Absent minded

out as an in-house department, MTL is now established as an independent OH
services provider, specialising in sickness absence programmes.  By Eliza O’Driscoll

MTL Medical Services started out in the public sector as a team of seven or
eight nurses providing an in-house service to Liverpool bus company.

When the company was privatised in 1986 the OH service began to look for
external clients and eventually became an independent provider of OH services.
Its most long-standing client is Mersey Travel, the company it stemmed from, but
it now have a long list of public and private sector clients.

MTL’s first London client was Enfield Borough Council, which it acquired in
1996. "We saw the advert in OH Journal and thought we would give it a go –
and we got it," says professional development manager Graham Johnson. MTL
then opened a London office after its parent company bought part of London
Transport and rapidly acquired other clients including the London councils of
Camden, Havering and Lambeth. The company now employs 54 staff.

With a long and varied client list MTL offers a wide range of services from
pre-employment medicals to sickness absence programmes, health surveillance,
health promotion, counselling and vaccinations.


Sickness absence is one of the main concerns for many of MTL’s clients.
"We do a two-hour session on attendance management for human resources
managers when we take on a client," says Johnson, "and we will give
them training."

The approach the client decides to take to sickness absence is entirely up
to them, Johnson continues. "We will do whatever they want us to do, but
we will not be compromised either as a business or as OH professionals."

"Different clients may have different priorities," points out
business director Julie King. "One may have a welfare-oriented ethos while
others want you to police their employees."


Does the team find that as workplace stress becomes more widely publicised
employers are looking to them for help on the issue? "Employers are not
responding as dramatically or as fast as you would expect. If I was a human
resources person I would be sitting up and taking notice a bit faster,"
says Johnson. "Some managers see stress as different from any other
hazard. It should be treated like back pain."

And senior occupational health adviser Sue Jury believes employers need to
make sure they are better informed on the subject. "Very often they know
they have to do something but they are not sure what," she explains.

"Some employees may go off sick with stress as a signal to employers
that something is wrong."

Johnson points out that people are no longer retire on grounds of
ill-health. "Employers need to look at making reasonable
adjustments," he says.

"For the past couple of years it has been a battleground. Managers are
frustrated by the fact that you cannot specify that someone is not fit for
employment," he says.

"Not telling them what they want to hear is the main criticism we get.
You give an independent report to management that answers their questions but
it is not what they want to hear."


The Disability Discrimination Act has put the onus on occupational health to
provide management with accurate information about their legal duties,
unpalatable though it might be. "A lot of case law is coming down on the
side of the employee," says Johnson. "Therefore there is a greater
emphasis on reminding employers that if you did not do this before, you should
do it now."

"You have to explain to them that they have to be seen to consider
redeployment, for instance," says King. Jury illustrates this point with
the story of one employer losing a tribunal because they looked for a week to
10 days to find a suitable alternative position for the claimant and the
tribunal ruled that it was not long enough.

What is the most difficult thing about the team’s role? "The range of
companies we look after is the most difficult thing we have to deal with,"
says Johnson. "No two organisations will have the same mix of
requirements." For business development manager Chris Edwards adds,
"We have to respond to the individual company by providing the OH service
in a cost effective way for them."

The MTL team enjoys the challenge of designing the right service for each of
its clients. "We like to advocate the use of nurse-based services whenever
we can," says King. But she goes on to say that it is not about imposing
their idea of a correct occupational health service regardless of what the
client actually wants. "Our objective is to help companies achieve what
they want to achieve," she says.


One question that companies often ask them, says Johnson, is "If we
were to employ you, how soon would we seen the benefit in sickness absence

He emphasises that this is an impossible question to answer because making an
impact on something as fundamental as sickness absence requires a concerted
effort from the organisation – it cannot simply be left to OH to sort out.
"It is difficult to say we can reduce a firm’s sickness absence by a
certain amount next year. They have a part to play in the process as

The team sees a rosy future for the profession. "I think occupational
health is still in its growth. I see the future as a lot more information and
integration," says King.

"Now is a very good time to be in OH because the Government has put it
firmly on the agenda," adds Johnson.

So what skills should the occupational health nurse be bringing to the
profession as we head into the new millennium? "A good occupational health
nurse is the one with the right philosophy," believes King.

Johnson stresses the importance of looking beyond the strict terms of a
contract. "A good occupational health nurse is one that can drive the
contract forward. There are an awful lot who just do as per contract and do not
think laterally," he says.

Occupational health team at MTL Medical Services

Julie King – business development manager
Graham Johnson – professional development manager
Chris Edwards – business development manager
Susan Jury – senior occupational health adviser (South)
Dr Steve Malleson – senior occupational health adviser (South)

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