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Musculoskeletal Conditions

It is a pleasure to speak under your chairmanship, Mr. Streeter. I am grateful to the hon. Member for Rochdale (Paul Rowen) for allowing me to climb on to one of my hobby-horses, although I shall try not to detain hon. Members for too long. My interest in this issue comes from the fact that I have spent a large part of my professional career battling on the side of patients with the inflammatory arthritises, so I am pleased to be able to speak. I will talk under four headings, the first three being diagnosis, management, and work capability assessments for people with long-term conditions. I will then repeat the recommendations that were made so eloquently by the hon. Gentleman and the hon. Member for Manchester, Blackley (Graham Stringer). Diagnosis is one of my hobby-horses. How can we treat anybody in medicine unless we have the correct diagnosis? Right at the beginning, we have to divide the musculoskeletal disorders into two groups: the inflammatory illnesses, which can lead to crippling deformity and disability, and the disorders that are due to acute strains, backache and degenerative change. The word "arthritis" is an absolute bugbear. When a GP tells somebody that they have arthritis, they immediately leap to the conclusion that they have the worst sort of progressive arthritis. The word needs explanation. I have looked at the current dictionaries and, to my great relief, the "Chambers", "Oxford" and "Webster's" dictionaries all get the definition right. They define arthritis as a disease that causes painful inflammation and stiffness of joints, which is absolutely right. When I look at "Black's Medical Dictionary", however, it says:""Arthritis refers to any condition of joints of the limbs or spine associated with inflammation or structural change"." Straight away, it lumps osteoarthritis—degenerative change—with all the other conditions. We really should have a campaign about that to ensure that people with a degenerative change or a strain change realise that it is not potentially progressive. If we are to have better diagnosis, as has been said, we need better training for students, refreshers for GPs and greater awareness among people more generally. As with the cancers, there is a group of common symptoms that presents for the inflammatory arthritises. The first is stiffness that is much worse in the morning. Anybody who has painful joints with swelling, morning stiffness and signs of inflammation has an inflammatory arthritis, and they will have to jump up and down until their GP organises the basically simple blood tests that will confirm that they have an inflammatory illness. If it is potentially progressive, the earlier it can be tackled, the better.