The transition from conventional occupational health provider to consultancy
has proved a steep learning curve for William M Mercer OH head Christine Owen,
but one which has opened her eyes to a new and forward-thinking set of
disciplines. By Kate Rouy
The first thing I find out about Christine Owen, before I even meet her, is
that she is busy – very busy. Her diary is so packed, that it takes some
world-class juggling by her secretary to win me just an hour of her time.
An hour proves all too short a time to spend with the William M Mercer head
of occupational health consulting.
Her career began at St Bartholomew’s Hospital, London training as a nurse,
followed by hospital stints before a move to South Africa in the 1970s. On her
return she sponsored herself on the RCN’s occupational health nursing course,
including a placement at British Airways, where she subsequently worked for
five years. From BA she moved to shipping line Cunard, then to Phillips
Electronics as senior nursing officer.
Police challenge
From there she moved to the Metropolitan Police as head of occupational
health, safety and welfare. It is this period Owen describes as "the most
challenging of my life".
In her five years with the Met her achievements included the establishment
of the OHA team, its amalgamation with welfare and ultimately with officer
safety and fitness in multidisciplinary teams. She was also instrumental in the
formation of the organisation’s trauma support programme, designed to examine
the long-term cumulative effects of major incidents on those working in the
emergency services.
"It was a very exciting job, with so much to see and to do," she
says.
And it was this role with the police that attracted the attention of
consultancy William M Mercer. She joined the company three years ago, after
being headhunted – a move that surprised many of her OH colleagues, she says.
"’Who is Mercer?’ is what most people said," she says. "And
true, it is not as high profile as it deserves being one of the biggest
consultancies of its kind in the UK – in the world, actually."
Broader role
Her new role couldn’t be more different to her previous OH positions.
"There is no OH provision. What I am doing is true consultancy, working
with clients on a fees-plus-disbursement basis," she says. She heads a
team of eight consultants and is looking to recruit more.
"My role is to look at the broader aspects of any health strategy for a
client, looking at healthcare, examining needs and provision, and helping the
client to put together a new, integrated and focused strategy. This will
encompass all aspects of health, such as sickness absence, and stress
management, as well as legislative issues and health risk management.
"When we go to see a client, we have to demonstrate added value in very
defined terms, we have to be utterly client-focused, on their issues and needs.
In addition, we have to demonstrate to them that we can deliver the results
before we do it.
"Typically we would go to a client and identify where the losses are,
audit their healthcare provision, and evaluate the impact on the organisation
of ill-health and absence. We might also do some case management just to
encourage the client, to show how they can manage long-term disability
cases."
Making this transition from an occupational health provider to consultancy
work has not been easy, concedes Owen.
"Initially I ran into a brick wall of insurance and pensions
jargon," she says. It was a sharp learning curve. "I have to have a
really in-depth understanding of any business we go into, and how it works.
Only then can we make what we are proposing work for the client."
She also welcomes the opportunity to develop more long-term links with
clients.
"Being in consultancy is not, as many people perceive, like working in
casualty, where all you can do is staunch the bleeding, then the patient is
whipped off to the ward and you never see them again," she says. "We
work on relationship-based consulting, and we believe in a transfer of
knowledge. We do not dip in and out, our clients feel they learn a lot from us.
I really like that. Also I am fundamentally a nosy person and this job gives me
a great opportunity to take a much closer look into other people’s
businesses."
New practices
Owen’s role would be no place for a shrinking violet. "I work fairly
high up, at director level, and I do a lot of presentations. I love that, and
also speaking at conferences and talking to the press. It is all part of
raising our profile, which is very important."
Her work at Mercer has also introduced her to some work practices she had
not encountered in her previous OH roles.
"The thing about this job is it is very commercial," she says.
"We have to operate on time charges, which means we have to account for
every moment of our day through our time-record system. Also as we all charge
out at different rates, you have to delegate, to push the work downwards. Both
these have proved very good disciplines for me. Mercer also operates a peer
review system, with every item: letters, faxes, reports going through someone
else who is technically and professionally competent. That has also proved to
be a good discipline and one which delivers tremendous added value, even though
it can make meeting deadlines challenging."
Commercial outlook
She clearly relishes her role. "I have an enormous amount of freedom,
but there is always that expectation that we will generate the revenue,"
she says. "There are a whole different skills sets needed to do
consultancy work, but there are such opportunities to make OH really work, such
as in the development of data bases and benchmarks. Our knowledge of the market
is huge."
She also thrives on the commercial aspects of her work.
"When you are inside a business as an occupational health provider, you
think you have got it sorted. But there is a world of difference between
working within an organisation and operating as a consultant focused on the
financial and commercial realities within an organisation. As an OHA you do not
count the time and the costs, working to the quarter hour when you are doing a
report or a project, not only for yourself but for everyone involved.
"The other issue is the marketing. If I went back into an organisation
as an OH provider I would do it differently – as a businesswoman, not as a
health professional.
"Of course, you have to be careful not to lose sight of the health
perspective," she says. "But we have to be commercial and we have to
look at the business aspects in order for the healthcare aspects to be taken
seriously.
"When I work with clients I establish what their emotional,
technological and financial appetite is to address healthcare issues. I explain
the options and I propose a template for the job. The client has only a certain
amount of budget so you have to make every penny count. That is the thing about
consultancy and occupational health, both are a people business. A client will
buy you first, your organisation second, and what comes behind it third."
Status conscious
Owen believes a similar principle should apply for OH providers.
"This is what a lot of people forget and they forget how important it
is particularly in OH," she says. "Anyone in occupational health
needs to get themselves into a position where they are credible. In many
organisations they are seen as "nice to have" and may have to make a
good case and negotiate hard to attract the budget they need to operate
effectively.
"But we can and must prove a direct relationship between risk reduction
and cost reduction. There is no place for fluffy, unquantifiable ideas."
She also believes that occupational health needs to be more willing to move
with the times in order to keep its status within the organisational structure.
"In OH we get defensive and hide behind the issues of confidentiality.
We still tell people what we can’t do, not what we can. We have been slow to
lock into the new technologies. In an age of instant access many OH services still
expect clients to wait weeks for a doctor’s appointment. We are not asking
professionals to drop their standards simply to move with the times; not
everything needs to be done face-to-face.
OH is a slow growing specialism in a time of huge growth in the health
arena. We need to seize the opportunities. As OH professionals we are not
leading the debate, we are not even putting our own views forward." It
need not be like this, however, she maintains.
"OH is a career with some of the biggest opportunities in healthcare.
But I can see it ending up with the OH role being filled by other
professionals.
I think the education system has an awful lot to do with this – we are not
educating people appropriately. We are not churning out the people who can
operate in this cut-throat challenging corporate environment. We have to fight
the battle of the balance sheet, and if the OH profession is going to survive
then it has to find the way of getting the right people into the business and
keeping them there. Currently, the opportunities for personal and professional
development in OH are second to none" she adds. "The remuneration
opportunities in this job are about the best in nursing. You may have to work
damn hard but they are there. The difficulty is to manage healthcare within a
corporate environment and make these two work together to create a win-win
situation. That is hugely challenging.
"I think OH has to reinvent itself, portray itself as a profession that
offers a breadth of opportunity that no other aspect of nursing does."
Sector opportunities
She cites the huge interest in all aspects of health at the present time.
"The fastest growing dotcoms are health-based," she says.
"Health is high profile."
But, she claims, occupational health professionals need to work together
much more as a coherent unit in order to tackle a number of workplace issues.
"For example, there is still a lack of quality information about what a
psychological risk assessment and an effective organisational stress management
programme should look like. If we are not careful we are going to end up in a
situation where stress is going to be managed by litigators and the media.
Surely the OH profession should be able to bring together its wealth of
knowledge and influence if not drive the agenda. But currently we are not
sharing that information nor evaluating the outcomes of what we do.
When I was in practice I felt the isolation of the way we operate and itched
to get people to work together more. The AOHNP has started to encourage it. But
I don’t think we have ever quite managed to make our networks work."
As a consultant, Owen says she now looks at OH through a very different set
of eyes than she did before.
"The Mercer name is very well respected," she says. "However,
people are looking at what you can do for them, not just for your credentials.
More importantly they are looking for what you can do for them that they cannot
do for themselves. There is a big difference between intervention for its own
sake and that which works. Often when I audit OH services I find a lot of
activity but limited impact that delivers results."
She will work with clients with no current services or the OH team if one is
already in place.
"Working with clients you have to be absolutely certain about what you
are going in there to do. For example, is the aim to start with what they have
and mould and shape that or to work from a blank sheet of paper. We identify
the needs and lay out all the options, and look to involve the in-house team.
We pull all that together, cost it, and look at all the implications and the
benefits in individual, operational and financial terms. We often have tough
debates and expect to have to predict with accuracy the ultimate outcomes.
"We also look at the culture of the organisation as well as its health
status," she adds.
"We always look at the management and communication structures, as all
this impacts on anything you want to do in health. We can use health as a good
tool for cultural and organisational change. It is recognised as a plus, both
from an employer and employee point of view if it is handled well."
Owen believes the opportunities within OH are "absolutely huge.
Organisations who manage employee health well are going to be the successes of
the future. There is great prestige in this job. Occupational health does not
always promote itself well. But I for one am quite proud of what I have achieved
as an occupational health professional."
Owen’s route to the top
– St Bartholomew’s Hospital, London, nurse’s training
– Hospital nursing work
– Nursing work in South Africa
– RCN occupational health course
– British Airways
– Cunard
– Phillips Electronics, senior nursing officer
– Metropolitan Police, head of occupational health, safety and welfare
– William M Mercer, head of occupational health consulting
Business lessons for OH
Gain credibility – have a good business case, drive the agenda to
raise the profile of OH
Move with the times – lock into new technologies, seize opportunities
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Educate – be aware of business issues and create chances
Work as a team – share information, be results-focused
