Musculoskeletal Conditions and Employment

Tom Randall Excerpts

Wednesday 10th January 2024 Westminster Hall

[Tom Randall (Gedling) (Con)]

It is a pleasure to serve under your chairmanship, Dame Caroline. I congratulate the hon. Member for Wirral West (Margaret Greenwood) for bringing this very important subject to the House. This is a timely debate and, as she outlined in her speech, getting various parts of the population into work and getting people back into work are popular with the Government at the moment, but they are important on their own terms as well. She properly outlined the human cost that these conditions cause in her speech. Via the charity Versus Arthritis, which does so much good work in this field, one of my Gedling constituents commented on her condition:

“Living with arthritis changes you and turns your world upside down.”

I know that that will be the experience of many people.

Although the human cost is very important—and perhaps the most important factor—it is worth focusing on the economic cost, given that the focus of this debate is employment. It is also worth looking at some of the steps that the Government are taking to try to mitigate this. Conditions such as arthritis in the popular imagination are perhaps still thought of as being something that affects pensioners. That is the popular image, but we know, and we should know, that it is far more widespread than that. More than 10 million people in the UK—one in six of our constituents—have arthritis; that is one in six of our constituents with pain or fatigue and with restricted mobility. People with arthritis are 20% less likely to be in work than people without arthritis and 12% of sickness absence in the NHS between September 2021 and August 2022 was due to back problems and other MSK conditions, which illustrates how widespread this is.

I declare an interest as the co-chair of the all-party parliamentary group for axial spondyloarthritis, but the charity that supports people in that space, the National Axial Spondyloarthritis Society, estimates that a patient aged 26, who has waited eight and a half years for an axial spondyloarthritis diagnosis is likely to lose around £187,000 in their life, the majority of which derives from a loss of productivity due to reduced employment. The average patient incurs costs of around £61,000 in out-of-pocket expenses while waiting for a diagnosis, including the cost of medication, travelling to appointments and private healthcare appointments such as visits to chiropractors. The scale of this issue is quite staggering. According to the Office for National Statistics, 23.3 million working days were lost in 2021 due to musculoskeletal conditions. The cost of working days lost due to osteoarthritis and rheumatoid arthritis was estimated at £2.58 billion in 2017, rising to £3.43 billion by 2030. There is a definite need to address this with some urgency.

In that light, I welcome the announcement in the last Budget of over £400 million in funding for employment support and resources within MSK and mental health services, with £100 million specifically to support people with MSK conditions. That funding includes tailored employment support within MSK and mental health services in England, including expanding the well-established and successful individual placement and support scheme and scaling up MSK hubs in the community. The experiences of people with arthritis and MSK conditions must be at the heart of that extension and the development of new services, to ensure that the Government create efficient resources that meet the needs of people with MSK conditions. I understand that the IPS scheme is already well established for people with mental health problems and they are usually referred to it from within the healthcare system. Having that support on offer and available to people with arthritis and MSK conditions could mean that they find suitable work that does not have a negative impact on their MSK health.

The Government have said that they will ensure digital resources such as apps for the management of mental health and MSK conditions are readily available so that more people can easily access the right support for them. I hope that that will include employment support. While the Budget leans towards a digital first approach, as everything does these days, I hope that the combination of apps and tailored employment support within a community will allow people to access support in a variety of ways and choose the method that suits them.

I also welcome the recent announcement that employment advisers will be introduced into MSK pathways to support people with MSK conditions back into work. People with arthritis and MSK conditions need equitable access to employment support programmes.

[Mr Gregory Campbell (East Londonderry) (DUP)]

On the issue of employment support, does the hon. Gentleman agree that it is important that advisers and people in that position understand some of the lesser-known conditions? For example, I have had some experience of syringomyelia of the spinal cord. Knowledge and experience of such conditions at an early stage can help considerably to keep people in work or get them back into work if they have been off.

[Tom Randall]

The hon. Gentleman is absolutely right. We need to be smart. We can talk about MSK as an umbrella term, but within that there are lots of different conditions with different symptoms that affect people differently. That is where we need to be smart. Some people will have conditions that enable them to work on some days, while flare-ups on another day might prevent them from doing so. A one-size-fits-all approach is probably less likely to work. If we are serious about getting people back into work, which we should be, we need to be creative about that and try to recognise, as the hon. Gentleman said, the broad range and spectrum of conditions and how they affect different people. That is a difficult task, but it is something we should certainly aim for.

Programmes such as Access to Work may not, on the surface, appear relevant to many people with arthritis who might not consider themselves to have a disability, but they need to have access to such programmes. Following the hon. Gentleman’s comments, the potential impact of arthritis and MSK conditions on people’s ability to work and their experiences of work can be misunderstood, particularly when the severity of conditions fluctuates unpredictably over time. I hope that, as he said, employment advisers are skilled and confident in supporting people with arthritis and MSK conditions, and that they receive the training they need to know how they affect people’s experiences of employment.

Perhaps the most important thing we need is a change of mindset. Over recent decades, we have revolutionised the way in which we approach wheelchair users and talk about mental health in the workplace: we are more positive about and accommodating of various things. We have been open, embraced that and made the necessary adaptations to bring people into the workplace, but we have not quite got there with musculoskeletal conditions, arthritis and other things. The Government and employers should create flexible workplaces so that people can participate in society. That change of mind—that forward thinking—will be good not only for society and the Exchequer but, most importantly, for the people involved. Instead of being at home in pain, they will be out in employment, which will be fulfilling and good for them. That is what we should be aiming for. It will perhaps be a long process, as it is about changing minds, but we should commit ourselves to it today.