Occupational health centres recommended by Dr Donald Bruce of Trident Medical Services

The government should consider establishing a network of regional occupational health centres, into which workers could be directly referred by doctors, nurses and other specialists, the immediate past president of the Society of Occupational Medicine has said.

Dr Donald Bruce, now occupational physician with Trident Medical Services, was outlining his vision for the “four pillars of occupational health” to last year’s Royal College of Nursing Society of Occupational Health Nursing conference.

The conference, which took place in Cardiff in December, was held jointly with the Society of Occupational Medicine.

Bruce was updating a seminal 1981 British Medical Journal article of the same name by Professor Corbett McDonald.

“Occupational health is one of the few, if not the only, specialty where GPs or other specialists are unable to refer for advice,” he pointed out. “I would like to see units where doctors and nurses could refer people for occupational health advice,” he added.

Much like an earlier debate at the conference (see opposite page, top), Bruce suggested there should be a separate specialty of occupational health, overseen either by a faculty or academy of OH.

The centres could be co-appointed with the Health and Safety Executive and there could also be centres of excellence in teaching established, with Manchester, Glasgow and Aberdeen all possible choices, he argued.

More collaborative working – the overarching theme of the two-day conference – would be essential, McDonald added.

As part of this new working, Bruce was enthusiastic about the expansion of the use of technicians within the profession, both for smaller and larger employers.

“It is crazy to have nurses doing stuff that technicians are perfectly capable of doing and doing well,” he said.

But he also warned against OH being handed on a plate to primary care. “I am quite philosophically opposed to general practice getting too involved in occupational health issues. There are too many conflicts of interest. I think that is a substantial barrier,” he said.

There was a need for much greater collaboration, not just between OH physicians and nurses, but with all sorts of other areas and specialties.

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