On Tuesday, Dame Carol Black and I participated in a Roundtable event in the House of Commons - the seat of the British Government. This was a well attended, lively event and I was given the opportunity to make the following speech about the Fit for Work programme:
“For last 18 months The Work Foundation has been conducting research across 23 countries examining the impact of MSDs – including Inflammatory Diseases – on labour market participation. Rheumatoid Arthritis (RA) was one of the conditions we examined in detail because we know that levels of work disability and withdrawal from the labour market are high among people with RA – up to 40% within 5 years of diagnosis.
We’ve been looking at the direct and indirect costs of sickness absence from work and of permanent work incapacity attributable to RA. We have also looked at the interventions which Governments, clinicians and employers can take which can keep people with RA attached to the labour market and help them lead fulfilling working lives and make their contribution to a productive economy.
We launched our report in Brussels two weeks ago and we are trying to influence both National Governments and the European Commission to support steps which maximise the Labour Market participation of people with RA. We are doing some of this Advocacy work in collaboration with EULAR.
A key issue (one of many) is that current employment legislation in EU does not recognise MSDs which are not caused by work. Manual handling (CLBP) and Display screen equipment (WRULDs) are in scope – but the duty of care to support those with pre-existing conditions – such as RA – where poor working conditions can make these conditions worse, is currently out of scope.
Good Work is good for health: this includes control over tasks, control over pace & time; manageable physical work demands & an ergonomically suitable working environment; flexibility of working time.
We must reverse the focus of policy & practice from Incapacity to Capacity – the UK ‘fit note’ idea is intended to reinforce this message.
People with MSDs – including RA – can also experience periods of depression or anxiety which can complicate the process of returning to work. Policy-makers, clinicians & employers need to build this into the way they manage job retention & return to work (RTW).
Up to 30% of people with RA avoid disclosing their condition to their employer or colleagues – part of the self-stigma experienced by many.
Early Interventions can be critical, for example:
- Accurate & early diagnosis
- Early access to treatments and therapies – especially if early symptoms can be arrested and remission achieved
- NAO data shows that early treatment brings economic & productivity benefits
- TWF shows that early intervention can prolong careers and delay premature withdrawal from the labour market and that there is an economic ‘premium’ to early intervention.
There is considerable political focus on incapacity in the UK at the moment, especially as we are seeking to reduce public expenditure. However, as long as the debate has a punitive tone and is dominated by speeches and newspaper articles which focus on getting the feckless & ‘workshy’ off benefits and back into work, we are going to struggle to address the far more serious issue of how we avoid people with long-term and chronic health conditions becoming detached from the labour market until way after this recession is over.
During the Fit for Work study I’ve met hundreds of people with RA and other inflammatory conditions. None have been feckless or ‘workshy’. Most have been energetic, passionate, proud, determined, analytical, resourceful and dignified. I have been privileged & humbled to work with them & I am all too aware of the talent that goes to waste if people like this are lost to the world of work.”
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