Backing Dame Carol Black all the way: comment

Where were you on Monday 17 March? Was it a special day for you? And if not why not? For 17 March 2008 was the most significant day in the history of Occupational Health, apart from the birth of Ramazzini (1633), in my opinion.

For those of you still in the dark, the long-awaited ‘Review of the health of Britain’s working age population’ finally saw the light of day. What a dreadful weekend had preceded it? Being a member of the National Stakeholder Council for this tome I had a pretty good idea what to expect and had been very pleased with the first draft that I’d seen a little while ago, but had it metamorphosed into something completely different during that incubation period?

We knew that Carol Black was scheduled for interviews on the TV on Breakfast News time and, as it became clearer which channel and when, we were texting each other madly. We were infuriated that Carol Black’s interviewer wouldn’t let her talk about the scope of the recommendations in Working for a Healthier Tomorrow and kept drawing her back to the ‘good news’ piece of dragging poor Incapacity Benefit claimants wailing and screaming back to work. However, I still didn’t really know what the final document contained.

I was invited to the lunchtime launch in London and arrived ridiculously early, but was able then to speed read it from cover to cover and heave a sigh of relief that there were no nasty surprises. Yes it’s ‘broad brush’ and I guess the devil’s in the detail, but the intention is quite clear – OH has arrived and with a public health focus of our own creation, not a ‘one size fits all’ approach that some of our nursing colleagues would like us to adopt.

To quote from the document: “The Review has highlighted the challenges and opportunities for the occupational health speciality to unite all those engaged in improving, safeguarding or restoring the health of all working age people. It is a once-in-a-generation opportunity to build on the successes of the past and make a real difference in the future.”

The remit is larger to include those of working age that are workless, to help them enter or return to the workforce. More broadly, it’s about improving the health of working-age people.

Clearly, we’ll need to work more creatively and closely with other stakeholders – GPs, occupational therapists, physiotherapists, safety reps and vocational rehabilitation teams to name but a few – but we cannot do this alone and this is where sound workforce planning principles come in.

Many people that responded to the review mentioned the need to educate school age children on the benefits of work and this, too, is covered. One of the biggest culture shocks we get in a lifetime is when we leave those carefree schooldays and, if we’re lucky, go to work.

The recently formed Occupational Health Clinical Effectiveness Unit is quite rightly commended and acknowledgement is given to the need to give this work higher profile and fast, to develop national standards for OH. But there is so much more to in the report and I’d urge you all to get copies quickly in order to be ahead of the game.

Time for change

A few days later when all the excitement had died down, David Bolchover, in his comment piece in the Times (Thursday March 20, 2008) discussed the Review and referred to an EU-funded study from the European Foundation for the Improvement of Living and Working Conditions (2007) and an HSE report of 2006 that examined the difference in sickness absence levels between the public and private sectors (and, more significantly, the sickness levels of the employed and the self-employed, including company size).

The average annual sickness absence per worker for a public sector organisation employing more that 250 people was eight days, while for a similar sized private company it was 6.9 days. For businesses with less than 25 staff the average drops to 3.9 days.

Bolchover goes on to look at the self-employed worker who has 100% attendance born out of necessity as in short, no work = no food. But let’s not forget the self-employed are so out of choice – we enjoy it so we ignore our ailments.

However, for those that are in employment or would like to be, the Black report and its recommendations will bring about significant changes and benefits if implemented.

OH role

For those of us in OH, the document states that “strong professional leadership is [the] key to success” and “occupational health will always have a leading role.”

Now it’s up to us to work together, take our place at centre stage, and show what we can do now we’ve been given the chance.

Thank you Dame Carol, if we in OH don’t view these recommendations in a positive light then we only have ourselves to blame when we are subsumed by some other entity. I for one think you’ve done a cracking job.

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