Meeting of the Parliament 28 May 2025
It was once the case that middle-aged working men were placed on incapacity benefits. They were from post-industrial communities and they were stuck on incapacity benefits for years. That had a detrimental effect on their lives, on the economy and on the country’s tax base.
The situation has changed. Younger people with mental health conditions and neurodevelopmental conditions such as ADHD and autism are stuck on benefits and support at a very young age. We are losing them not just at middle age through to their retirement but at a young stage in life. That is bad for them, because they are stuck on those benefits for their whole life. It is not good for their health, it is not good for the economy and it is not good for the country’s tax base.
We see that in the figures. The 16 to 64-year-old inactivity rate in Scotland is at 24 per cent. The level is 21.7 per cent in England, which is bad enough. That sits with the demographic challenge of our ageing population, who are not ageing well—they are ageing with long-term conditions, which places a significant pressure on public services, and those who are retiring early add to economic inactivity. That pincer movement is having a dramatic impact on our economy and on our tax base. In other words, it is just not sustainable—and that is without mentioning the impact on individuals who are struggling with their conditions for years on end.
I attended the St Andrews ADHD support group earlier this year. There were bright, intelligent people there—people who were full of ideas and really engaged, but who were struggling to get the support that they needed. One parent told me about their son, who was diagnosed with ADHD at school, where he got the right support and was stabilised. When he left school, he came off the medication, went off the rails and got into trouble—he had difficulties with the police and the justice system. They tried to get him back on, but three years later, they are still waiting.
All that time, he has been unable to work or to contribute—a bright young lad who could make a huge contribution to the country, and who could take the burden off the state. It is a crying shame that he is not just one; he is one of many. That is why we need to provide solutions.
The Royal College of Psychiatrists’ stepped care approach, with the four-tier national programme that has been talked about today, is of course the right route. People do not have to just take a medicalised route; some can perhaps get benefit from alternative methods of support. Waiting for years for even that is unacceptable, however, and that is why the pathway needs to be implemented with urgency.
Children 1st says that the medicalised route is not necessarily the appropriate way for young people and suggests that whole-family support is an alternative that can work. We need to get things co-ordinated fast, because the crisis has bedevilled the country.
I want to provide one further challenge to the NHS as a whole. If we are to deal with the economic inactivity levels, we will have to place the right priority and the right funds in the right places. If we do not tackle the issue of economic inactivity, we will not have the tax that is necessary to pay for our NHS services. My appeal to the Cabinet Secretary for Health and Social Care is that he considers the overall allocation of resources and recognises that huge challenge.
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