Opinion

Is it time for employers to play a greater role in public health?

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Ill health – irrespective of what caused it – has a negative impact on productivity and public finances. The business case to address this health gap persists.


With more of us living longer, and living longer with health conditions, the costs associated with ill health – whether from reduced economic productivity or increased public spending – is likely to increase in the coming years. In the UK alone, the state spends over £12bn a year on health-related benefits and foregone taxes and employers face a £9bn bill. Yet the response so far to address this issue has not been effective.

In the workplace, the ‘health’ in health and safety remains pretty clear: health risks that arise from work activities must be controlled and there are clear duties about who is responsible for doing this. There are still compliance problems of course, as the growing costs of sickness absence due to stress and muscoleskeletal disorders testify, but the legal framework and the regulatory response is highly developed (if not, according to some, fully resourced).

However, given the impact of poor health on economic performance, impairments to health from non-work sources such as cancer, mental health problems or poor diets, would seem to make investment in this area worthwhile. The question arising, then, is about who and how.

From a regulatory point of view there are no duties to reduce such health risks and the institutional architecture to deliver improvements is not really in place.

Our attitude to responsibility in this area is also quite complex. There is something very powerful behind the principle of the Health and Safety at Work Act that those who create the risks have a duty to manage them. If we extend this principle to other aspects of health, we would say that generally it is the individuals who are responsible for their health and if they endanger their health through the choices they make, they must live with the consequences. Of course when this relates to cancer or disability, then it may be that no one is responsible, as it just happened from random (possibly genetic) factors.

In either case, one’s health is mostly seen as a private matter and the lack of regulation and institutional involvement reflects this. Even this is complicated when you consider the impact of work on existing health conditions, as recent research shows in relation to work-related stress and cancer. But the fact remains that ill health – irrespective of what caused it – has a negative impact on productivity and public finances. The business case to address this health gap persists.

The Way Forward: policy options for improving workforce health in the UK, the first white paper of the Health at Work Policy Unit of the Work Foundation, attempts to stimulate discussion and debate on this topic and is well-worth reading. One area is about the provision of workplace health and wellbeing programmes. Options about how to encourage workplaces to adopt them range from fiscal incentives such as tax breaks or levy systems to mandating employers to provide these programmes and responsible procurement by the public sector. Again though, questions of responsibility arise. Why should an employer pay for such a programme if one’s health is a private matter? Indeed why should governments?

This takes us back to where we started. The mantra good health is good business is backed up by the evidence. We now need to reframe it in terms of health economics that improved health will stabilise or even reduce public spending, as well as improve productivity.

An avenue to explore will be how the skills and experience of the health and safety community in identifying and managing work-related health risks can be harnessed for the future as economies change and the wellbeing agenda grows. Such a direction, in an election year where we need all parties to offer fresh ideas, could be the start of new efforts to promote health at work.

Matthew Holder is head of campaigns and engagement at the British Safety Council

 

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