Government Response To Review Of The Health Of Britain’s Working-age Population - A Missed Opportunity

The long awaited response from the government to Dame Carol Black's review was published this week. It will no doubt re-energise the debate around the delivery of healthy workplaces, modifying the lifestyles of workers and best practice in health and safety.

For many commentators, and trade unionists, the delivery of healthy lifetsyle messages into the workplace will do nothing to counteract sickness as a result of bad working conditions and a lack of good health and safety practice.

However, those delivering in part, the Health Work and Wellbeing initiatives such as that in the partnership between Liverpool PCT and Health@Work a Merseyside based charity organisation, expereince good responses so far from employers and employees alike.

The background to this is of course the fact that in March this year Dame Carol Black, the National Director for Health and Work, published her review of the health of Britain’s working-age population – “Working for a healthier tomorrow”. Ministers warmly welcomed her report and committed to publishing a formal response after carefully considering all Dame Carol’s recommendations.

The Government’s response – " Improving health and work: changing lives" which was published earlier this week on 25th November 2008 can be accessed on the DWP's website Working for health.

Dame Carol’s review covered Great Britain and the response reflects this and takes account of the devolved nature of key areas such as health.

The DWP press release in announcing the government response said,

"Today marks another milestone in the journey towards our vision of creating a society where the positive links between work and health are recognised by all, where everyone aspires to a healthy and fulfilling working life, and where health conditions and disabilities are not a bar to enjoying the benefits of work. Achieving this will require a fundamental change in our perspectives on health and work, a concerted effort to improve the world of work and a determination to find the best and most cost effective ways to support people to work.

Our response contains some key initiatives designed to help achieve those goals including; the piloting of “Fit for Work” and other early intervention services; the introduction of an electronic “fit note” to replace the outdated “sick note”; a range of measures to support SMEs; the creation of a National Centre for Working-age Health and Wellbeing; and a network of health, work and wellbeing coordinators to stimulate and support action at local level."

The TUC was quick to comment on the document forming the governments response to the Carol Black review:

TUC General Secretary Brendan Barber said:

"This goes some way towards addressing the health problems faced by people at work, and by those unable to work because of ill-health, but it could have gone much further.

Workers made ill by their jobs need early access to rehabilitation and better support to help them get back to work as soon as they are able to. While the 'Fit for work' pilots go some way towards achieving this, they will have little relevance to the vast majority of workers who fall ill or are injured through work.

More must be done to stop employees from becoming ill or injured in the first place. This report shows that ministers recognise the importance of enforcement in improving health and safety in workplaces. But without additional resources to the Health and Safety Executive and local councils, there is unlikely to be any increase in the number of safety inspections.

In addition, while the response strongly emphasises the role of small businesses in reducing ill-health, there is far less about empowering and supporting workers and those on benefits themselves."

Looking through the executive summary it is clear what the TUC mean. These are the key elements of the government's response and strategy:

Electronic ‘fit note’

A new electronic ‘fit note’ will replace the current medical certificate, and help GPs switch the focus of their advice to what people can do rather than what they cannot. The changes will improve the flow of information between employers, individuals and GPs.

Health, Work and Wellbeing Co-ordinators

The Co-ordinators will stimulate action on health, work and well-being issues in their areas, offering advice and support to help local partnerships and engagement with smaller business in particular.

National Centre for Working-Age Health and Well-being

The Centre will form an independent, authoritative body providing a range of core functions related to the health and well-being of working-age people; these will include: the gathering and analysis of data enabling the identification and monitoring of trends; and help in determining the impact of interventions and initiatives. It will identify evidence gaps and encourage research to close those gaps.

The Business HealthCheck tool

The Business HealthCheck tool will enable businesses to estimate the costs of sickness absence, turnover, worker ill-health and injury in their organisation; enable employers to identify the savings that could be generated by investing in health and well-being programmes; and help them measure the return on investment.

Occupational health helpline for smaller businesses

The development of an occupational health telephone helpline will offer help to smaller businesses by providing business hours access to professional occupational health advice for individual employee health issues (including mental health).

This latter initiative is nothing new and was a failed trial under the name of Workplace Health Connect. Set up to help employers, most of the calls in fact came from workers and not the employer. A legitimate question is of course will that be the same this time around?

Meanwhile, the BMA said that the package of measures announced to get people back to work and to help them stay in work may be a step in the right direction. Commenting on the government’s response to Dame Carol Black’s review of the health of the working-age population, Dr Laurence Buckman, Chairman of the BMA’s GP Committee, said:

“The BMA has been calling for the sick note system to be reviewed for over ten years and we believe a Fit for Work service to help people back into employment may be the right way forward. The new ‘fit note’ has potential, but we would like to see the findings of this evaluation because it’s crucial GPs can continue to act as the patient’s advocate and don’t end up policing the system for the Department for Work and Pensions.”

Dr Paul Nicholson, Chairman of the BMA’s Occupational Medicine Committee, said:

“We’re glad the government has recognised more needs to be done to help small and medium sized businesses deal with employee health, though we would have liked to have seen a commitment to making sure every worker has access to basic occupational health services. Employers do need to take more responsibility, particularly in difficult economic times like now, as work-related ill health problems may well become more common.”

Download the government response document 'Improving health and work: changing lives' here

Access the government Working for health website here

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