Health: Migraines

Viscount Younger of Leckie Excerpts

Tuesday 24th October 2023 Lords Chamber

[Lord Londesborough (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and declare an interest as a migraineur.

[The Parliamentary Under-Secretary of State, Department for Work and Pensions (Viscount Younger of Leckie) (Con)]

My Lords, NHS England estimates that 10 million people live with migraine in the UK, and that 3 million workdays are lost every year due to migraine-related absenteeism, which costs almost £4.4 billion. The Government are focused on supporting people with health conditions, including migraine, to remain and thrive at work through initiatives such as the Disability Confident scheme and the expanding access to quality occupational health provision and through evidence-based NICE guidance, which supports healthcare professionals and commissioners.

[Lord Londesborough (CB)]

I am very grateful to the Minister for his response to a Question that was last asked in this House in 1961. Fast forward 60 years, and the NHS devotes less than £200 million a year to treating a condition that, as the Minister says, affects 10 million people in the UK—many undiagnosed—and which costs us, according to my figures, backed up by the Migraine Trust, some £10 billion per annum. That figure comes from adding the fiscal and health burdens to the widespread loss of productivity across the economy. Given the slow and limited access to effective treatments, the lack of GP training and a shortage of neurologists, does the Minister agree that this invisible disability deserves much greater priority and resourcing across the NHS?

[Viscount Younger of Leckie (Con)]

I first congratulate the noble Lord for highlighting an important matter that has eluded the acute collective mind of your Lordships’ House at Questions for far too long. To add to what the noble Lord was saying, the House may know that migraine is the third most common disease in the world, behind dental caries and tension-type headaches. To answer his Question, I reassure the noble Lord that migraine and neurological conditions more generally are taken very seriously by the NHS. The Getting it Right First Time programme’s national specialty report on neurology makes specific recommendations on migraine care and is complemented by the NHS RightCare headache and migraine toolkit.

[Lord Allan of Hallam (LD)]

My Lords, the NHS website helpfully provides real-time information on wait times for headache and migraine referrals. Less helpfully, these currently range between 33 weeks and 53 weeks in my area of England. Is the Minister concerned about the impact of these wait times on the workforce, and would he support making structured headache services available in primary care so that we can try to get people to treatment more quickly?

[Viscount Younger of Leckie (Con)]

The noble Lord makes a very good point. Those who unfortunately suffer from migraine—as we know it comes in different types, stages and forms—can call 111, go to their GP if they can get an appointment quickly or go to their local pharmacy. I hope the noble Lord will find it helpful that the NHS workforce plan, announced recently, includes £2.4 billion funding over the next five years and provides projections for the help needed for dealing with such conditions.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the noble Lord’s original Question focused on the impact on the workplace. There is a lot of evidence from the Migraine Trust that employers are very unsympathetic to employees suffering from migraine. Does the Minister agree that, if the Government are to take forward a more cohesive strategy, education and working with employers to understand the impact of migraine on many of their employees may well pay dividends?

[Viscount Younger of Leckie (Con)]

The noble Lord, who has more experience in these matters than me, is quite right. My understanding is that, where an employee suffers from migraine, if the employer does not take it seriously or make certain allowances, this has a great detrimental effect on the employee. The noble Lord will know that the law says someone is disabled if they have a physical or mental impairment that has a

“substantial and long-term adverse effect”

on their

“ability to carry out normal day-to-day activities”,

including work. There is work to be done engaging more with employers to make sure they have that understanding.

[Baroness Sherlock (Lab)]

My Lords, can we clear that up? The Migraine Trust has had many sufferers saying they have been discriminated against at work. Some are forced into part-time jobs or even out of work. Given that the top triggers for migraine in the workplace include lighting, noise, stress, screens—things that employers could control—is the Minister concerned that, according to a Migraine Trust survey, over half of people affected said their employer had not made reasonable adjustments for them to stay at work, even though, as the Minister has just said, the law requires them to do that? What does he have to say to that?

[Viscount Younger of Leckie (Con)]

The noble Baroness is completely right. This follows on from my answer to the noble Lord. It is very important that employers get the message that they must make reasonable adjustments. It also brings into question whether someone should say that they are suffering from migraines when, for example, they go to an interview. Nobody has to tell their employer or potential employer that they are disabled, where that would be the right word to use. As I have said, more work must be done to ensure that employers have a greater understanding. It is of course in their interests to do so because, with that understanding, the employee’s productivity will be greater.

[Baroness Bennett of Manor Castle (GP)]

My Lords, the Migraine Trust and others are highlighting the fact that, as well as new drugs coming through the treatment pipeline, there is the—quite complex—possibility of treating migraine through diet. This is a very complex area. The chair of the British Association for the Study of Headache is calling for a nationally agreed educational framework and quality standard for primary care. Does the Minister agree with me that it would make sense to give GPs and other health professionals the tools to approach this in an organised way using the best possible treatments?

[Viscount Younger of Leckie (Con)]

The noble Baroness is quite right. It allows me to say—I asked about it during briefings—that GPs are given regular updates and training on how to treat migraines. I also asked as to whether the training was taken up properly by GPs, who we know are under pressure, and the answer is yes. Coming back to pharmacies, greater training is being encouraged and given by the Government to be sure that those who work in pharmacies have a greater understanding in terms of giving direct and more immediate treatment for migraines.

[Baroness Meacher (CB)]

My Lords, migraine is indeed unpleasant, but does the Minister have any estimate of the number of people who suffer from chronic fatigue syndrome in this country? It is a deeply serious affliction that certainly prevents people from working for long periods and there is no effective treatment. Can he comment on the numbers and research into treatment?

[Viscount Younger of Leckie (Con)]

I might be able to help the noble Baroness in some way. It is estimated that 190,000 migraine attacks occur every day in the UK. Over three-quarters of people who get migraine have at least one attack each month. Chronic migraine—it is a justified question—when a person gets a headache on 15 or more days a month, eight of them migraine, is less common but affects about two in 100 people.

[Lord Blunkett (Lab)]

My Lords, I have a non-pecuniary interest to declare. All this discussion on the advice that employers clearly need surely leads us to believe that we need a national occupational health programme, which could save tens of billions of pounds. Does the Minister agree?

[Viscount Younger of Leckie (Con)]

I will certainly reflect upon that and take it away, but I have given some idea as to the work we are doing with employers and—I say again—it is an incredibly important issue for all employers, particularly small businesses. There are 5.4 million or so of those in this country, for which there is little access to occupational health—something I could talk about another time—where advice needed for employees who suffer is better given.

[Baroness Blackwood of North Oxford (Con)]

My Lords, I declare my interest. I have had well-controlled chronic migraine, which was not managed until I was able to access a specialist. It was welcome that NICE recently approved a new drug for acute migraine and noted that the condition affects every aspect of life. Currently, when triptan is ineffective, there is no further standard treatment and people are advised to see a specialist. However, there is a significant shortage of access to those specialists and long waiting lists. I return to the question from the other side of the Chamber. What can we do to improve access to those specialists, get more migraines under control and those people back into the workplace? What would the Minister’s response be to the provision of something like migraine hubs such as those we have for musculoskeletal conditions?

[Viscount Younger of Leckie (Con)]

Indeed. Just to echo what my noble friend said, as she will know, migraine treatments include painkillers such as ibruprofen and paracetamol, medicines called triptans, to which she referred, and medicines including anti-emetics which stop one feeling sick. More than that, I allude to the NHS national workforce plan, whereby we have a long-term vision for the training required and individuals that we need to help deal with this difficult affliction.