Disabled People

Lord Luce Excerpts

Thursday 28th June 2018 Lords Chamber

[Lord Luce (CB)]

My Lords, it has been a most humbling experience to take part in this debate and listen to the very moving contributions that have been made. It was very ably led by the noble Baroness, Lady Thomas, and had an inspiring maiden speech by the right reverent Prelate the Bishop of London.

I will concentrate on what the Government are doing to help the millions of people with long-term health conditions to stay in work or to get back to work if they have been put out of their job. I have particularly in mind people suffering from musculoskeletal pain, chronic pain and the overlapping mental health problems, simply because I have experienced it for more than 45 years myself.

For the past 10 years, I have worked with the Chronic Pain Policy Coalition, focusing on the more than 8 million who suffer from chronic pain and back problems. Very many need multidisciplinary support. If we look back seven years to 2011, after 50 years’ experience of the sickness absence system, a fresh proposal came forward under the leadership of Dame Carol Black, with a report entitled, Working for a Healthier Tomorrow and a second report, Health at Work—an Independent Review of Sickness Absence. There were clear proposals on how to make it easier for people to stay in their jobs, including, first, the establishment of a health and work advisory assessment unit and a fit for work service, emphasising the capacity of the patient to return to work and not their incapacity; and, secondly, to include an occupational health work-focused assessment for employees off sick, or likely to be off sick, for more than four weeks.

On top of that there was a proposal for an advice service for employees, employers and GPs on this subject. The benefit for everybody if it succeeds would be employees with a better quality of life and retaining their jobs, employers with a more productive workforce, and, for the Government, there would be overall economic benefits. Indeed, looking back to 2000, when the last figures were available, chronic pain cost the economy well over £10 billion.

The Government have made progress and there is a higher proportion of disabled people in work now than four years ago. I welcome that, but much more needs to be done. Last November the Department for Work and Pensions produced a Command Paper entitled Improving Lives: the Future of Work, Health and Disability. Having read that, I conclude that the Government sense that the fit for work service experiment, as conceived by Dame Carol Black, has failed—or, at the very least, stumbled badly. The Government seem to be proposing in that paper that there should be a fresh approach to this challenge, not least in strengthening the occupational health service—at the moment, there are very few people in that profession—and helping employers and employees in different ways to improve the service.

The Government have set the challenge that we must be in a position by 2019-20 to set out a clear direction and strategy for future reform. To their credit they have set up an expert working group on occupational health to champion, shape and drive the work, plus an interministerial group to co-ordinate. I should emphasise that most employers, especially small businesses, cannot afford to employ occupational health people, and it is these small businesses that are most vulnerable and need most support for their employees. There are some good examples of employers who have a very good occupational health service, helping their employees and co-ordinating with the health service. So I look forward to hearing from the Minister her and her Government’s assessment of the former fit for work scheme and how the Government have decided to learn the lessons of the last four years to remove the obstacles to the success of the scheme and to make it work properly, to the benefit of all concerned.