Occupational health in 2008: opinion

More than any for some time, this one promises to be a happy New Year for occupational health.

We are waiting on the recommendations of a series of consultations that may strongly influence our specialism’s future: Dame Carol Black will offer us recommendations on work and health; Lord Darzi will advise on the future of the NHS; and the Department of Health will offer direction arising from the Commissioning Framework for Health and Wellbeing that suggests primary care trusts should commission specialist OH services for GPs’ patients.

Meanwhile, the National Institute for Clinical Excellence’s guidelines on workplace health issues are upon us, and we will finally be able to stop wondering what’s the purpose of having both a Health and Safety Executive and a Health and Safety Commission.

As we look forward to 2008, we should also reflect on the past year. It seemed to start with the same sense of anticipation of the coming one, but looking back, there’s not been much to show for it. However, it ended with two encouraging events – an awards ceremony that celebrated achievements in occupational health in the public and private sectors and small and large enterprises, and a combined OH medicine and nursing conference focusing on collaboration. It is this second matter that gives me particular optimism.

Is OH finally growing up? Are we losing the last remnants of the “them and us” generation? I think we might be. At the Cardiff conference, there were fascinating research projects presented by OH nurses and physicians which were warmly received by mixed audiences. At the same time, there were one or two presentations by OH nurses or physicians that left the audience with the same sense of disappointment. Irrespective of our professional background, we all have good and bad days.

Since the conference, I have heard only one person express cynicism about collaboration, and many express thoughtful support. No doubt there are some who will rue the ‘good old days’.

There is nothing wrong with reminiscing about the times when we had huge manufacturing and productive industries, and healthcare was more formal. But technology and practice have moved on – patients can buy many medicines for themselves without a prescription from either a doctor or a nurse, computers can diagnose and treat illness, and in the safest most secure workplace ever, we’ve invented a new epidemic, called ‘stress’. Sadly, or not, we now have the opportunity to create a new set of ‘good old days’.

A debate about collaboration is about exploring boundaries. On many issues, there will be strong agreement, on some there will be equally strong disagreement. Challenge and support in our debate shows mutual respect, and is collaboration at its best.

Last year, correspondents challenged the right of a doctor to discuss nursing issues. I never quite understood this – it seemed OK for patients, the public, and the media to do so, but apparently, not doctors. It’s impossible to discuss issues of importance to OH without discussing medicine and nursing. Even the most ardent critics of collaborative working recognise each profession has a critical role to play. With the coming challenges in 2008, there has rarely been a greater need to work together.

So make your professional resolution to contribute to the debate about the future of OH. If you don’t, then those who may well be less able and less informed will. And if I fall into this last category, then I make no apology.

 Dr Richard Preece is a consultant occupational physician

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