I can mention them. If you really capture the imagination of managers in their workplace, not only do you deal with the individual case in front of them but the whole workplace can become transformed and it is much better value for money.

Finally, in the weeks and months as we go on, I would like to continue to explore how regional variations pan out, because I deduce from the fact that there are quite big variations in some of these policy roll-outs that best practice is not being shared. That is another thing that Jobcentre Plus could do. This is a very important subject. I confess that I had not realised just how important it was until I started looking at some of these stats. I am sure that the Minister is on the case and very much look forward, as other noble Lords are, to hearing his response to this important debate.