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 work only 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.
It is a pleasure to be called to speak, Mr Betts.
I congratulate the hon. Member for North Warwickshire (Craig Tracey) on securing the debate. His introduction was excellent. The subject is important and topical, and one that I am aware of primarily through my constituents, as will be the case for others who participate in the debate. I hope that the Minister will give us some answers.
Recently, I read an interesting article in the Safety and Health Practitioner about this very issue. The crux of the matter is clear: with great respect, we are doing a disservice to those suffering from mental health issues if we make no changes. That is why this debate in Westminster Hall is important, even though many other things are happening in the House at the same time.
We are all aware of the massive impact that mental health issues have on our physical wellbeing, our mental acumen and our ability to cope with work relationships, home life and, simply, life in general. As an elected representative, I am into my 34th year, whether as a councillor, an Assembly Member or, now, an MP. Over all those years I have been very aware of those with mental health issues such as depression and anxiety, and the impact that all that has on their life, work, income and whole lifestyle. The issue is so important.
The article is worth reading—it would be time well spent—but I do not have the time to repeat it verbatim in full:
“In the workplace, mental health issues can have a serious impact on both the morale of employees, those suffering from mental health issues and their colleagues who then pick up the additional workload.”
If an individual is under pressure to work but is not able to cope and is doing less, who knows who else will have to do more? That is one of the reasons why I want to highlight the issue.
The article goes on:
“It can also impact an organisation’s productivity and profitability through overtime costs, recruitment of temporary or permanent cover—absence from work due to mental health issues is thought to cost the UK economy £26 billion per annum.”
That assesses the magnitude of the issue financially, but it only tells a small part of the story. Each one of us, as elected representatives, will have individual cases with which to illustrate matters. Furthermore:
“Mental health issues can appear as the result of experiences in both our personal and working lives.”
Sometimes people’s personal life spills over into their working life, and sometimes their working life spills over into their private life. The person who is always happy and jolly in the workplace might not be a happy or jolly person when he or she gets home.
The Health and Safety Executive’s draft health and work strategy for work-related stress identifies that 1.5% of the working population suffers from mental health issues, a figure that resulted in 11.7 million lost working days in 2015-16. That is another indication of how, if we improve the health ability of our workforce, we can save working days and thereby turn around the profitability of a company. Compare that figure with self-reported injuries: 4.9 million working days lost—the scale of workplace mental ill health is almost two and a half times the physical impact of unsafe workplaces and working practices. Clearly, something needs to be done. Perhaps the job of the Minister and his Department is to lead the way. Furthermore, it is suspected that at least a third of injuries go unreported, and the same is likely to be true for work-related stress.
The initiative “Mates in Mind” has identified that the suicide rate in the construction industry could be 10 times more than the rate for construction fatalities. If that estimation is true, we have a massive problem that needs to be addressed. I am pleased that the Government created a suicide prevention Minister—that is a direction we need to be moving in. That Minister is not present, but perhaps the Minister responding to this debate will also comment on that initiative.
In 2011, the then coalition Government developed “No Health Without Mental Health”, a cross-Government mental health outcomes strategy for people of all ages. It was a great idea, but it has not stopped the rise in the numbers of those with mental health issues. The document states how the Government want people to recognise mental health in the same way as they view physical and biological health.
The strategy also set out the aspiration of improved services for people with mental health issues. However, only an extra £15 million is expected to be pledged for creating places of safety and, with respect to the Minister, that amounts to only about £23,000 per parliamentary constituency. That is not a terrible lot per constituency—mine has a population of 79,000; I am not sure about the Minister’s constituency, but the average one has about 70,000, 75,000 or 80,000. If that is the case, that is about £3 per person, which does not really go anywhere towards addressing the issue.
According to the Centre for Mental Health, the financial cost to British business of mental ill health is an estimated £26 billion per annum, but positive steps to improve the management of mental health in the workplace can enable employers to save at least 30% of the cost of lost production and staff turnover. We are looking not only for the Government to do something but for companies to. It is important for companies to accept their responsibility—clearly, if they cut down on days lost to mental stress by making some changes, they thereby help themselves. If they can indeed save at least 30% of the cost of lost production and staff turnover, I say gently that it is an open-door policy and one that should be adopted right away.
One in four people will experience a mental health problem in any year. A common misconception is that mental health problems are only caused by issues at home—no, they are not—so some employers feel that it is not appropriate, or their responsibility, to intervene and provide support to employees. More commonly, the cause of an employee’s mental health problems is a combination of issues relating to both work and private lives.
To conclude, what I have sought today is not only to show in a small way support for the hon. Member for North Warwickshire but to seek Government intervention and help, and to raise company awareness. Companies have a clear role to play and one that they cannot ignore or not take responsibility for. I believe that the hon. Gentleman intended to demonstrate in his introduction to the debate that it is more cost-effective to take small steps to promote good mental health in the workplace, rather than having members of staff feeling like they cannot cope and going on the sick. We want to prevent that if possible.
I believe that enforced lunch breaks away from desks are an essential component, for example. It is all too easy for people to stay at their desks—my staff do it all the time. I was thinking about this before the debate: sometimes we ought to say to our staff, “Girls, go on down to the wee café there and take half an hour, 45 minutes or an hour, whatever it may be, away from the office”, because if they stay to eat their lunch, they also answer the phone. If someone comes in, they speak to them. I am not saying that they should not do that, but I am saying that the two—work and breaks—need to be divorced from each other.
I do not have all the answers but I do believe that we must do more—not because that is good for business, but for the sake of our one in four who are struggling with their mental health and who simply need help.
Sitting suspended for a Division in the House.
It is a real pleasure to serve under your chairmanship, Mr Betts. I congratulate the hon. Member for North Warwickshire (Craig Tracey) on securing this debate and on speaking so passionately and eloquently, and with such knowledge of this subject.
I have been in the position of being off work long term with stress, which is a mental health issue. I was in the fortunate position of being on full pay. A colleague of mine—a fellow college lecturer—was also off long term with stress but she did not want to admit to her employer the real reason why she was off sick long term. It still requires a great deal of courage for someone to admit that they have a mental health issue. As usual, the hon. Member for Strangford (Jim Shannon) gave us a very good picture of what is going on in Northern Ireland, and concentrated on the economic case for dealing well with this issue. Employers have a part to play.
Hon. Members would not expect me to do anything but talk about Scotland—that is my role here, because there is some good work going on in Scotland on this issue. I am sure the Minister knows of some of it, and I would like to draw it to his attention. In the workplace, mental health issues can have a serious impact on the morale of employees: those suffering from the mental health issues, and their colleagues who pick up the additional workload. They can have an impact on an organisation’s productivity and profitability, through overtime costs and recruitment of temporary or permanent cover. Absence from work due to mental health issues is thought to cost the UK economy £35 billion per annum. We can play with those numbers but it is still a huge amount of money. A total of 91 million days are lost each year due to mental health problems. The scale of workplace mental ill health is almost 2.5 times the physical impact of unsafe workplaces and working practices.
In January 2016, the Conservative Prime Minister pledged to
“tackle the stigma around mental health problems.”
I am sure she really meant it. She also pledged an extra £50 million, expected to be used to create places of safety, which, as was mentioned, is about £23,000 per parliamentary constituency—not nearly enough. The House of Commons Public Accounts Committee said in September that it was “sceptical” about the Government’s attempt to improve mental health services without a significant amount of extra cash.
Providing support for employees is very important for the individual concerned. There is a strong business case for getting it right on mental health at work. We must eliminate stigma and discrimination in work. That requires a joined-up approach and a genuine commitment to support staff and to make it okay to talk about mental health. The Scottish Government funds the “See Me in Work” programme, which aims to support organisations to improve the working lives of employees with mental health problems, to encourage an equal and clear recruiting process and to ensure that those returning to work following ill health are fully supported back into the workplace.
The Scottish Government are working with employers on how they can best act to protect and improve mental health, and to support employees experiencing poor mental health. That will help employers to identify and provide appropriate training opportunities. To support workplace mental health and wellbeing makes economic sense for businesses. The Scottish Government are exploring with others innovative ways of connecting mental health, disability and employment support in Scotland. That will allow individuals to more easily navigate the current fragmented and complex landscape of support, allowing them to find a way to support at an early enough stage to make a real difference to their ability to sustain or return quickly to paid work when they encounter problems.
When I had my experience, everyone around me knew that I had a problem; I was in the middle of it and did not know. We need to look after each other when we are in such a situation. People who develop poor mental health should receive support to stay in work, just as they would if they had physical health problems. The Scottish Government endorsed “Good Mental Health For All”, which was published by NHS Health Scotland in 2016.
Issues that can contribute to inequalities that can lead to poor mental health include low pay and working poverty. The Scottish Government believe in promoting fair work and the real living wage. The real living wage as defined by the Scottish Government is £8.75 an hour. The UK promotes a living wage, for over-25s only, of only £7.83. People who are in employment but who are not earning enough to sustain themselves and their families often find themselves with bad mental health, because of the sheer pressure on their daily lives due to low wage employment.
We need to look early at preventive mechanisms, so that subsequent generations will be able to enter and remain in work. As with most systemic problems, the earlier we can get to people to help them, the better for all concerned. Prevention and early intervention are key to minimising both the prevalence and incidence of poor mental health and the severity and lifetime impact of mental disorders and mental illnesses. Prevention and early intervention must be a focus of activity and funding. The Scottish Government are funding an improved provision of services to treat mental health problems among children and adolescents so that, when they grow older, they can cope better with their illnesses in the workplace. Teaching our children resilience from an early age will help with mental health issues over a whole lifetime.
In December 2017, the Scottish Government announced a £95,000 investment in a youth commission on mental health, which will be delivered in partnership with the Scottish Association for Mental Health and Young Scot. It launched formally in April. As reported by the mental welfare commission for Scotland in 2016, there has been an improvement—a lower incidence of young people being admitted to non-specialist wards—and we want to see that continue. Mental health really deserves parity of esteem with physical health.
Mental ill health accounts for the biggest cohort of people unable to work due to sickness, yet that cohort has the poorest outcomes from the Department for Work and Pensions-contracted Work programme. The Department’s own evaluation of the Work programme suggests that it is not leading to the provision of appropriate specialist support. Instead, people with more complex needs are often parked by providers. The activities that people are asked to do are often inappropriate, with their conditions not being taken into account. That leads to a higher turnover of staff and more days off. Both employers and employees are incurring costs from the UK Government’s Work programme, which in many cases is shambolic.
The UK Government should scrap their work capability assessments so that people with mental health problems are better able to enter the workforce in jobs suitable for their needs. The current isolated nature of the WCA means that it functions as an eligibility test for employment and support allowance but not an assessment of what support is needed.
No Government can ignore the financial effect of absence from work due to mental ill health. I look forward to the Minister’s response to some of the issues raised today.
It is a pleasure to serve under your chairmanship, Mr Betts. I thank the hon. Member for North Warwickshire (Craig Tracey) for securing such an important and timely debate. Further, I thank him for his thoughtful speech. My friend the hon. Member for Motherwell and Wishaw (Marion Fellows), who represents two places that she knows I am familiar with from my childhood, spoke incredibly bravely, which is no surprise, about her own battle with mental health in the workplace. Everyone in the Chamber will agree with her that prevention and early intervention must be the key when we are looking at all aspects of mental health.
As other cases that we have heard about have shown, for the one in four people who experience mental health issues there are serious consequences in all areas of their lives. Of course that includes work, which the hon. Member for Strangford (Jim Shannon) said is where we spend most of our time—I am sure hon. Members agree. Right now, it is estimated that up to 5 million workers are experiencing a mental health condition, although we all acknowledge that it is difficult to quantify such numbers when we are talking about millions of people. Many are frightened to come forward, for a variety of reasons.
The human cost of the mental health epidemic we face is incalculable, and every individual deserves the treatment they need. When it comes to mental health in the workplace, research from Mind and others has shown that we can put a number to the cost of failure to fund our mental health services adequately. Poor mental health at work is estimated to cost taxpayers between £24 billion and £27 billion a year in NHS costs, benefit costs and lost tax revenue.
The costs for British businesses are also significant. Research from the insurance sector shows that it costs small and medium-sized enterprises £30,000 to replace a staff member in recruitment costs, training time and lost productivity. When 300,000 people with long-term mental health problems are losing their jobs each year, that is no small problem. The hon. Member for North Warwickshire also alluded to that figure. The total annual cost to the UK economy from our mental health crisis is an eye-watering £99 billion.
There is also a flip side. As the TUC points out, UK workers with mental health problems, despite often suffering illness, contributed £226 billion to UK GDP in 2016. Their work supports our economy and our society must support them. However, in so many cases of poor mental health at work there is a direct, negative link to Government policies. Many of the worst-affected professions are in our public services, which have suffered under austerity. For example, the Office for National Statistics has found that health and social careworkers—including those who treat others for mental health conditions—are at an especially high risk of experiencing poor mental health. It also found that low-income workers who do not earn enough to make ends meet, sometimes receiving a top-up via universal credit, are more than twice as likely to experience poor mental health as other workers. Not being able to put food on the table and being forced to rely on the shambolic universal credit system is enough to affect anybody’s mental health.
What about people in precarious work? Under this Government we have seen an explosion in the number of insecure workers: staff on zero-hours, temporary or agency contracts and workers forced to be self-employed so that employers do not have to take responsibility for their rights. Research from the GMB union—I declare an interest as a proud member of it—showed that more than 60% of precarious workers had suffered stress or anxiety as a result of their work or had been to work while unwell for fear of losing their pay or their job. Over a third would also struggle to cope with an unexpected bill for £500, with all the anxieties and stresses that creates.
Those with barely any employment rights have three options when it comes to their mental health. They can take days off unpaid, lose their insecure work due to their condition or suffer in silence, continuing to work as things get worse and worse. Seventy-eight per cent of the workers the GMB spoke to had previously been in permanent employment. That is not flexible working; it is the new normal. The Prime Minister has declared that austerity is over and promised to tackle insecure work. The Budget will be the test of whether she means it.
Health Ministers have given us warm words but little action on mental health. The Farmer-Stevenson report made a number of recommendations on mental health and employers, which the Government claimed to support wholeheartedly. However, almost a year since its publication, how much action has there been? Several recommendations were addressed to the Government, including changes in the public sector and ensuring the NHS prioritises mental health. However, the NHS is crippled by cuts, and its own staff are suffering. For example, the GMB found that 39% of ambulance workers have suffered from post-traumatic stress disorder, and 12% took sick leave due to stress, anxiety, depression and related conditions in 2016-17, which totalled 80,000 sick days. Given that the chronic lack of funding for frontline mental health services has led to excessive waiting lists for even basic talking therapies, is it likely that those workers got timely and effective treatment as the Farmer-Stevenson report advocates?
The report also recommended an increased role for the Health and Safety Executive. However, instead of providing resources for its work, the Government have continued to cut its funding. In a particularly bitter irony, the HSE now has one of the highest levels of anxiety among its staff of any public service employer. Perhaps the Minister can tell us who will inspect the inspectors. What resources will go to the HSE and what progress has been made in implementing that specific recommendation?
One of the report’s key findings was that the stigma around mental health is still a barrier for employees seeking support. Other Members have alluded to that. The Conservative manifesto committed to
“extend Equalities Act protections against discrimination to mental health conditions that are episodic and fluctuating.”
That would protect people who have long-term mental conditions from discrimination, and people who have short-term episodes of poor mental health, such as those caused by bipolar disorder.
People with such life-changing conditions might be deemed by an employer not to meet the current Equality Act 2010 definition. In one case, a worker with bipolar disorder was stable on medication, but asked to start work a little later because of the effect of the medication. Their boss refused. Mental health charity Rethink advised the worker that they could take legal action, but they felt that would just cause more stress. With the stigma around complex conditions such as bipolar disorder, when will the Equality Act 2010 be extended so that people get the support they so desperately need?
Similarly, employers sometimes see making reasonable adjustments as doing someone a favour rather than meeting their legal obligations. I have heard this in my constituency surgeries—I suspect others have heard the same. Will the Minister tell us how the Department has been monitoring progress from employers on achieving their legal obligations and what it has done to ensure proper HR training and processes?
Given that people spend on average 90,000 hours at work over a lifetime, the Government must ensure that employers prioritise health and wellbeing in their workplaces. The Government must also put their own house in order. Mental health services are still reeling from years of underfunding and we are all paying a price. It is high time this Government put their money where their mouth is.
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.
Moving on to the remarks of the hon. Member for Dewsbury, I politely and gently remind her that the funding picture in the NHS is not quite so gloomy as she painted it. We are backing our commitments with some significant funding increases in this space. We have record levels of investment in mental health, with annual spending reaching just under £12 billion just last year. The Prime Minister, as I have mentioned, has announced a five-year funding settlement. That is not the picture that the hon. Lady paints.
How would the Minister respond to the professionals I speak to every single week, who tell me that mental health services—particularly child and adolescent services—are in crisis; that on some weekends there is not a single psychiatric bed available in the country; and that people are travelling up to 300 miles to get an inpatient psychiatric bed? Perhaps there are positives out there, but it is difficult to say that things are not so gloomy when that is what I hear every week.
The hon. Lady makes a fair point. The need to travel hundreds of miles out of area, in some cases, for inpatient treatment is something that we desperately need to tackle, and we are tackling it. That is why we are putting in the investment. I gently remind her again of the additional £20 billion a year in real terms for the NHS over the next five years. Nobody is saying that this is a perfect situation, but we are matching our words with real-terms cash and investing a further £1.4 billion for mental health services for children and young people, which I am sure she would support.
We briefly mentioned the Stevenson-Farmer report, and I remind the hon. Lady that we responded in full through the “Improving Lives: the Future of Work, Health and Disability” Command Paper and fully supported all 40 recommendations of the Stevenson-Farmer review. Progress is being made, and has been made, on implementing those recommendations.
My hon. Friend the Member for North Warwickshire raised the role that the insurance industry can play. We recognise the positive aspects of group income protection for helping to retain sick employees, in particular access to expert-led health services and the financial certainty it offers individuals. I am not entirely sure that the product is widely known out there in the business space; I have run businesses for the last 20-odd years and was not aware that such insurance products were available. I very much hope that my former colleagues are tuned in at this precise moment and will do some research on it.
GIP is clearly a product that works well for those employees who choose to buy it, and we encourage the industry to continue to promote its benefits. I am sure the Association of British Insurers is doing a good job of that. However, we believe that small and medium-sized enterprises, in particular, lack sufficient incentives to invest in GIP as it is currently structured, because they often choose not to offer sick pay for periods beyond statutory requirements. That is why we have been looking more broadly at incentives and obligations on employers. We will continue to engage with the industry, and I know that the ABI will play a big role in that as well. We are listening closely to employers’ views about the appropriate products that retain the positive aspects of GIP and that overcome the existing barriers to increasing take-up.
By working with our partners, including employers, the Government can continue to tackle poor mental health, ensuring that disabled people, and people with physical and mental health conditions, go as far as their talents can take them.
I thank every Member here for their contribution and for the general spirit of the debate. It has been conducted in the way that I hoped it would be. It is clear that we all want to see progress on this matter.
The hon. Member for Strangford (Jim Shannon) made some excellent comments, as usual. His arguments complemented those that I put forward, particularly on the role that companies can play. However, it is important that we give companies the tools—whether through Government action, insurance products or whatever else—to allow them to play that role. He also mentioned a critical point about encouraging people to come forward and share their health issues.
I also thank the Opposition Front-Benchers for their comments—particularly the hon. Member for Motherwell and Wishaw (Marion Fellows), who shared her experience. Only if people come forward and share their experiences will others understand that they are not the only ones to have such feelings. That can happen to us all, and such case studies are the best way to help us to progress. No strategy will work without people coming forward; it is a two-way street. I will particularly reflect on the hon. Lady’s comments about teaching resilience, particularly to younger people. That is important, not only in these matters but throughout their lives in general.
I also thank the Minister. We are all pleased to hear that good progress is being made and that good, positive steps are being taken. I appreciate as well as anybody that there is no quick fix to this issue, but the Government are taking it forward and driving it. Steps such as getting more people into work are critical to doing that. However, the more people in work, the greater the potential for people to suffer from these difficulties. It is important to recognise the issue and provide solutions and tools to enable business to combat it.
It is key that we, as Back-Bench Members, continue to push this issue and encourage the Government to keep it at the forefront of their thinking. At the end of the day, tackling it will bring a benefit not only to employers and the people affected but to the overall success of our economy and our country.
Question put and agreed to.
That this House has considered the financial effect of absence from work due to mental health problems.