Occupational health in serious condition

Ten years ago, 50% of the workforce had access to an occupational health service. Today just 30% - seven million of Britain's 25 million workers - have this benefit, according to new research from the Health and Safety Executive (HSE). Back-up examines the decline and new TUC research aimed at revitalising it.

The HSE report, Survey of use of occupational health support, says the main reason for the decline in occupational health provision has been the shift from employment in large companies (employing more than 250 workers) to small ones (employing 10-50 workers).

It found that across every sector, large enterprises were far more likely to provide occupational health services - 74% compared to just a third of small firms.

Encouragingly, the research found that trade unions were a positive feature in occupational health provision and "featured as an incentive for, and source of information on, occupational health support" but "not strongly except in certain regions and sectors".

Few employers cited union pressure directly as a reason for having occupational health provision but the report concludes that safety reps are central to increasing awareness of occupational health issues in smaller companies as they are most often the individuals responsible for occupational health.

The research carried out for the HSE by the Institute of Occupational Medicine also found that:

* 40% of employers spend under £1,000 a year on occupational health, but less than one in 10 of such employers (9%) actually work out whether they are saving money or wasting it;

* even among employers paying over £30,000 a year, only just over half (59%) evaluated their expenditure; and

* the main reason given for providing an occupational health service was the need to protect the health of the workforce, but other issues mentioned were concerns about litigation, and the costs of sickness absence.

The research found that in some industrial sectors employers claimed that they didn't have occupational health support because there were no relevant hazards. This included more than 20% of finance sector employers (where stress and repetitive strain injuries are common); over 15% of transport companies (where musculo-skeletal disorders and working time are issues); and over 10% of retail companies (where musculo-skeletal disorders are also common).

It is clear from this finding that employers need to both recognise the health problems in their industries and play a far greater role in prevention and rehabilitation.

Rehabilitation

TUC research published in last month aims to encourage this development. Rehabilitation and retention: what works is what matters is based on a survey of union reps in 1,200 workplaces who were asked what was done for people whose ill-health or injury affected their ability to work. It found about a third of workplaces surveyed (34%) exhibited good practice on rehabilitation, but only 8% achieved best practice.

Based on the findings, the TUC says there are seven steps which employers should take to prevent workplace injuries and illnesses:

* establish clear policies on rehabilitating their injured workers;

* separate sickness absence management from disciplinary processes;

* work with unions and the workforce to develop policies on rehabilitation, and be open about the implementation of those policies;

* respond actively to sickness absence, by staying in touch with workers off sick and referring them for medical checks early;

* adopt a multi-disciplinary approach to rehabilitation, involving senior and line managers, personnel and health professionals;

* presume that sickness absence is work-related (and investigate possible causes) unless proved otherwise; and

* provide access to good occupational health facilities.

TUC general secretary John Monks said: "People at work don't expect to be injured or made ill by their work, and their bosses don't intend to hurt them but when the worst happens, we need to get people back to health and back to work, and Britain isn't good at that. Rehabilitation is good sense, it's good business and it's good for people."

A full TUC briefing on the Survey of use of occupational health support is on the TUC website at www.tuc.org.uk as is the report Rehabilitation and retention: what works is what matters or phone: 020 7636 4030 to get printed copies.