Devil’s advocate: Presenteeism can damage mental ability

A new study was published in January showing that Whitehall civil servants working the longest hours suffered the largest declines in mental function during follow-up. Few would argue with this intuitive finding – recent headlines strongly suggest that people in central government departments have lost the plot, especially those in the Treasury.

The evidence from this latest study is not easily dismissed – the Whitehall study has been a production line for influential research reports.

Rationality hit

The loss of reasoning ability observed was significant. Does this, for example, explain the inability to post personal information from A to B without losing it?

The study examined many factors that might have contributed to the decline in mental function and found, for example, that it wasn’t associated with a combination of sleep disturbance, health risk behaviour, sex, and marital status. I’m sure this will come as a relief to those, much loved by tabloid journalists, who are struggling to differentiate between work and leisure. An untested, but attractive explanation is that senior civil servants are specifically selected because of a propensity to lose mental function.

Unfortunately, the study didn’t differentiate between government departments. Presumably, larger departments such as the Department of Health (DoH) and the Department for Work and Pensions (DWP) have suffered most. What is the evidence?

The baseline for the study was 1997-1999. It was during this time the DoH set a Working Well Together target to reduce absence in the NHS by 30% (by 2003). After failing to meet it (actually, the public sector situation got worse) this target was reset for the public sector as a whole in 2004 to be met by 2010.

Take a second shot

It was also in the baseline period that Securing Health Together 10-year targets were being prepared for publication in 2000 by the Health and Safety Committee (now part of DWP). It had cross-government support, including from Wales and Scotland. The targets were:

  • a 20% reduction in work-related ill health
  • a 20% reduction in ill health among members of the public caused by work
  • a 30% reduction in the number of work days lost due to work-related ill health
  • everyone currently in employment but off work due to ill health to be made aware of opportunities for rehabilitation back into work
  • everyone currently not in employment due to ill health to be offered opportunities to prepare for and find work.

These were admirable targets, as pertinent today as they were a decade ago. They deserve to be remembered. If there was a flaw in the targets, perhaps it was that the ambition was not underpinned by adequate reasoning. Reasoning is a mental function we now know to have been set for a significant decline in the hardest working civil servants at that time.

The clock is counting down to 2010 with little indication the current targets will be met. Working longer hours to achieve the targets is now out of the question. Not to worry – a whole string of new actions have been published in Improving Health and Work: Changing Lives. We must hope that the objectives were not prepared by civil servants who had worked too many hours.

It’s been a long day. I think I set out to make the case for working less to achieve more. Does this all make sense? I forget.

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