Impact of government cuts on OH

Although occupational health was not targeted in government cuts, it will be caught in the cross-fire. Nic Paton reports.

It is fair to say the words “occupational health” did not pass Chancellor George Osborne’s lips when he stood up in the House of Commons to announce the details of the Comprehensive Spending Review in October.

But to assume that occupational health will not be affected by the profound changes the review will make to the UK’s economic and spending landscape over the next four years would be a big mistake.

In fact, occupational health practitioners across the public and private sectors and in the NHS (despite the latter being nominally ring-fenced from the review’s cuts) could all be significantly affected by what we might term the post-review “new normal” we are entering.

Making the case for OH

The key thing for OH practitioners to recognise from the review is that, even if they are not directly in the firing line, they will probably be caught up in the maelstrom, warns Graham Johnson, Bupa Health and Wellbeing UK OH nursing development manager.

For example, consider the cuts being planned for local government, an area where OH provision has traditionally been strongly represented. The chances are that if managers are looking to make savage cuts across the board, OH is unlikely to escape.

“We have to recognise that reducing headcounts could have an impact on OH teams too. In some local authorities, in particular, I would not be surprised if some teams were losing people,” Johnson says.

Yet, conversely, in a straitened climate, local authority managers are not going to want to see either absence or the cost of managing absence going up. So, if the business case can be made that it needs to be maintained as a priority, there may be a greater emphasis and focus on absence and attendance management and, who knows, even the possibility of increased investment or new thinking.

“Many local authorities between now and next March will be looking at how best to use the limited resources they have. So we may start to see more remote models or more outsourcing to the private or commercial sector,” predicts Johnson.

Changes to welfare could also have a significant knock-on effect on OH. First, and most positively, the Government’s pledge to increase spending on “talking therapies” could mean greater support for people with mild to moderate mental ill health.

Psychological therapy

Any network of psychological therapy centres will need to be backed by good workplace-related support, from either within or outside the workplace, cautions Sean Duggan, chief executive of the Centre for Mental Health (formerly the Sainsbury Centre for Mental Health).

“Extending access to psychological therapies should ensure that people of all ages and with a range of mental health problems will get evidence-based therapies more quickly than they do today.

“If this is provided alongside good-quality employment advice it should help more people with mental health problems to stay in work when they become unwell.”

Changes and ramifications to OH

Just as importantly, the planned changes to employment and support allowance, particularly the introduction of a 12-month cap on claiming it, something specifically designed to encourage people off benefits and back into the workplace, could have significant ramifications for OH professionals. This will particularly be the case if it falls to OH to be case-managing all these individuals with chronic conditions either back into the workplace or supporting them in work once they have made that transition.

Especially for people with mental health problems, where their inability to work may not be immediately apparent, it will be of a paramount importance that mental health assessments are accurate, fair and carried out by trained professionals, says Mental Health Foundation chief executive Dr Andrew McCulloch.

Long-term view for OH

Finally, perhaps the longest-term ramification of the spending review for OH professionals could be the acceleration in the raising of the retirement age for men and women. Of course, moving to 66 by 2020 will not result in vast changes straightaway. But, given both the demographics and the UK’s pension crisis (itself set to be addressed in many changes, including a new national pension scheme, from 2012 onwards) few, if anyone, expect the cut-off age to remain at 66.

As Bupa’s Healthy work report recognised earlier this year and The Work Foundation’s “Healthy work: challenges and opportunities to 2030” report last year showed, this changing demographic has the potential to lead to huge challenges for OH. There is the prospect of OH professionals having to manage a much older, sicker working population in the future.