Craig Tracey (North Warwickshire) (Con)
I beg to move,
That this House has considered the financial effect of absence from work due to mental health problems.
It is a pleasure to serve under your chairmanship, Mr Betts. World Mental Health Day took place a week ago, and I am pleased to have secured this debate on such an important issue so close to the marking of that day. It is hugely encouraging that in the last couple of years the world has woken up to the realities of mental illness. According to the mental health charity Mind, in the UK alone, one in six workers is affected.
The issues and challenges surrounding those suffering and recovering from mental ill health have become better understood and, as a result, its prominence as a public policy issue has grown considerably. NHS England’s five year forward view dashboard provides statistical evidence of the Government’s investment in mental health services, with a total planned spend of £11.9 billion in this financial year. Encouragingly, over the last two years, there has been a total real-terms increase of 3.7%. However, despite that investment, the Government’s landmark independent review of mental health and employers last year showed that 300,000 people in the UK lose their jobs every year as a result of long-term mental health issues, and that nearly 13% of all sickness absence days in the UK can be attributed to a mental health condition.
The workplace needs to be at the forefront of better policy to secure better outcomes for sufferers. Today, I intend to focus on the financial effect that absence from work because of mental health has on the individual, their employer and, in turn, the economy. Eighteen months ago, I led a debate in this very Chamber on employers’ role in improving work outcomes for people with long-term health problems. One of the most telling pieces of information that I discovered was from the research at that time by the Mental Health Foundation, which found that 45% of working people with a diagnosed mental health problem had not disclosed it to their employer in the past five years. Of those who had felt able to tell their employer, only half reported mainly positive consequences. Someone who took part in the research concisely summed up the reality in a single line, which I am sure rings true with people here today. They said
“no one is able to say, ‘I have a mental health problem and I can’t come to work today’.”
At the time I was encouraged to hear of the review carried out by Lord Dennis Stevenson and Paul Farmer, entitled “Thriving at Work: a review of mental health and employers”. On publication, the report set out a mental health vision for our country by 2027. The report proposed that all organisations
“whatever their size, will be equipped with the awareness and tools to not only address but prevent mental ill health caused or worsened by work”;
that they would be
“equipped to support individuals with a mental health condition to thrive, from recruitment and throughout the organisation”;
and that they would also be
“aware of how to get access to timely help to reduce sickness absence caused by mental ill health”.
It is well documented that one in four people is affected by a mental health problem—the effects of which are wide-ranging—at some point in their life. Those problems can affect an individual’s physical health, their relationships, their financial resilience and their work life. Mental health problems are also linked to other illnesses and fluctuate significantly. Often, people suffering from mental ill health find themselves needing to take a period away from work to recover, which may lead to a significant reduction in income. That reduction often means that people fall behind on their bills, rely increasingly on credit or run down their savings, which can also have the effect of prolonging their illness further.
Not only is supporting those affected by mental health issues the right thing to do, but it makes total economic sense. A joint study soon to be published by Mind and the Chartered Insurance Institute puts the annual cost of mental ill health to employers in the UK at as much as £42 billion, with the total cost to the UK economy estimated to be £99 billion. Those costs come from presenteeism—when individuals are at work but significantly less productive because of their condition—as well as from sickness absence and staff turnover. With such a significant impact, it stands to reason that if we are to improve the mental health outcomes of our society, we need to focus on supporting the workplace to help drive that.
The Stevenson-Farmer review highlighted the fact that the average return on investment of workplace mental health interventions is £4.20 for every pound spent. Clearly, we need to look at ways in which companies can develop preventive strategies to secure the right work-life balance and develop a holistic understanding of wellness, while also encouraging staff to look after both their physical and mental wellbeing. It is reassuring to see therefore that a range of tools are already available to assist employers. Training managers and empowering HR professionals, who can then give line managers the support they need, should be a priority for employers large and small across the country. A critical point to return to is that if employees do not feel able to disclose a health problem, employers cannot hope to put in the right support for them. The earlier open and supportive conversations take place between an employer and an employee, the more effective the support will be.
As a former insurance professional and chairman of the all-party parliamentary group for insurance and financial services, I emphasise the role that health and protection insurance benefits can play to support employers in identifying the solutions that work best for their workforce. From my ongoing conversations with all parts of the insurance industry, it is clear to me that it is constantly working to improve understanding of medical conditions, as well as the availability of existing and new treatments, while helping customers manage the financial risks of their medical condition. The growth in resources offered by insurance companies to support firms and workers experiencing mental health difficulties is testament to how seriously those issues are taken by the industry. As an example, AXA PPP healthcare has teamed up with a health tech start-up, BioBeats, to help employees manage stress and fatigue through wearable technology.
We need to remember that for many of us, the workplace is where we spend most of our time. Employers of all sizes and from all sectors should be prepared to support their staff through periods of crisis when they are unable to work as a result of mental ill health, by providing preventive measures and access to early rehabilitation, and offering them a financial safety net if they need to be off for longer periods of time. Insurance products such as income protection can—and do—help with that, producing results than benefit employees as well as employers. However, there remains a need to raise awareness among employers and the workforce about the need for, and availability of, insurance solutions in the workplace. To aid that, there needs to be a conversation with Government about how we can incentivise employers to take up covers such as income protection for their workforce. The new Single Financial Guidance Body should be at the forefront of that as it has the potential to place a significant focus on improving greater financial resilience as well as improving awareness of protection.
Our mind is our most valuable asset, and like any asset, we need to make sure that it is properly taken care of. As the Government’s review demonstrated, the UK can ill afford the productivity cost of poor mental health. Moreover, the cost to individuals is difficult to calculate. While the insurance industry has made progress in helping to support its customers and employees through mental health struggles, that will only work if people feel supported enough to seek the help that they need while at work.
There is a huge incentive for employers, for the Government and for the industry to work together to better improve policy, minimise the financial impact of sickness absence because of mental health problems, promote sustainable recovery and, in turn, improve productivity. I look forward to hearing colleagues’ contributions and the Minister’s response.
The Parliamentary Under-Secretary of State for Housing, Communities and Local Government (Nigel Adams)
It is a pleasure, as always, to serve under your chairmanship, Mr Betts. I congratulate my hon. Friend the Member for North Warwickshire (Craig Tracey) on securing this important debate and on putting his point across with such characteristic eloquence.
I was particularly struck by the recognition in the debate that employers and Government both have a stake in the nation’s mental health. The Government provide the necessary health support, offer a safety net when people are out of work and promote the right action in the workplace. However, employers are increasingly recognising that they have a crucial role to play in creating healthy workplaces to enable their employees to remain in work and thrive, providing a supportive environment in which their employees can discuss health issues, and helping people return to work promptly when they fall ill.
Mental health is a matter of national importance. It is particularly relevant this month, following World Mental Health Day on 10 October, during which the Prime Minister announced that the Government are providing £1.8 million over the next four years to cover the cost of calls to the Samaritans helpline. This will enable more people to receive support when they reach out for help.
The Prime Minister is personally committed to improving mental health services and addressing one of the most burning injustices in our society. As we have heard, the Government are backing that up by investing record levels in mental health, with annual spending reaching just under £12 billion last year. In addition, the Prime Minister announced a five-year funding settlement, which will see the NHS budget grow by more than £20 billion a year in real terms in the next five years. In return, she has asked the NHS to develop a long-term plan for the next 10 years. She has been clear that mental health needs to be a key element of that.
Financial difficulties can have a serious detrimental impact on mental health, but mental health problems can devastate our finances, too. As we heard from the hon. Member for Dewsbury (Paula Sherriff), one in four people who suffer from mental health problems may have debt problems as well. Supporting people with their financial resilience is vital. We are committed to addressing issues faced by people who fall into problem debt. This year, the Government commissioned the Money Advice Service and spent just over £56 million to provide help to more than 530,000 people.
The NHS provides some services to people who may be experiencing the symptoms of debt problems or financial difficulties. Mental health services, including improving access to psychological therapies, may also signpost patients to debt advice services as part of their care. In our 2017 manifesto, we committed to developing a breathing space scheme for people in problem debt. We will publish a consultation shortly and lay before the House regulations on breathing space by the end of 2019. The Prime Minister has also announced a review of the practice of GPs charging patients to complete debt and mental health evidence forms. We are considering options to end the need for GPs to charge their patients to provide this information to their creditors, and I know that that will be welcomed.
We know that too many people with a mental health condition do not participate fully in key activities of society, including work. The figures are stark: people who are unemployed for more than 12 weeks are between four and 10 times more likely to suffer from depression and anxiety. That is why this Government are committed to supporting people with mental health conditions who are out of work, including through our Jobcentre Plus network. All work coaches across the network receive training on supporting people with health conditions and disabilities. In addition, the roll-out of the health and work conversation across the UK supports work coaches to continue to build engagement with claimants who have disabilities and health issues.
The Government also continue to invest in mental health-related trials and studies. These include doubling the number of employment advisers in IAPT services and launching a £4.2 million challenge fund to build the evidence base of what works to support people with mental health conditions, as well as musculoskeletal conditions.
The good news is that staying in or returning to work after a period of mental ill health can help mental health recovery. Good work supports our good health. It keeps us healthy, mentally and physically. It enables us to be economically independent and gives us more choices and opportunities to fulfil our other ambitions in life. Our Command Paper, “Improving lives: the future of work, health and disability”, which was published jointly by the Department of Health and Social Care and the Department for Work and Pensions last November, sets out a comprehensive strategy for achieving the Government’s challenging target of ensuring that 1 million more disabled people are in work by 2027.
Given the scale of this ambition, a key part of our programme is to achieve transformational change by focusing action on three key areas: welfare, workplace and health. We have made good progress. Employment rates are at historic highs and the number of disabled people in work reached 3.5 million in 2017, having increased by nearly 600,000 since 2013. The Government recognise the crucial role of employers in creating mentally healthy workplaces. Too many people fall out of work because of their mental health. We are asking employers to do more to prevent that.
That is why, as we heard from my hon. Friend the Member for North Warwickshire, in January 2017 the Prime Minister commissioned Lord Dennis Stevenson and Paul Farmer, the chief executive of Mind, to conduct an independent review into how employers can better support all employees, including those with mental ill health or wellbeing issues. The review set out a compelling business case for action, with the central recommendation that all employers should adopt a set of six core mental health standards to encourage an open and transparent organisational culture that supports employees’ mental health. Those standards included developing mental health awareness among employees, encouraging open conversations about mental health and routinely monitoring employee mental health and wellbeing.
The review went further by recommending that all public sector employers, and private sector companies with more than 500 employees, deliver mental health enhanced standards, including increasing transparency and accountability through internal and external reporting. We have made progress with implementation and are developing with partners, including employers, a framework for voluntary reporting on mental health and disability. We will publish supporting guidance, including on the important issue of how to encourage employees to disclose health issues.
It will take time before we can call all of our workplaces truly healthy and inclusive, but we have been encouraged by the level of engagement and commitment to this agenda. Momentum is building around the challenge to all employers to adopt the core standards that lay the basic foundations for good workplace mental health, and to larger businesses to adopt the enhanced standards. Following the Prime Minister’s acceptance of the Stevenson-Farmer recommendations as they apply to the NHS and the civil service as major employers, both organisations are making progress.
Working in partnership is vital. The Government recognise the collaborative approach that has created the new mental health at work gateway, which is aimed at employers, senior management and line managers, to help them to support a colleague, challenge the stigma or learn more about mental health in the workplace. Looking at the wider system in which employers make decisions, the Government are committed to reforming the current system of statutory sick pay so that it supports more flexible working, which can help people to return to work after a period of sickness.
I will use this opportunity to take a moment to address some of the points raised by hon. Members in the debate. I will come on to my hon. Friend the Member for North Warwickshire shortly. The hon. Member for Strangford (Jim Shannon), who gave a characteristically eloquent exposition of the issues, talked about employees sharing responsibility. I could not agree more, and nor could the Government. Employers have a key role to play in creating good working conditions and providing supportive line management so that people have the opportunity to speak out about issues and keep in contact with employees. I was encouraged by what he said about ensuring that his own staff took breaks and had some downtime during the working day.
It is also important that we keep in contact with employees who happen to go off sick. The Government have worked with Mind to produce a new website resource, and we are reviewing current obligations and incentives to see what we can do to encourage more good behaviour. The hon. Gentleman talked about suicide prevention; as hon. Members will be aware, on World Mental Health Day the Prime Minister announced not only the appointment of my hon. Friend the Member for Thurrock (Jackie Doyle-Price) as Minister for suicide prevention, but, as I mentioned earlier, almost £2 million to cover the costs of calls to the Samaritans helpline, where there will be help for people who reach out.
The hon. Gentleman also talked about parity of esteem for mental and physical health. It was this Government who legislated for parity of esteem by making mental and physical health an equal responsibility for the NHS in the Health and Social Care Act 2012. We are also backing our commitment with a significant increase in funding.
We are all extremely delighted to see the hon. Member for Motherwell and Wishaw (Marion Fellows) in her place, and it was a genuine pleasure to hear from her. It takes enormous courage to admit that one has suffered mental health problems, so to hear that from the hon. Lady was incredibly moving, and it was a privilege to be in the Chamber for that moment. It is important that employers create the right supportive environment. One thing we are doing is investing to make sure that there are 1 million mental health first aiders in the workplace, which is crucial.
The hon. Lady talked about the impact of low wages, and I agree with her. That is why we introduced the national living wage and are providing in-work financial support through tax credits and now through universal credit. That also makes it easier for people to move in and out of work, removing difficult transitions. She mentioned work capability assessments; it is true that they are designed to determine benefit eligibility, but they should not be viewed in isolation. We provide personalised and tailored support through work coaches in our jobcentres.
The full Hansard transcript can be found here: