Musculoskeletal Conditions and Employment

Vicky Foxcroft Excerpts

Wednesday 10th January 2024 Westminster Hall

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

It is a pleasure, Dame Caroline, to serve under your chairship, and I am grateful for the opportunity to respond to this debate on behalf of the shadow work and pensions team.

I congratulate my hon. Friend the Member for Wirral West (Margaret Greenwood) on securing this debate. She is absolutely right to say that the Government must have a cross-departmental strategy to address this issue, and must ensure that the Health and Safety Executive is properly funded to ensure that all of us are safe in the workplace. They do that alongside trade unions. Many important points have been made in the debate and I hope that the Minister will respond to them in detail.

I apologise to my right hon. Friend the Member for Hayes and Harlington (John McDonnell), because I must make a little criticism of the Government and nudge them at this point. The Minister will already be aware of my thoughts about the Prime Minister’s decision to downgrade her role as the Minister for Disabled People, Health and Work. I assure her that I will do all I can to get her and her role repromoted to where they should be. It is so important that we do that.

The number of people who are economically inactive because of long-term sickness has risen to over 2.5 million, which is an increase of more than 400,000 since the start of the pandemic, and the figure is now higher than ever. That has a huge impact on our economy, as well as on individuals’ health, wellbeing and ability to support themselves and their families.

The increase in the number of people off work because of long-term sickness since the pandemic is costing the country an extra £15.7 billion a year. Along with mental health conditions, musculoskeletal conditions—or MSK conditions, as I will refer to them, to make sure that I do not pronounce “musculoskeletal” incorrectly—are one of the main reasons for long-term sickness. They affect one in five of the people defined as being economically inactive.

As my right hon. Friend the Member for Hayes and Harlington said so eloquently and respectfully, we need proper resourcing of the HSE. That is really important in terms of cross-departmental working. Also, the HSE is a very powerful example of employers, trade unions and others working together. He cited the example of baggage handling workers. I was personally involved with such work myself before I was an MP, when I was working for Unite the union. There was a really strong campaign for those workers, and it really made a difference for them.

Over 20 million people in the UK, or almost a third of the population, have an MSK condition. However, with NHS waiting lists at a near-record high, people are waiting months for trauma treatment or orthopaedic treatment. As many people have already said, according to Versus Arthritis, over 1 million people are waiting for such treatment, many of them having to put their life on hold while they wait. In 2021 alone, arthritis and other MSK conditions resulted in the loss of 23.3 million working days.

Last month, I asked the Minister several written questions on what steps her Department is taking to help people with MSK conditions to re-enter the workforce. First, I would like to place on record my concern about the fact that the Department has made no estimate of the number of people awaiting treatment. That prompts the question of whether it really has a grip on the extent of the problem. In her response, the Minister outlined the package of measures set out in the spring Budget and the autumn statement to tackle the leading health-related causes of economic inactivity, including MSK conditions. Those measures include introducing employment advisers into MSK services, developing and scaling up MSK community hubs, and making the best use of digital health technologies, alongside various pilots and commitments to exploring new ways of providing timely support and improving occupational health problems. That is not ambitious. It is simply more pilots, and more exploring what to do, from a Government who have been in power for over 13 years. Furthermore, will the Government be open and transparent, and publish the details of those pilots? I have asked for this information in many written parliamentary questions, and sadly they are not forthcoming.

I would like to touch on two initiatives, the first of which is Access to Work. The Minister already knows some of my thoughts on this, but I will reiterate them. Her predecessor, the hon. Member for Corby (Tom Pursglove), when asked numerous times, continued to assure me that the Department for Work and Pensions has increased the number of staff working to clear the Access to Work backlog, but it does not appear to be going down. In November 2022, the backlog was 25,281, but a year later, it was 24,339. I think we will all agree that there is not much sign of progress.

Secondly, the much-criticised Disability Confident scheme is also in need of urgent reform. Recent analysis by Disability@Work shows that even employers who have achieved level 3—the highest level—are no more likely to employ disabled people than those who have not signed up to the scheme. It also shows that disabled people working for Disability Confident employers do not report better experiences than those working for employers who are not members of the scheme. The Minister’s predecessor admitted to the Work and Pensions Committee in the summer that it was time for a root-and-branch review of Disability Confident, so I am interested to know what progress has been made. I also want to add my voice to calls for an update on when the major conditions strategy will be published.

I end as others have, by paying tribute to the organisations that support people with MSK conditions—many are here today and without them many people would be struggling even more than they already are. I reiterate what my right hon. Friend the Member for Hayes and Harlington said. Government must engage with those affected by these conditions. After all, these people are the experts by experience.

--- Later in debate ---

[Mims Davies]

I thank the hon. Lady for reiterating that point for her constituents. These hubs in the community will deliver both that physical activity and those interventions. I understand her point, and I know that support for pools has come to councils from the Department for Digital, Culture, Media and Sport. What the hon. Member has said is very specific, and I will take that away in the cross-Government work that I am doing. I think, as well, that it is a lesson for many of our local authorities to think very carefully about the decisions they make and how they affect the whole community. It is vital that people understand that the wider impact might involve losing more than just swimming lessons—and that is not easy in itself. The hon. Member has rightly put that on the record for her constituents.

Employment advice and NHS talking therapies will be included in our interventions, along with individual placement and support in primary care and increasing work coach time in jobcentres. The hon. Member for Motherwell and Wishaw spoke about making sure that we listen to and engage with people, and do it in the right way, and I wholeheartedly agree with that individual approach.

All these investments are part of a much wider agenda to tackle inactivity due to long-term sickness. We also announced our Back to Work plan in the autumn statement. It includes doubling the number of universal support employment programme places; increasing occupational health take-up in businesses, including SMEs, which is absolutely key; testing new ways of providing individuals receiving a fit note with timely access to their key support; and supporting people with health-related barriers to work through the 15 WorkWell pilot areas that we are working on. WorkWell is accepting applications for funding from local areas across England, with pilot areas due to be announced in April and more details in the autumn. I will be working with the Minister for Employment, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) on this matter.

[Vicky Foxcroft]

I thank the Minister for giving way. She has pointed to a number of Government pilots and I know there are other pilots. In my contribution, I asked whether the Government would be transparent and publish data on those pilots. Does the Minister want to put on the record whether the Government would be willing to do that?

[Mims Davies]

I thank the hon. Lady for that ask. This is still being worked out. I am conscious that one of my predecessors in DWP warned about having “more pilots than easyJet” and about making sure that they work and are right. Once we have more details, I am sure we will be in a position to share them with her, so I will come back to her on that matter. It is early in my tenure, and I want to get to grips with this. When I am in a position to share, of course I will do so.

We have talked about the impact of poor MSK health on individuals and employers. We know that over 20% of employees and self-employed people have an MSK condition and that it is a leading cause of working days being lost through sickness and absence, accounting for over 23 million lost working days. My hon. Friend the Member for Gedling spelt that out strongly. Tackling these disparities and managing these conditions are absolutely key.

When it comes to women, the older population and certain ethnic groups, understanding the prevalence and the impact of the condition and doing more on prevention are key in terms of managing and supporting people. A predominant symptom is pain, which limits people’s mobility and dexterity. Living with pain is awful, managing it is incredibly stark, and it is very difficult for people to fully participate in society, so we need to make sure that people have a healthier home and working life.

We know that osteoporosis, which causes fragility and leads to fractures, disproportionately affects women. The Government’s women’s health strategy is key to understanding specific actions to improve women’s experiences and outcomes in relation to osteoporosis. I look forward to meeting Dame Lesley Regan, our women’s health ambassador, on this matter as soon as our diaries allow. I know she is very focused on this, and we will raise the profile of those issues. I have been very engaged with her in my work on menopause and employment action, and I will continue to do that.

I have talked about supporting employers and workplaces as key enablers for disabled people with health conditions to remain in work, so let me briefly cover prevention. Adults in employment spend a large proportion of their time in work. How we are engaged with in our jobs and workplaces has a massive impact on our health. Therefore, in 2022, the Government and the Society of Occupational Medicine published the MSK health toolkit for employers and further education institutions, which encourages employers to support adolescents and young adults with MSK conditions. We have also produced the MSK toolkit for employers, which has been developed in partnership with Business in the Community and provides practical information for employers of all sizes to address MSK conditions in the workplace for the working age population. We need to look at the adjustments and support there.

I thank Thriiver in my constituency, which is a brilliant group of people who deliver around £4 million to £5 million of support through the Access to Work scheme. They gave me a stark insight into what they feel should be done, which I fed back to my predecessor. We know that the grant scheme plays a key role in enabling people. The point about literacy and digital skills has been noted. I also note that the Chairman is looking at me, so I will conclude.

There are a few matters that I might write to Members about. I think we have all agreed that poor MSK health has a significant impact. The delays to Access to Work are improving—we have been forensic on that. People need support from employers, from Government, the wider economy and the NHS. We will continue to focus on good jobs to help everybody thrive and have fulfilling lives, with the benefit of health and wellbeing behind them. That is the best route out of poverty.