Protecting the health of the working age population
1 Sep 2010
Dan Lucy, Research Fellow
With a new coalition government in place, and public sector budget cuts under way, it is timely to consider what this means for existing policy around health and work, and what the future might hold.
Under the previous Labour government, the benefits to health of ‘good’ work were recognised, a Director of Health and Work was appointed, and a multi-stranded approach to protecting and improving the health of the working age population was proposed, and shortly afterwards set in motion. The approach included: introducing the Fit Note (a replacement for the medical sickness certificate); pilot occupational health helplines for small and medium-sized businesses (SMEs); pilot Fit for Work services in 11 areas across the UK, designed to aid recovery and return to work following a period of sickness absence; and education to GPs about health and work.
The coalition’s programme for government included a number of commitments of relevance to protecting and promoting the health of the working age population.
Post-election, much of the rationale for policy intervention remains, with occupational health services still the preserve of the few rather than the many, and a relatively high, but stable, bill for benefit payments provided to those unable to work due to a health problem or disability (approximately £12.6 billion for the year 2008-2009). Research commissioned by the Department for Work and Pensions has shown that three-quarters of benefit claimants were in work either immediately prior to their claim, or within the previous two years. In addition, with increasing public sector efficiency a continuing issue, driving down absence rates and improving productivity (across the economy) remain key policy issues. Previous research has highlighted the costs of sickness absence to both employers and the economy, and the importance for economic growth of improving the health of the working age population.
Review of health and safety
The coalition has announced that Lord Young will undertake a review of health and safety legislation, including assessing how to reduce burdens on small, local and voluntary sector organisations, and whether or not legal protection can be extended to include all people acting in good faith, including public sector professionals. Underlying this review appears to be the belief that the prevailing health and safety culture is excessive, and existing regulations place too great a burden on employers. Dame Carol Black’s review noted that the number of injuries suffered at work had decreased by 70 per cent since the introduction of the Health and Safety at Work Act 1974. However, the Act is perceived to have been less effective in preventing occupational illness, and despite efforts by the Health and Safety Executive (HSE) to help employers to better manage common health problems within organisations, latest HSE statistics show that musculoskeletal disorders and stress remain the two main causes of self-reported work-related illness (approximately 950,000 people in 12 months), and working days lost due to ill-health. There is clearly a danger that a review of health and safety provisions or resources could result in less protection for employees, and an increase in workplace injuries and ill health.
Coalition commitments on work and health
The coalition’s programme for government included a number of commitments of relevance to protecting and promoting the health of the working age population. These included:
- a commitment to support the National Minimum Wage
- a review of the benefits system to remove disincentives to work
- improving the Access to Work scheme to make it easier for disabled individuals to compete for jobs
- extending the right to request flexible working to all employees, consulting with business on how best to do so.
- In addition, the programme commits the government to reassessing all current claimants of Incapacity Benefit for their readiness to work. Access to benefit on the grounds of incapacity has been made tougher with the introduction of the Employment and Support Allowance (ESA), with a greater focus on what claimants can do rather than what they cannot. There exists the possibility of a gap in services developing for those unemployed individuals with an existing health problem who are considered fit enough to return to work but who need some support to do so.
As shadow health secretary, Andrew Lansley proposed tax breaks for employers that invest in workplace and occupational health, and suggested that if elected, the Conservative Party would consult on measures to incentivise preventative measures in occupational health. In a pre-election Green Paper, the Conservatives also suggested that, if elected, they might consider offering matched funding for businesses that spend capital on promoting health improvement. The paper also suggested that there was a need to help employers see the benefits of investing in health or, alternatively, better apportion costs between employers, individuals and the NHS. It is unclear what the present thinking of the Coalition Government is on these issues, but a Public Health White Paper scheduled for late 2010 might offer some answers.
What this all means
It is still early days for the coalition, and it is too soon to reach a definitive judgment about what effect the new government may have on policy surrounding health and work. There are compelling underlying reasons for a continued focus on protecting and improving the health of the working age population, although with budget cuts under way, the status of the health, work and well-being initiatives launched under Labour may be uncertain. What we know to date of coalition plans presents a mixed picture, with commitments to improving public health balanced against concerns over the review of health and safety legislation and what this may bring.
 Waddell G, Burton AK (2006). Is work good for your health and well-being? London: TSO (The Stationery Office
 Black C (2008). Working for a healthier tomorrow. London:TSO
 HM Government (2008). Improving health, changing lives. London: TSO
 Kemp PA, Davidson J (2008). Routes onto Incapacity Benefit: Findings from a recent survey of claimants. DWP Research Report 350
 Bell M, Kossykh Y, Ridge M, Woolley N (2008). An empirical analysis of health and economic growth in the UK. HSE Research Report RR639
 For example, The Management Standards for Work-related Stress, and the ‘Bad backs’ campaign.
 Health and Safety Statistics 2008/2009, HSE
 Conservative Party. A healthier Nation: Policy Green Paper No. 12
For more information on this work, please contact Jim Hillage at IES