Nearly two decades on from her seminal ‘Working for a healthier tomorrow’ review, the UK has made little progress in tackling the deep “structural problems” it faces around work and health, Professor Dame Carol Black has said.

Dame Carol, whose recommendations included replacing the sick note with the fit note, was speaking at last week’s health and work ‘summit’ organised by the think-tank The Work Foundation at Lancaster University and the Centre for Organisational Health and Well-being.

At the same event, Sir Charlie Mayfield, author of the Keep Britain Working review, urged a future Andy Burnham-led government to see fixing workplace ill health as “one of the biggest opportunities we have to drive growth”.

Dame Carol, in a question-and-answer session with Work Foundation director Ben Harrison, argued that, while progress had been made, especially in terms of the engagement of employers with health and wellbeing, the problems she identified back in 2008 in her review of work and health were still with us.

“The structural problems have not gone away; the changes that needed to be made to our welfare system even when I did my report are still on the whole with us,” she said.

While successive administrations had attempted reforms both to benefits and workplace provision, our system remained fragmented. “We have fiddled at the edges. It has been a series of stops and starts,” she said.

Intervention when someone goes off sick still does not generally happen quickly enough, she highlighted, and the GP fit note does not work as she envisaged it back in her review. Statutory sick pay was, too often, used by employers as a way to ‘manage’ employees out of the workplace and into the benefits system.

“It is not lack of initiatives, it is not lack of people wanting to do the right thing. I fear it is lack of a determination of our policy-makers; I think they know the problems, but somehow we have not been able to do sustainable change,” she told the summit audience.

“I wanted [the fit note] to be for our general practitioners to be able to have the conversation of what might you be able to do, not what you cannot do, so I am going to sign you off from work. I think I was naïve or perhaps hopeful that we would be able to work with the Royal College of General Practitioners and enable them to find the time and the space,” Dame Carol said.

With fit note reform back on the government agenda, she was asked by the audience what her hope was for this process. “What I hope is that the learning, can it be brought together? So that we can start to have a real programme around what is the best way to keep people in work early or get them back to work,” she said.

Combined with the expected Keep Britain Working healthy standard, employers needed to be able to draw on a “basket” of interventions, she argued, backed by as much evidence as possible. “That you know you can use with confidence and get the right result,” she said.

Finally, with Andy Burnham’s expected arrival in Number 10 next month – who will be the eighth prime minister since the publication of Working for a Healthier Tomorrow – what was her hope for this new administration, she was asked.

“I hope he will appoint a very strong secretary of state in DWP [Department for Work and Pensions] who has got the courage and the vision, and also the resilience, to see that we are not going to be able to get things better in two years; the basic reforms that need to happen,” she replied.

“That they could set out a programme that won’t disadvantage people who are in the benefits system at the moment but will allow us, with confidence, to move forward sensibly so we don’t have so many people out of work,” Dame Carol added.

Separately, the summit saw the Work Foundation publish a report analysing employer views on workplace health.

The Unequal Support report argued that, while health-related exits from work are slowing, practical provision and support still remains limited. Moreover, support is often lowest where health risks are greatest.

It recommended the need to embed prevention and healthy job design as a core employer responsibility. It called for the establishment of local ‘work and health’ hubs for small and medium-sized enterprises.

It argued for the piloting of ‘supported workdays’ that allow workers to remain in work during period of reduced capacity. And it called for government to undertake a consultation on the appetite for a new statutory right to paid time off for medical appointments.

As the report concluded: “Given timely access to healthcare – without requiring employees to use annual leave or absorb income loss – supports earlier intervention and faster recovery.

“Government should consult with employers and employees on the introduction of a new right to paid time-off for medical appointments. A similar entitlement is already available to pregnant employees, recognising its importance to sustaining workforce participation during that period.”

 

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The post Dame Carol Black: UK still not tackling workplace health ‘structural problems’ appeared first on Personnel Today.

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