Black marks for employers on health

The MHF have welcomed the publication of Carol Black's report for the government on work and health Working for a Healthier Tomorrow despite its lack of gender analysis.

Of the 2.2 million British workers who currently have an illness that was caused or made worse by their work, the majority (by a ratio of about 3:2) are men suggesting a truly comprehensive study of health at work would need to take gender into account.

However, the report, which cites the MHF/BT Work-Fit programme as an example of good practice, is the first of its kind to make clear the close link between work and health. Work can cause ill health; ill-health can make work difficult causing poverty and more ill health.

MHF CEO Peter Baker said: "Carol Black's report presents the now undeniable case for much greater investment in workplace health improvement programmes. What is often overlooked, however, is the particular opportunity that exists for improving the still poor state of men's health through well-targeted workplace initiatives. The evidence is that this can significantly improve men's knowledge of health, detect potentially serious conditions earlier and improve their health outcomes. We very much hope the Government will take this into account when it responds to the report later in the year."

Black, who is a member of the House of Lords and the government's National Director for Health and Work puts the economic costs of sickness absence and worklessness associated with working age ill-health at over £100 billion a year - greater than the current annual budget for the NHS.

Her report says that the business case for investment in the health and well-being of employees is inadequately understood by employers - particularly smaller businesses who want for advice.

The importance of the physical and mental health of working age people is also insufficiently recognised in society. GPs often feel ill-equipped and ill-trained to advise patients on remaining in or returning to work. There is insufficient access to support for patients in the early stages of sickness while the detachment of occupational health from mainstream healthcare has undermined holistic patient care. Moreover, existing departmental structures prevent government from fully playing its part in meeting these challenges.

Black believes that the current sickness certification process focuses on what people cannot do, "institutionalising the belief that it is inappropriate to be at work unless 100%". She says the numbers on incapacity benefits represents "an historical failure of healthcare and employment support" and a failure in employment and skills programmes. Pathways to Work, while successful overall, has had limited effect for those whose main health condition is a mental illness, she says.

She calls on government, healthcare professionals, employers, trades unions and all with an interest in the health of the working age population to "adopt a new approach to health and work."

Government should work with employers and representative bodies to develop a robust model for measuring and reporting on the benefits of employer investment in health and well-being, Black says. This should feature in the board room and in company accounts. She urges an enhanced role for Safety and Health practitioners and, where present, trades union safety representatives.

Government should initiate a business-led health and well-being consultancy service geared particularly towards smaller organizations and launch a major drive to promote understanding of the positive relationship between health and work.

GPs and other healthcare professionals should be supported to adapt the advice they provide and help people enter, stay in or return to work. "The paper-based sick note should be replaced with an electronic fit note", Black says and her report suggests piloting a new Fit for Work service based on case-managed, multidisciplinary support for patients in the early stages of sickness absence, with "the aim of making access to work-related health support available to all - no longer the preserve of the few".

• The report can be downloaded here

OTHER RESPONSES:

"Government must also look at how it can transform work into a more rewarding and less harmful experience"

Welcoming the report, TUC General Secretary Brendan Barber said: 'There is currently insufficient support for people who are off work because they are ill or injured and the TUC agrees with Dame Carol that more needs to be done to encourage those on long term benefits back into the labour market. This is best done by doing more to prevent workplace accidents and illnesses, and by giving ill or injured workers early access to rehabilitation.

"In the UK millions of ill or injured workers are being dumped on benefits when they have treatable medical conditions, but often no access to treatment. Ministers need to come up with practical solutions based on prevention, early access to rehabilitation, and universal occupational health coverage. The government must also look at how it can transform work into a more rewarding and less harmful experience."

The TUC has called on the government to "clamp down hard on employers who exploit their staff through bad conditions, long hours, or stressful workloads. That means more resources for the Health and Safety Executive, local authorities and other enforcement agencies, and stronger legal protection for agency, temporary and other vulnerable workers.'

Paul Farmer, chief executive of mental health charity, Mind, echoed the stress on helping staff to work at work rather than to be made ill by it. "Dame Carol is right to say that it's not just employees who need support with sickness, employers need help too. The best employers have carefully crafted employment policies and practices that help staff stay in work or recover quickly, but many others are unsure about how they can support their staff.

"This report should be required reading for all involved in health or employment. If thoughtfully implemented, Dame Carol's recommendations, particularly her emphasis on early intervention and support for people when they first experience a problem, will deliver rewards that could benefit many people's lives. Putting staff wellbeing on company balance sheets is an astute idea - giving employers the tools to measure and to improve their employees' wellbeing will be crucial in moving to a healthier workforce."