Return to Work

– in the House of Commons at 4:36 pm on 24th February 2005.

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Motion made, and Question proposed, That this House do now adjourn.— [Vernon Coaker.]

Photo of Ms Sue Doughty Ms Sue Doughty Shadow Minister (the Environment), Environment, Food & Rural Affairs 4:41 pm, 24th February 2005

I am grateful for the opportunity to raise this issue this evening. It arises from the problems encountered by my constituent, Dominic Ponsillo, whose parents have come here tonight to listen to this debate because they feel it is so important.

Dominic Ponsillo is a former Royal Mail employee. He sorted mail, and I understand that he was one of the best and fastest there. In January 2003, he suffered a severe illness: chronic epididymo-orchitis, from which recovery is slow, normally taking a number of months, if not years. The illness renders the patient tired with repeated testicular pain. He was a good employee and wanted to return to his job. When I spoke to his doctor today, the doctor welcomed the fact that he was seeing someone who really wanted to get back to work, whereas people so often come in for a certificate so that they do not have to go back. The doctor said that Mr. Ponsillo's return to work needed to be gradual, at a pace that would not adversely affect him. In the event, the difference of understanding between the doctor, who was expecting a gradual return, and the employer, the Post Office, which had a rigid procedure, led to a complete breakdown of relations between employer and employee, and culminated in him losing his job—unnecessarily, in my opinion.

The issue that I want to cover this evening is how to manage the return to work of an employee after an illness in a way that is not only seen to be helpful to the employee in terms of his return to full health, but recognises the situation in which the employer is placed. Although the case that I am raising relates to the physical illness of my constituent, it is also of interest in respect of any case of prolonged illness, physical or psychiatric, where the employee may at first be unable to undertake the hours and workload that their job normally entails. It is also of interest given that the Government are seeking to encourage more people to return to work after lengthy illness.

From this case, it is clear that the employer had one set of expectations, and the medical staff another. Indeed, at certain points, it was not entirely clear whether my constituent was on sick leave in the eyes of the Post Office. These points are important in large organisations such as the Post Office, which have been trying to reduce absenteeism and sick leave, but incorrect understanding of the situation may mean that time not worked during the rehabilitation period may be recorded and count towards future disciplinary action. It is also clear that the medical advice provided in this case just did not fit Post Office procedures.

Mr. Robinson, who is here this evening and who employs my constituent's father, is a friend of the family and has worked on the case with me. We found that there was a clear difference between the standard practices of the employer and those asked for by the doctor, with, indeed, the support of the occupational physician, who was acting for the Post Office. The Post Office's employment rules said one thing, while the medical officer representing the Post Office and the GP representing my constituent were both in agreement about a different set of procedures.

We have tried to reach an amicable resolution with the Post Office and have given it months of opportunity to answer questions about what the procedures should be. On 6 December—we are now in February—we received a letter saying that it would outline the procedures so that we could fully understand them. However, we are yet to receive a further letter.

Mr. Ponsillo was taken ill in January 2003. In August 2003, his doctor judged him to be 85 per cent. better and signed certificates to allow him a graded return to work. The medical expectation was that the patient was officially off sick, but could, if he felt up to it, return to work for up to the number of hours stated on the certificate. Dr. Arnold, Mr. Ponsillo's general practitioner, believed that the certificate was a legally binding document and thus that it was not for the employer to interpret or disregard what was written. A letter that Dr. Arnold wrote to the senior appeals manager of Royal Mail service delivery when Mr. Ponsillo appealed against dismissal—he eventually lost his job—stated:

"I know Mr Ponsillo has had considerable opposition from his manager . . . I did not hesitate in suggesting to him that he sought legal representation for unfair treatment."

Confirmation of that approach was provided in a letter from an occupational health officer for the Post Office, Dr. Guess, who confirmed the need for a gradual return to work. She said that she had made no statement that my constituent was fit for normal duties.

Mr. Ponsillo's line manager went against medical instructions. After the initial six-week period of rehabilitation, the line manager should have ensured that the situation was reviewed, as per the instructions from both doctors. In fact, the occupational physician asked on 1 October for a report to be obtained from my constituent's doctor and to see Mr. Ponsillo in clinic. She subsequently noted in a memo that she made no comment to state that he was fit for normal duties. In response to a query from the line manager, she had advised that the period of rehabilitation was indeed prolonged, but that she would assess the case if requested and review his rehabilitation.

In October, however, Mr. Ponsillo's manager sent him a note stating that he was to return to work full time and confirming that his rehabilitation period had expired. The note went on to say:

"as of the week commencing 6/10/2003 you are to report for your normal work hours."

On 9 October, despite the information provided by both doctors, the manager required my constituent to return to full-time work and warned him in writing that an absence of more than one day would trigger stage 3 action. However, Mr. Ponsillo felt at that time that he was not able to do the hours expected. Indeed, he took two weeks of his holiday to try to speed up his recovery. After that time, there were regular disputes between him and management about the number of hours he was supposed to work and whether he was sick or on holiday. That was extremely confusing for someone who was qualified to work in a sorting office, but not well versed in the finer points of contract and dispute procedures. One of Mr. Ponsillo's supervisors then made the nature of my constituent's illness known to his colleagues, including the swelling of his testicles, so he had to endure the embarrassment of knowing what his work mates were saying.

The situation got worse. Mr. Ponsillo became more and more stressed because he was worrying about how he would cope with doing more hours in his job than he could possibly manage. Sadly, owing to the stress that was caused, he swore at his manager and appeared threatening, so he was summarily dismissed. He appealed the case and although the doctors and both the hon. Member for Coventry, North-West and I made representations, the appeal was upheld, despite the fact that not all medical information was available for the appeal because it was claimed that it had been lost in the office. Losing information about the case seems to be part of the problem.

Mr. Ponsillo did not pursue a case for unfair dismissal because he was advised that if a barrister examined the narrowness of the case—the threatening behaviour to his employer—the dismissal would be upheld. However, had he looked at the wider situation and the stress leading up to the dismissal, the outcome would have been different. Mr. Ponsillo had to make a decision at the time. He was offered a reference that did not say what had happened and decided to take that option, so he lost his job with no appeal.

Had there been clearer guidelines that could have been understood by my constituent, his doctor and his employer, he would still be at work. His GP told me today that his behaviour had been completely out of character. Everybody I know who knows him says the same thing: it has never happened before.

The Post Office uses a procedure known as the Newcastle process of rehabilitation, which has specific guidelines about the hours to be worked and the total number of weeks considered as rehabilitation. It is inflexible and does not take into account the health needs of the individual. It allows only six weeks' recovery time.

In her final report on the case, for Mr. Ponsillo's appeal against dismissal, Dr. Guess, on behalf of the employer, said:

"Mr. Ponsillo tells me that at five weeks back to work he was still only doing half his hours. If he was suddenly asked to do full hours this would not be a usual step in a graded return to work and not what he had anticipated."

We should bear in mind that he wants to go back to work. He is not a malingerer. Dr. Guess went on to say:

"Rehabilitation uses gradually increasing hours and tasks to rebuild confidence and work tolerance after a period of absence with ill health. It is important that the steps are graded and not too large as the latter is likely to set back progress. I suspect that he would also feel anxious and angry as he tells me he believes it was what was advised by Employee Health Services and his GP. It does not seem appropriate to use annual leave to facilitate his recovery and this suggestion is likely to make an employee feel resentful or angry."

There is still a dispute about whether Mr. Ponsillo was expected to use annual leave to further his recovery. There is certainly a difference of opinion with the employer about what is normal practice in the Post Office. Dr. Guess made it clear that had he progressed through his rehabilitation as planned, he would now be working normally. She recommended that a report be obtained and that she saw him in the clinic, but that was not carried out.

As the House can see, clarity is needed about rehabilitation and graded return to work. We need clear guidelines. Employers need to set review dates so that progress can be assessed, with an agreed plan for the future. It is important that medical views are taken into account. In the Post Office, where there is a clear hierarchy, if a manager tells an employee, "You will do it this way", an employee is unlikely to argue back and challenge authority.

It cannot be right that an employee is uncertain about the basis on which he or she should be working in a graded return to work. It cannot be right that a rehabilitation process is so inflexible that when there is a query as to whether an employee is fit to carry out full-time duties there is no medical follow-up, especially with a major employer. Such things are important at a time when the Government want an increase in the number of people returning to work after illness. We want people to work if they can, but it is counter-productive to fail to recognise their health needs and abilities. I hope this debate will provide the Minister with an opportunity to bring clarity to such situations.

Photo of Geoffrey Robinson Geoffrey Robinson Labour, Coventry North West 4:53 pm, 24th February 2005

I am grateful to Sue Doughty, with whose agreement I am participating in the debate. It is unusual, but certainly not unfortunate, that there is agreement on an Adjournment debate across the Chamber.

I am pleased to acknowledge my interest in the affair. The young man has been known to me for many years. His father has worked for me for many years. He is an outstanding employee and a man of great integrity. The family are exemplary in all respects, so it is strange that the situation that we are discussing tonight has come out of the blue.

The case concerns a young man who has been dismissed after many years of effective service. He was described as one most speedy and effective sorters in the Post Office operation in Guildford, but he has been summarily dismissed. I shall discuss the circumstances of his dismissal, which I in no way seek to defend, in a moment, but I want to question the chain of events.

The hon. Member for Guildford has provided an accurate chronology, so I have no need to repeat it, but I shall examine the principal events. The young man experienced a severe, embarrassing, debilitating male illness, so he was naturally no longer required to work. Logically and appropriately, he then agreed a programme to take him back to work with his GP, the Employee Health Service, which is a medical body that works for the Post Office, and Post Office management. Up to that point, no real problem had occurred.

The EHS recommended that he be re-interviewed and reassessed on his return to work and that a realistic view be taken. However, he got a letter from his manager, which stated that he should return to full-time work and that he would be dismissed if he took one absence, rather than a normal, progressive continuation of the return to work procedure. First, the Post Office did not comply with the requirement that he must be interviewed again from a medical point of view. Secondly, at that point the young man's doctor said absolutely that the young man should not return to work and should not be further consulted and introduced to the stresses and strains involved.

The letter from the manager, which came out of the blue, said that the young man should return to full-time work, that if he did not like it, he should sleep on the floor and that the so-called Newcastle procedure would be used. I have asked several people, including the young man concerned, Dominic, about the Newcastle procedure, and none of them had ever heard of it. In my industrial experience as an employer—I make no secret of having always been on the management side—one never goes directly against doctors' orders. That is the one thing that one is not allowed to do. Nevertheless, the young man's manager did not care about doctors and said that the young man should return to work.

At this point, the young man made a fatal error. He should have said, "That is not right. I am entitled to a review under EHS procedures. You are going against what my doctor says. This is putting me in a totally impossible position." However, he tried to make a deal. Instead of saying, "I am not fit enough to return to work", he said that he would give up some of his accrued holiday. Who has ever heard of somebody with a doctor's order saying that he should not return to work, who has the EHS saying that his position should be reviewed and who says that he will take accrued holiday to substitute for his absence? I do not like to say this, but that tells me that industrial relations within the Post Office are not what they should be.

The Post Office has entered into a new arrangement, which I do not understand, with the young man, who thought that he was fine. I think that the decision to make a deal was a huge mistake, but it was not his fault. The situation is symptomatic of something being wrong with industrial relations, perhaps just in that depot or perhaps generally in the Post Office.

The key thing that he had to avoid was another day's illness—that has been denied neither by the management nor by him. So when, under these strange arrangements, he wanted some time off work, he phoned up to say, "Look, I'm going to have tomorrow off." The man agreed. Then one of his managers suddenly said, "No, I don't agree." The effect of that—I can see that I have the full agreement of the hon. Member for Guildford—was that he was sacked. Then he lost his cool. He went into work thinking that he would be sacked and said things that none of us would seek to defend.

No impartial person looking at that situation could understand how a procedure was gone through whereby this young man's doctors' orders were ignored, as were the recommendations of the Employee Health Service, which is the medical advisory authority to the Post Office. A completely unconventional and unsustainable arrangement was entered into by managers, who said afterwards that they had behaved entirely correctly. My right hon. Friend the Minister, whom I am pleased to see here today, has no operational responsibility for the Post Office, but all of us in this House have a deep moral responsibility for the way in which Government organisations, such as this one, conduct themselves on matters of working practices and human dignity—even basic human rights, which is what it comes down to at the end of the day.

Perhaps the family feel that they will have to pursue the matter further—I hope not—but the situation cannot be left as it is. A young man has been sacked, after many years of exemplary service, for an outburst that was provoked by the most atrocious, irresponsible—perhaps even illegal—behaviour. I put this question directly to my right hon. Friend: are managers in Government organisations allowed to override doctors' orders with impunity? If so, where is the redress? There is an inequality of treatment here that needs explanation and justification, and we look to her to put it right.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions 5:03 pm, 24th February 2005

As you know, Madam Deputy Speaker, those of us who have had the privilege of serving as Ministers in Northern Ireland retain a deep and abiding affection for all affairs relating to the Province, so it was with a degree of disappointment that I missed some of the previous debate. I was attending the construction summit at the QE2 conference centre, where we debated issues to do with health and safety at work—interestingly, the subject of ill health received particular attention.

I congratulate Sue Doughty on securing this debate on a very important issue. I thank her for highlighting the experience of her constituent, and I appreciate that there is interest outside in what is being said here in the Chamber. Although it would be inappropriate for me to comment on the specific case in question—the hon. Lady and my hon. Friend Mr. Robinson have given us some detail about the experience of the hon. Lady's constituent—I welcome the opportunity to speak to the House about the wider implications for Government. If I take a broad approach to replying to the debate, perhaps I can say one or two things about the specific points that the hon. Lady raised, which might offer some reassurance to her and my hon. Friend the Member for Coventry, North-West.

I stress that the issue affects many Departments and I may not have all the answers today, although I have developed an acute interest in the subject through my work as Minister for Work. I will ensure that other colleagues, who may have a responsibility for some issues that the hon. Lady raised, take note of our deliberations.

We are closer to full employment in Britain today than at any time for a generation, with 2 million more people in work now than in 1997. However, huge challenges remain. We cannot say that genuine full employment has been achieved when nearly one in every 13 of us is out of work and claiming an incapacity benefit. Many have been forced out of work by an illness or a medical condition, as the hon. Lady described. There are therefore 2.7 million people who might be said to be unable to work.

The United Kingdom loses nearly 39 million working days every year. The Confederation of British Industry estimates that that costs the UK economy approximately £11 billion. Those absences are bad for workers, bad for business and bad for Britain. Managing absences from work due to ill health or disability is therefore critical and we take a keen interest in it. Learning from experience is an important part of Government policy.

Long-term sickness absence is not inevitable. When employers work in partnership with their employees, aided by the right help and advice, sickness absence can and should be effectively managed. For people with many health conditions, effective and timely advice and support would help them manage their conditions before they became intractable. However, only 3 per cent. of companies have access to or use comprehensive occupational health, safety or return-to-work support. That is disappointing.

There are examples of organisations' good practice in managing sickness absence and return to work.

Photo of Geoffrey Robinson Geoffrey Robinson Labour, Coventry North West

I take the point that my right hon. Friend will not enter into the particulars of the person who has been mentioned. However, I am sure that the hon. Member for Guildford would join me in asking my right hon. Friend to undertake to draw to the attention of the Post Office chairman—a man whom we all know personally—what happened and ask him for his personal response. I know that the hon. Member for Guildford has tried to approach him and get a view from him, but she has not succeeded. I appreciate that my right hon. Friend cannot express a view but if she can ask the Post Office chairman to take a view and let us know it, we would be grateful.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

I am interested in that suggestion. I shall make a few comments about the Post Office and the experience that has been described. I shall not ignore it—I can say one or two things about it. I shall also give some thought to my hon. Friend's comments.

I wanted to give one or two examples of good practice simply to show that good work is being done. We want other employers, who perhaps do not use best practice, to learn from that. Rolls-Royce introduced a policy whereby any employee who is absent for more than four weeks receives attention. That includes physiotherapy for both work and non-work injuries. The policy has assisted many employees to stay in work or return to work more quickly. At the same time, Rolls-Royce has improved productivity.

Unfortunately, that approach is far from universal, and a culture can exist whereby long-term sickness absence is accepted as a fact of life. When employers try to do something about it, they and their managers often lack even the necessary skills and support to act effectively.

If people were provided with appropriate advice and support from their employer or GP at the outset of a spell of sickness, were equipped by the NHS to manage their health problem, and perhaps were pressed by the Department for Work and Pensions, for which I am privileged to work, to address other obstacles and helped to find work, I am sure that current employment and health outcomes could be massively improved. That process often starts with good advice on fitness for work and rehabilitation from the employee's doctor—their GP—which might include the fact that the GP feels strongly that the individual needs more time for rehabilitation. The DWP supports hard-pressed doctors in what we acknowledge is a difficult role by providing guidance, support materials and accredited online training to assist them. We recognise, however, that more needs to be done to help doctors to advise their patients.

It is also worth remembering that while sickness certificates record the GP's advice to patients about fitness for their usual job, it is the employer's responsibility to determine whether the employee is fit for work and in what capacity. The GP will know their patient well, but will not always be aware of the full details of the workplace situation.

My hon. Friend the Member for Coventry, North-West and the hon. Member for Guildford have pressed me on how the apparent injustice that they describe can arise. The only circumstances in which employers are compelled to take account of the health condition of an individual are those resulting from the Disability Discrimination Act 1995, which affords protection against discrimination for people who are defined as disabled for the purposes of the Act. Under that Act, employers are legally obliged to make reasonable adjustments to aspects of work such as the working conditions or workplace, or to provide specially adapted equipment for people with a disability as covered by the Act. That might include a gradual return to work.

Photo of Ms Sue Doughty Ms Sue Doughty Shadow Minister (the Environment), Environment, Food & Rural Affairs

I appreciate that the Minister is covering the wider issues as well as the narrower points that the hon. Gentleman and I raised. In this case, however, in which the employee was outside the scope of the DDA—he was at work, he became ill and was still an employee—the occupational health officer was familiar with his case and had asked for, received and carefully read the information provided by his GP and the specialist who treated him, and yet the employer failed to discuss with her whether he was able to do the work that he was supposed to do and how many hours he should be doing it for. In his case, if he got tired, he would experience extreme pain that would cause him to roll on the floor holding himself. He certainly did not want to be put in that situation in the workplace, as it was embarrassing to him. All he wanted to do was get better and do a full day's work but be allowed the space to do it. It particularly concerns me that the employer could continue to ignore the opportunity to get my constituent fit and well and performing as well as he had done previously, as he had been a really good employee.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

Back-Bench Members of the House can sometimes comment much more freely about decisions in relation to individual cases. I do not have that freedom. I will, however, take up the point that has been made, particularly in relation to the apparent rigidity of the policies that the Post Office appears to have in place, with the chairman of the Post Office. I am happy to undertake to do that.

Photo of Geoffrey Robinson Geoffrey Robinson Labour, Coventry North West

We are grateful that the Minister has undertaken to do that, and that is the whole purpose of tonight's debate. Does she agree that it cannot be right that employers override doctors' instructions and views and force somebody back to work, whether indirectly, voluntarily, through some form of Spanish practice, or whatever? I was an employer—you will forgive me for saying this, Madam Deputy Speaker, coming from the west midlands, as I do—and the one thing we never did was override doctors' advice. How can it be that some Newcastle agreement or other arrangement can entitle the Post Office, a national organisation, to do that with impunity? I am relieved that the Minister will take up the issue and seek an answer from the Post Office management.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

I want to make it absolutely clear that what I am about to say is not what I believe necessarily happened in this case. It may often be the case, however, that an employer has people with medical conditions working for him or her. People react differently to medical conditions: some people with common medical conditions can go on working, while others find themselves unable to do so. What I have learned while working on this is that there are times when we must challenge the clinicians who advise employees. Sometimes returning to work is a valid option when support is provided. When employer and employee work together with medical advisers, the best outcome will be achieved for the individual; it is when that partnership breaks down that things go wrong, and this seems to be an example of that.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

I do not want to give way too many more times, but we have a little more time.

Photo of Geoffrey Robinson Geoffrey Robinson Labour, Coventry North West

My right hon. Friend puts it very precisely: that partnership has indeed broken down. There is no doubt about it. The medical evidence suggested that there should be a review—which was refused—and that the employee was not ready to resume full-time work. That evidence was ignored; some Newcastle agreement was invoked, which was absurd, because no one knows anything about it. I have still not found what it is. The man was ordered to return to work full time, and told to sleep on the floor if he felt tired. The whole thing is ridiculous. Perhaps the plans we have for the Post Office will change the situation, but can my right hon. Friend not see that the arrangements did break down, and do need investigation and rectification?

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

I am reluctant to go quite that far, but I will say this. We feel strongly that vocational rehabilitation has the potential to help us and other stakeholders to achieve our goals. The experience of the hon. Lady's constituent, as she has described it, is of interest to us, not least because that individual has maintained a positive attitude and a wish to return to work throughout his unhappy experience, but also because it involves what is almost a public sector organisation in which the Government have a clear interest. Following today's debate—and having read the report of it—I will contact the chairman of the Post Office, so that he can reassure himself that its policies are based on experience and best practice.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

I will give way one last time to the hon. Lady, as this is her debate.

Photo of Ms Sue Doughty Ms Sue Doughty Shadow Minister (the Environment), Environment, Food & Rural Affairs

I am very grateful.

I too have employed people who have returned to work gradually, and I know that these are delicate circumstances. On the one hand, an employer does not want to force someone to work; on the other, the employer has a budget and hopes that the employee will make a full recovery and return to work.

There is, however, a wider issue, which is why I was keen to bring this matter to the House's attention. There are lessons for employers about getting people back to work—not necessarily those covered by the DDA, but others who have had a lengthy sickness. The main issue in this case is how much better it would have been had the manager concerned taken the advice of the organisation's own doctor, and asked for a review. The ongoing period of several weeks could then have been discussed. The case has a wider implication: I do not want other people in other organisations to be deterred, or to be treated in the way in which my constituent was treated.

Photo of Jane Kennedy Jane Kennedy Minister of State (Work), Department for Work and Pensions

That experience and anecdotal evidence will help us in considering how to improve the support and advice given to people working with an individual who is experiencing a health problem, and who wants to retain their employment while doing so.

There is some good evidence on restoring function and enabling a gradual return to work, especially for certain specific health conditions, but evidence on what is truly effective vocational rehabilitation is somewhat contradictory and inconclusive. We are seeking to redress that by collecting information that will give us a solid evidential base upon which to take forward further work. There is a change in attitude among not only employers but the medical practitioners interested in this field, and a willingness to engage in dialogue with the Government to try to improve the experience of those going through such difficulties. I am certainly enthusiastic about this development, and I know from my work as chairman of the taskforce dealing with these matters that there is interest in it across government.

We will continue to look at various options, including how statutory sick pay impacts on people in such circumstances, in order to make these improvements. The Government are committed to making changes on a number of fronts to maximise the opportunity for people with disabilities and health conditions to stay in, or return to, work. But this is a shared agenda, and the support of employers and trade unions, as well as of individual workers themselves, is needed if we are to achieve the objective that all who participated in this useful debate share.

I have given undertakings on the specific points raised by my hon. Friend the Member for Coventry, North-West, and I will look into the detail of the case described by the hon. Member for Guildford. I hope that our further work together on this issue will provide a little more clarity and, perhaps, encouragement to the family whose case she has described today.