Musculoskeletal Conditions and Employment

Rupa Huq Excerpts

Wednesday 10th January 2024 Westminster Hall

[John McDonnell (Hayes and Harlington) (Lab)]

I want to continue in the same spirit as the hon. Member for Gedling (Tom Randall). It is entertaining and sometimes enjoyable to have debates in which we just kick the Government and other political parties, but Westminster Hall debates are often a way to share information about our own experience of policy development and our constituents with the hope that the noise we make is listened to by the Minister and their advisers. We often find that there are shared issues that we can all learn from.

As the hon. Gentleman said, in the past there was almost a stigma around MSK conditions. Back pain was seen as an easy excuse to pull a sickie, when actually it is incredibly significant for individuals’ lives and, as the hon. Gentleman and my hon. Friend the Member for Wirral West (Margaret Greenwood) said, for the economy overall. I congratulate my hon. Friend on putting this issue on the agenda.

I want to go through the experience of my constituency and set out what has led me to the debate. At Heathrow airport, which is in my constituency, there was almost an epidemic of back injuries among baggage handlers. Some Members may recall, when they went through the airport over the years, that there were different campaigns about the weight of the baggage. Although mechanisation was introduced, the work nevertheless involves physical exercise, so we had an epidemic of people who were going sick as a result of back pain. We went through all those allegations of people fraudulently going sick, but when we did the investigations, working with the employer and the trade unions, we discovered the scale of the back injuries over almost a generation, along with the consequences.

The lesson we learned is that, through joint campaigning with the employer, the trade unions and local health bodies, we were able to introduce practices that minimised the damage that was being done to these individual workers, even though the problem continues. For large employers, it is easier. The epidemic of back injuries in my constituency at the moment is among smaller employers, whose actions are often on the margins of legality and they fail to take reasonable care of their employees.

Through airport campaigns, which involved Unite, GMB, the Public and Commercial Services Union and other unions coming together, we found that we needed engagement with the HSE at the earliest stage. We need guidance in place that can be applied so that the employers recognise their responsibilities and the trade unions representing their members can enforce the guidance through negotiation and, if necessary, through various forms of industrial action if individual employers are not adhering to those guidelines.

This is not in any way an attack on the Government or anything like that, but I want to flag up the resourcing of HSE, which my hon. Friend raised. There is an issue here that has to be addressed. I know that individual Ministers have to fight their corner with the Treasury for resources in their patch. Whenever the Minister goes into budget negotiations for her field again, she will have cross-party support for securing additional resources for the HSE. The current denial of those resources means that inspection and intervention processes are not working as effectively as they should to prevent actions that put people’s livelihoods in danger as a result of back injuries. One problem is that small companies are infrequently inspected these days, which means that incidents are arising where companies are ignoring basic guidelines set out by the HSE.

With regard to incidence, my hon. Friend the Member for Wirral West has set out the scale of the problems. I want to congratulate Versus Arthritis, which works so hard. We are all drawing on the briefing we received from the organisation.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

My right hon. Friend, who is a near neighbour of mine as a Heathrow MP, is making a powerful case. He mentioned Versus Arthritis, of which my constituent, Julian Worricker —as a media person, you will know him, Dame Caroline —is a champion, as am I. My right hon. Friend talked about big or large employers. Some of their advice is well intentioned, such as the information on diet for people with arthritis, saying they should have oily fish, omega 5, extra virgin olive oil and all this healthy stuff. In a cost of living crisis, that may be difficult for people to buy when it is so much cheaper to get Iceland stuff for 99p or whatever it is, with loads of fat in it. Does my right hon. Friend agree with me?

[John McDonnell]

I am glad my hon. Friend has raised that matter in advance of my raising it. Poverty almost certainly relates to that, as it does to work practices, particularly with regard to hours of work. Fatigue then leaves people open to making mistakes at work, particularly around handling goods, heavy lifting and not following practices because they are just so tired. In addition, my hon. Friend’s point about diet is fundamental. A number of constituents have seen me and said, “This is the advice from my local doctor or whoever about what I should be eating, but I literally can’t afford it,” or they do not have the support they need to enable them to go on a path of healthier living and a healthier diet.

Versus Arthritis also made the point that for many of our constituents with these injuries, in the winter conditions, the cold affects them. There is nothing in the financial support that we give people that reflects or effectively deals with the incidence of cold. From the briefing we have all received, for my constituency the figure is 15,000 people. In other words, one in six people in my constituency have some form of condition. They are in pain, they experience fatigue and at times have restricted mobility. That is an epidemic by any calculation, and it has an impact on the economy overall. However, for many of the constituents I have met, it is also savaging their quality of life and, as a result, some of us have a sense of urgency about the need for action.

I have to raise the issue of waiting times for diagnosis and treatment, which has become a real problem. In my area, the numbers waiting more than a year for operations and interventions are better than some: the national average is 6%, whereas in my area it is 3%. We are performing better than the national average, but even 3%, which is a couple of hundred people waiting more than a year in my area, is a significant number. Hon. Members will know that when we meet those people, they are waiting in real pain and I am finding that the mental health consequences are significant too. People are desperate to support their families and they feel guilty that they are not doing so. At the same time, they are frustrated because they literally do not know what to do in that waiting period. I come to the points the hon. Member for Gedling made with regard to support and access to work. I cannot agree with him more about the significance of this. While I welcome the additional funding that has come from Government, we have found in the past—this relates to the work capability assessment, which I will come on to—a lack of expertise in assessment and advice. Exactly as the hon. Gentleman said, there is a range of conditions and, in many instances, very specific advice is needed—even at first assessment. We have to bring relevant expertise into the pathways at every stage and be capable of drawing on that, otherwise we just get things wrong. If the wrong advice is given, that adds to the pressure and stress on the individual.

The issue with the work capability assessment, which we have been dealing with since its inception, is—to be frank—the brutality of it. The regime has now become even harsher. We have been in debates here on a number of occasions, and we have even heard of suicides taking place as a result of the work capability assessment implementation. That relates to the lack of expertise in the assessment. Harsh conditions are placed on people who cannot meet those conditions, and as a result they lose their benefits. In addition to losing their benefits, there is a feeling of guilt and ostracisation in the community itself, and a stigma attached.

It is important that the Minister sits down with the Public and Commercial Services Union, which represents the civil servants administering these benefits. They are saying to us that their caseloads have increased dramatically, and that as a result they do not feel they have sufficient staff to deal with individual cases effectively. The pressure that many of their members are under is unacceptable, and the problem of being able to deal with their caseload properly has become insurmountable.

My final point is about the strategy for the future. The key thing that comes out of discussion with virtually every organisation we meet, whether it is Versus Arthritis or the Royal Osteoporosis Society, is the importance of engagement with the sufferers themselves and their representatives. It is similar to the disability principle, “Nothing about us without us.” Engagement with MSK sufferers is absolutely key to developing the future strategy. I also put in a plea for engagement with the trade unions representing many of the workers who have been involved in back injury cases and in prevention work. The hon. Member for Strangford (Jim Shannon) made a point about small businesses. The Federation of Small Businesses has really been helpful on a whole range of these issues, not only about how it can advise its members on best practice, but also reporting back on what it feels are impediments to getting people back into work, and the support needed for small businesses to make reasonable adjustments for people suffering from these conditions.

There is a desperate need to move forward. I welcome what additional money there is, but it will not be used effectively unless there is proper engagement with all concerned with the experience that we have had over the last generation. In my constituency, I am hoping that we can overcome the issues of access to proper advice and to health treatment, and do much more on the preventive side, because many of my constituents are disabled for life as a result of past practices.