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.

Oral Answers to Questions

Tom Randall Excerpts

Monday 6th March 2023 Commons Chamber

[The Parliamentary Under-Secretary of State for Work and Pensions (Mims Davies)]

The Government are projected to spend £30 billion—about 1.3% of GDP—on support for renters. Approximately £100 million has been allocated for the discretionary housing payment in 2023-24 to help local authorities, if necessary, which can top up from their own funding to help the hon. Lady’s constituents.

[Tom Randall (Gedling) (Con)]

T5. A constituent of mine who has been in full-time work since he was 16 is now in his mid-40s and is unable to work as he awaits major surgery. For people like him, navigating a complex welfare system for the first time is difficult and worrying. Does my hon. Friend agree on the importance of people such as my constituent being able to access clear advice about the welfare benefits system to remove added financial worries? Will he outline the support available for people in such circumstances to access high-quality occupational health support to help them get back to work?

[Tom Pursglove]

I wholeheartedly agree with my hon. Friend and send my best wishes to his constituent for their surgery. The Department offers support through disability employment advisers who work alongside all work coaches, specialising in finding the right support to help customers who have a disability or health condition into work. I know that the dedicated team in Nottinghamshire would certainly be delighted to engage with my hon. Friend or his constituent and try to help with this issue.

Oral Answers to Questions

Tom Randall Excerpts

Monday 11th July 2022 Commons Chamber

The Secretary of State was asked—

[Tom Randall (Gedling) (Con)]

1. What estimate she has made of the number of universal credit claimants in Gedling constituency who will receive a cost of living payment.

[The Parliamentary Under-Secretary of State for Work and Pensions (David Rutley)]

Despite what has happened today, our spirits will not be dampened, and I am sure that the Chamber will be in full flow before we know it.

Universal credit claimants who received at least 1p during assessment periods that ended between 26 April and 25 May 2022 will be eligible for the first instalment of a cost of living payment worth £326. Latest statistics show that 4,800 households in Gedling were in receipt of universal credit in February 2022.

[Tom Randall]

Will my hon. Friend confirm when the more than 10,000 households in my Gedling constituency that are eligible for a cost of living payment should expect to receive that help from the Government?

[David Rutley]

The first instalment of the means-tested cost of living payment of £326 will be paid to eligible households from 14 July. I am pleased to remind colleagues that the payment is the first in a £15 billion package of measures to help households this year.

Pension Schemes (Conversion of Guaranteed Minimum Pensions) Bill

Tom Randall Excerpts

2nd reading
Friday 26th November 2021 Commons Chamber

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

I beg to move, That the Bill be now read a Second time.

First, I want to congratulate the right hon. Member for North Somerset (Dr Fox) on the progression of his Down Syndrome Bill, which I very much support.

My Bill makes changes to the legislation governing the way occupational pension schemes can convert guaranteed minimum pensions into other scheme benefits. The Bill is very technical looking, but it is extremely important. It will help occupational pension schemes to correct a basic issue of men and women being treated differently in those schemes because of the impact of having a guaranteed minimum pension. It will help enable pension schemes to ensure that people do not receive less pension income than they would have received if they had been the opposite sex. In other words, it will help schemes to correct a situation that has been judged since 1990 to be fundamentally unfair.

Guaranteed minimum pensions, or GMPs, are the minimum pension that certain occupational pension schemes have to provide to their members. This applies to occupational pensions contracted out of the additional state pension between April 1978 and April 1997. It ensures that members receive a broadly similar amount of pension income in retirement as they would have received had they not been contracted out.

However, guaranteed minimum pensions differ for men and women, reflecting historical differences of treatment in the pension systems based on sex. People with the same employment history can have different amounts of guaranteed minimum pension depending on whether are men or women, even if they do exactly the same job for the same time at the same salary. It is not even as straightforward as men getting higher guaranteed minimum pensions than women; in fact, both men and women can lose out on pension as a result of their sex.

Successive UK Governments have made it clear since 1990 that occupational pension schemes need to equalise pensions to correct for these effects of guaranteed minimum pensions. In 2018, a High Court judgment confirmed that occupational pension schemes must equalise pensions to address these differences. Speaking as someone who has worked and built up occupational pensions of my own, it seems wrong that people can lose out on even a small amount of pension income purely because of these differences. Occupational pension schemes are therefore required to do something called equalisation—going back and correcting people’s overall pension to ensure that it is not lower than it would have been had the person been of the opposite sex.

[Tom Randall (Gedling) (Con)]

I thank the hon. Lady for bringing the Bill forward. She is talking about the history of this technically complex issue, which goes back to 1990. Does she agree that the changes introduced by the Bill are well overdue and that, by bringing it forward, we will get the change that we should have had a long time ago?

--- Later in debate ---

[Tom Randall (Gedling) (Con)]

As legislators, we look at the proposed legislation before us when we are preparing to speak in debates. As I was preparing to speak in the previous debate, I picked up the Down Syndrome Bill and, from the face of the Bill, was able to very quickly glean what it was about and understand its general thrust. As I picked up this Bill to prepare, however, I read that

“GMP conversion” means—

(i) the amendment of a scheme in relation to an

earner who was alive immediately before the

conversion date so that it no longer contains the

rules specified in sections 13(1)(a) and (b) and

17(1)”.

I am glad we have got that cleared up. So I congratulate the hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) on not only introducing the Bill, but bringing it to life and explaining it in a way that this pensions layman was able to understand. I feel that I have made much more progress in the last half an hour than I have in the last few days of trying to get to grips with the Bill.

As I understand it—as I say, I claim to be no expert in this field—what we are seeing today is the end of a very long journey towards equality which we should have addressed before now, but better late than never. As I understand it, the old state pension had a number of elements to it, including a contracted-out part where one could obtain an occupational pension scheme that had a guaranteed minimum pension. Because of the way that the guaranteed minimum pension was calculated, there were various inequalities, including differentiation on a person’s sex and age as existed at that time. That has been corrected to some extent following the 1990 court case—it is bizarre that it has taken so long for us to get to this stage—but I understand that the industry has a number of concerns that are still extant with the existing legislation, including how conversion applies to survivor benefits, the element that can be inherited by a member’s widow. It does not provide for circumstances in which a scheme’s sponsoring employer no longer exists and cannot consent to a proposed conversion exercise, and also in terms of requiring schemes to notify HMRC that they have carried out the conversion exercise.

I understand that the Bill will

“Clarify that the legislation applies to survivors as well as earners.

Provide for a power to set out in regulations the conditions that must be met in

relation to survivors’ benefits.

Provide for a power to set out in regulations detail about who must consent to the conversion.

Remove the requirement to notify HMRC.”

It is a technical piece of legislation, but it will, I hope, bring us to the end of a long road. I congratulate the hon. Member for Rutherglen and Hamilton West on introducing it and explaining it so cogently to us laymen, and I look forward to seeing it on the statute book very soon.

Elections Bill (Third sitting)

Tom Randall Excerpts

Committee stage
Thursday 16th September 2021 Public Bill Committees

[Paul Bristow]

Thank you.

[Tom Randall (Gedling) (Con)]

Q Mr Mcleod, good afternoon. I would just like to clarify a couple of points. You said in your evidence earlier that you had seen stuff. You are here as the chief executive of a charity, Race on the Agenda. The charity has not commissioned any research into this matter at all?

Maurice Mcleod: No, it has not.

[Tom Randall]

Q So, there is no primary evidence about participation? You are just commenting on stuff that you have seen in the press or elsewhere?

Maurice Mcleod: Absolutely. I am not claiming that this is based on any specific research that ROTA—that is my organisation—has done. There is an amount of research out there, I guess.

[Tom Randall]

Q Sure. We heard some evidence yesterday about voter fraud and where it has occurred. We heard evidence from Tower Hamlets, as we discussed, and Slough and inner-city Birmingham, where voter fraud has occurred. Those places tend to have higher non-white populations than other places. Would you agree that the serious victims of voter fraud are ethnic minority people?

Maurice Mcleod: I would argue that it is all of us. If there is anything going wrong with our electoral system, we all suffer. We might end up with a Government who we do not want or a local authority that did not actually win the vote. We all suffer if there is voter fraud.

[Tom Randall]

Q To the extent that it does occur, if voter fraud affects an area, it is more likely to affect—as we heard yesterday, the biggest victims in Tower Hamlets were the Bangladeshi population, who were disenfranchised because an election was stolen from them. If we agree that it is a problem, it is going to affect non-white populations in this country.

Maurice Mcleod: Yes, if we agree that it is a problem. I am afraid that I have not seen the evidence from Tower Hamlets, but I will take your word for it; I am sure you are right. Like I say, I am not sure whether it would have been solved by the measures that you are talking about bringing in, but if it is a problem, everyone suffers. I do not think just the residents or the voters in a particular area who might be disenfranchised suffer. We all suffer because our system does not work properly then.

[Tom Randall]

Q Sorry, you say you don’t know, but perhaps examples from Tower Hamlets are more pertinent than examples from the United States.

Maurice Mcleod: Yes—sure, of course. Absolutely. But I would also like to know how prevalent this is. Is it a one-off situation in one place that needs to be dealt with in a particular way, or is it an endemic thing in our system? I am not really convinced that it is endemic in our system. I guess that is what I am saying.

[Tom Randall]

Q Finally from me, we talk about how it affects ethnic minority groups, but that is not one group of people. Do you accept that there is a lot of diversity within that? When you say that this might have a particular effect on minority groups, what does that mean in practice?

Maurice Mcleod: Do you mean the voter ID measures?

[Tom Randall]

Yes.

Maurice Mcleod: If there are particular groups—the Gypsy, Roma and Traveller community was mentioned earlier; those communities are particularly vulnerable to this—who, for one reason or another, are less likely to have the ID required, the impact will fall disproportionately on them. If a larger percentage of black Caribbean people do not have this ID, bringing in the measure will have a bigger impact on them.

[Tom Randall]

Q My understanding is that Cabinet Office data suggests the reverse of that. That is your supposition on this point, but you have commissioned no research to back that up?

Maurice Mcleod: No, I have not.

[Patrick Grady]

On a point of order, Ms Rees. Can I just confirm that witnesses have been invited to speak to this Committee on the basis of their experience and there is no requirement or expectation of any of the witnesses who appear today or who appeared yesterday to back up their evidence with primary source research evidence? We have not asked any other witness to detail the evidential base. We are entitled to ask questions and witnesses are entitled to respond on the basis of their experience. Can I confirm that, please?

Universal Credit and Working Tax Credit

Tom Randall Excerpts

Monday 18th January 2021 Commons Chamber

[Tom Randall (Gedling) (Con) [V]]

Opposition day debates are allocated to the Opposition by the Government, and in the Opposition’s social media noise, they do not mention that on such days, while matters are debated and discussed, they are not decided on in the same way as they are through the ordinary legislative process. They are not backed up by White Papers or detailed policy, yet the Opposition rely on the public quite understandably not knowing the difference.

After the last Opposition day debate, my Labour predecessor dutifully posted the centrally supplied Labour attack graphics, and had to wade into the vitriolic comments under his Facebook post to ask posters to take care with their language, to which the first reply was:

“can we say Scum? Asking for a friend”.

This is just a mild example of what happened as a result of the last debate—a direct consequence of the efforts of the Labour party to stoke up an emotionally charged atmosphere at a difficult time. I can cope with that bad language, but I know that colleagues faced worse, including threats that required police intervention. So I hope the Opposition will consider carefully—I heard their spokesman’s comments earlier—the impact of their choice of language when they present the reality of this non-binding vote. It would also be helpful if the Opposition could present a motion that is consistent with their Front-Bench policy. Their stated aim is to abolish universal credit. What would that achieve? Chaos. Imagine if Department for Work and Pensions staff, plunged into an unexpected epidemic, had been forced to try to operate a number of different benefit schemes. The welfare system would have struggled to cope. The resilience of the system is a tribute to the sterling work of DWP staff, who have faced a challenge, stepped up and met it. I thank all the staff at the jobcentres that serve Gedling. I have been inspired by their enthusiasm over the last months.

In the last Opposition day debate on free school meals, I said that, although Labour might claim a moral victory, it did not address the fundamental issues, which the Government had to now address. Very much the same applies today. This Government are taking action: the hardship fund; the covid winter grant scheme; the kickstart scheme; the restart scheme; millions of pounds of support for councils to help the poorest; the holiday activities and food programme; the flexible childcare fund; the furlough scheme; bounce back loans; rates relief; VAT deferrals; protection for renters; mortgage holidays; and much, much more. This is all supporting Gedling residents during these difficult times. While Labour plays on people’s emotions, it offers no solutions, and this Government are offering to support the most vulnerable in society. I know they will continue to do so at the next Budget, when spending matters will, quite properly, be announced. So in this debate, the division is clear, and I know which side I am on.

Oral Answers to Questions

Tom Randall Excerpts

Monday 19th October 2020 Commons Chamber

[Will Quince]

It is right that those claimants who owe the Department money are able to resume payments to reduce their debt. We continue to apply a flexible approach to recovery and endeavour to recover without causing undue financial hardship. Anyone unable to afford the rate of recovery proposed is encouraged to contact the Department so that an affordable rate of repayment can be negotiated. In May, we will be launching the breathing space scheme to help to prevent problem debt and provide support to people who fall into that problem debt.

[Tom Randall (Gedling) (Con)]

What steps her Department is taking to ensure people of all ages have access to the job market.

[The Parliamentary Under-Secretary of State for Work and Pensions (Mims Davies) [V]]

Our plan for jobs includes suitable interventions for people of all ages to support people back into work, including employment support delivered by our jobcentres, where we are doubling the number of work coaches across our national network. Last week, I held my latest meeting with our older workers champion, alongside employer organisations, focused on our fuller working lives agenda and opportunities for the over-50s.

[Tom Randall]

In the current pandemic, people of all ages are suddenly being made redundant. I was recently contacted by a 57-year-old constituent in Gedling, who is now looking for work and retraining. Does my hon. Friend agree that it is particularly important to help this sector of the population, and what help can I offer to my constituent to ensure that her skills are utilised?

[Mims Davies]

I thank my hon. Friend for raising this concern in his constituency. I assure him that the Government recently announced, in the plan for jobs, new funding to ensure that more people, including our older workers, get tailored Jobcentre Plus support to help them to find work and build the skills they need to get into new work, including the sector-based work academy programme and our new online job-finding support service. On 29 September, the Prime Minister announced a major expansion of post-18 education and training to prepare all workers for a post-covid economy, including a lifetime skills guarantee to give adults the chance to take free college courses by valued local employers.