Among the long and neglected to-do list of UK policy, six areas in OSH are in need of urgent attention and legislation. This is our manifesto for systemic and lasting change.
As the UK Conservative government begins work on a fresh legislative agenda, IOSH is urging the new administration to turn its attention to workplace health and safety. IOSH wants to see rapid progress in six key areas of OSH, from mental health and health-based modifications at work to the gig economy and post-Grenfell building regulation.
Brexit has been a sticking point, draining much attention from UK domestic policy (see What’s the impact of Brexit?). ‘These are all areas that have been neglected for far too long,’ says Richard Jones, IOSH head of policy and regulatory engagement.
The neglect is amplified by rapid economic and demographic changes in the UK’s workforce. An ageing population, technological change and more insecure gig working plus larger numbers of small- and medium-sized enterprises (SMEs) and self-employed all contribute to the pressing need for better workplace health management.
IOSH has prioritised the six areas for several reasons. They reflect IOSH’s six global priorities: fatal injuries, occupational cancer, wellbeing, rehabilitation, musculoskeletal disorders, and sustainability and human capital. They also align with the IOSH manifesto, making the case for health and safety, occupational health (OH), designing-in safety and health, developing competent workforces and championing social responsibility.
Crucially, the six areas are also rooted in ongoing discussions between government and the OSH community. ‘These are all areas that government has already consulted on or reviewed, or were in the Conservative manifesto,’ Richard explains. ‘We want to make sure that the UK government follows through on improvement work already begun or committed to. That’s why we are highlighting them – and will keep highlighting them.’
IOSH’s six areas for urgent progress In the UK
- Occupational health service reforms and subsidies
- The right to request health-based modifications at work
- Mental health at work improvements
- Modern working practices reform
- Better transparency on preventing modern slavery in supply chains
- National ‘post-Grenfell’ reforms on building regulation and fire safety.
1. Occupational health reforms
During 2019 in the UK, there were 1.4 million cases of work-related ill health, 600,000 cases of work-related stress, anxiety and depression, 500,000 cases of musculoskeletal disorders, and 13,000 deaths caused by past workplace exposures to chemicals or dust. The economic impact is massive too: 23.5 million working days were lost to work-related ill health and an annual cost to the UK economy of £22bn.
Driving down this ill health depends on universal access to high-quality OH services, yet access remains the preserve of too few. ‘Access to OH services is very patchy,’ says Richard. ‘In the private sector, only 39% of workers have access. Research shows that the UK is short of more than 40,000 OH professionals, a major shortfall that we must address.’
SMEs and the self-employed face particular challenges, with small firms five times less likely to invest in OH services than larger firms. The government’s 2019 consultation on reducing health-related job loss, Health is everyone’s business, acknowledged that OH advice is effective in supporting a return to work, but
that cost can be a barrier for SMEs.
‘The upcoming Employment Bill needs to include a right for all workers to request a more predictable contract’
It’s an issue that IOSH has raised with the UK government, both in its response to the consultation and in its current call to improve access to OH services. According to Richard: ‘IOSH commissioned a survey of SMEs in 2012, and 40% told us that tax breaks would help them do more on OH. That’s why we’re asking the government to introduce economic incentives like tax breaks and vouchers or subsidies to help SMEs and the self-employed access high-quality OH services.’
Increasing demand, however, must go hand-in-hand with boosting capacity. The General Medical Council reports that the number of specialist OH physicians declined by 20% between 2012 and 2018. The Faculty of Occupational Medicine (FOM) says: ‘Funding models for training and developing the OH workforce – physicians, nurses and allied health professionals – should be designed to meet population health needs,
as is the case with other health specialities.’
The FOM is also concerned about low levels of provision in SMEs, but views innovative delivery models, such as access to OH advice via the NHS, as the best remedy: ‘Subsidies to employers or individuals may have a place but should be linked to access to competent, quality-assured OH advice and prioritisation of access to NHS interventions,’ it says.
2. Right to request health-based modifications
In tandem with OH market reform, the UK government consultation Health is everyone’s business discussed the need for a clear legal framework for employers, mooting the possibility of introducing a legal right to request workplace modifications for people not covered by the Equality Act 2010.
IOSH is calling on the UK government to introduce a right to request health-based modifications, which would, for example, give women going through the menopause the right to ask for a desk nearer a window or have a fan nearby, allow flexible working or a change in tasks. ‘It’s about recognising the need for workplaces to be more worker-friendly and accommodate individual needs more,’ says Richard.
3. Mental health at work
In 2017, Thriving at work – the independent review on improving mental health and supporting workers with mental health problems to remain in work – found that 300,000 people in the UK with long-term mental health conditions fall out of work each year, and that poor mental health costs employers up to £42bn a year, with an annual cost to the UK economy of up to £99bn.
Thriving at work concluded that, with the right support and adjustments, many people with mental health conditions could remain in work. It set out a framework to enable all UK employers to address workplace mental health. And it called on the UK Health and Safety Executive (HSE) to do more on mental health during inspections, revise its guidance on the duty to manage work-related mental ill health, and widen its management standards for stress.
‘Digitalisation has created an “always-on” culture. We want the government to consider a right to switch off to prevent this intrusion’
The 2019 Conservative manifesto reiterated the party’s commitment to parity of treatment between mental and physical health and promised legislation to ensure that patients with mental health conditions have greater control over treatment. But despite increasing public discussion around mental health – from campaigns such as Time to Change and Heads Together to awareness programmes such as Every Mind Matters and Mates in Mind – IOSH wants to see more education about the nature of ‘good work’ and its importance in supporting mental health so that employers can do more to create healthier workplaces.
IOSH is also concerned about rising levels of workplace stress. ‘Last year, Britain had over 600,000 cases of work-related stress. That’s the largest number for 18 years. It’s worrying,’ says Richard. ‘We would like to see financial incentives for SMEs to better support mental health at work, and we would also like the government to support the “right to disconnect”.’
Workers at French firms with more than 50 staff have had a legal right to disconnect since 2017, and Italy followed suit in 2019. Companies such as Orange, VW and Axa have introduced similar policies. ‘Digitalisation has created an “always-on” culture,’ says Richard. ‘We want the government to consider a right to switch off to prevent this intrusion.’
4. Modern working practices reform
As well as being good for mental health, a right to switch off and greater focus on what makes work good are also central to modern working practices and the gig economy. With more than three million people in the UK facing insecurity at work and 1.4 million contracts lacking a guaranteed minimum number of hours’ work, many modern working practices can adversely affect safety and health.
In 2017, the government-commissioned Taylor review of modern working practices found that despite record levels of employment in the UK, the quantity of work needed to be matched by its quality. The report, Good work, called on government to ‘adopt the ambition that all work should be fair and decent’ – a view echoed by IOSH.
‘The report found problems with one-sided flexibility and insecurity in the growing gig economy. The government is committed to taking action on this and has already legislated in some areas, like protecting agency workers and extending the right to a written statement for all workers, but IOSH is keen to see further progress,’ says Richard. ‘The upcoming Employment Bill needs to include a right for all workers to request a more predictable contract and make flexible working the default unless employers have a good reason not to.’
As well as taking forward recommendations of the Good work plan, the report’s author and chief executive of the RSA Matthew Taylor wants to see progress made towards an integrated single enforcement body. Matthew says: ‘Economic successes must be enjoyed by all workers – should the labour market not deliver good work, then we stand little chance of boosting our national productivity in the long run.
‘The government should focus on creating the conditions for good work for all. Those in low-skilled jobs ought to have greater control over their working hours, an awareness of their rights, a sense of progression and lifelong learning. Good work will restore the link between hard work and fair pay.’
What's the impact of Brexit?
‘Brexit is a long-term strategic project; the act of leaving is only the start,’ says Richard Jones. ‘It must now run in parallel with domestic priorities. The UK’s domestic situation – which includes many pressing workplace issues – can’t continue to be put on hold. Failure to prioritise a safe and healthy workforce would be a mistake in our view. It’s short-sighted, counterproductive and a false economy.’
Sajid Javid, the former chancellor, poured cold water on expectations of a level OSH playing field in January: ‘There will not be alignment, we will not be a ruletaker, we will not be in the single market and we will not be in the customs union – and we will do this by the end of the year.’ But the EU has said one of its priorities in negotiation is to prevent the UK from easy access to the single market without maintaining similar labour and environmental standards. It is unlikely non-alignment will occur for its own sake, so the scope for reducing any health and safety protection is narrow, but the Brexit process has been unpredictable and that shows no signs of changing.
5. Preventing modern slavery
Few people will forget the 39 bodies of Vietnamese nationals found in a container lorry in Essex last year. For professionals, the changes required to prevent a similar incident are happening too slowly.
The Home Office estimates around 13,000 people in the UK are victims of modern slavery, and while the Modern Slavery Act 2015 was world-leading when it was introduced, the crucial clause on transparency in supply chains (TISC) is failing to work as intended.
IOSH is calling for a ban on combustible cladding on all high-rise buildings, more action on sprinklers, and the Hackitt review’s safety case regime
‘Forty per cent of organisations are failing to comply with TISC, and of those that do disclose, the statements are often of poor quality,’ Richard explains.
‘We want to see a central, government-run repository of statements, standard core content requirements for disclosures; we want TISC extended to the public sector and organisations with a turnover below £36m; and we want the government to remove the ability of organisations to say they are taking no steps to tackle modern slavery – we think that’s wrong.
‘Everyone should be acting to eradicate modern slavery, and it’s only through transparency that stakeholders can hold organisations to account for the actions they take to tackle it.’
6. Building regulation and fire safety reform
Another graphic illustration of health and safety failings was the 2017 Grenfell Tower fire in London, which killed 72 people. Here too, progress has been painfully slow. Dame Judith Hackitt’s review of building regulations and fire safety revealed extensive problems and a system not fit for purpose. The government accepted the recommendations in full, as well as those from the first phase of the public inquiry by Sir Martin Moore-Bick. It plans to set up a new building safety regulator within the HSE. But it has also threatened to name and shame organisations that don’t improve their buildings.
IOSH is calling for a ban on combustible cladding on all high-rise buildings – both residential and non-residential – more action on sprinklers, the introduction of building and fire safety competence requirements and the safety case regime recommended by the Hackitt review, and clarification of the regulatory reform fire safety order to ensure everyone understands that it now applies to external walls, cladding and fire doors in residential premises.
There is much at stake: changes will reduce harm significantly. ‘Realistically,’ says Richard, ‘IOSH expects all six to be delivered in this parliament. The Queen’s speech included bills on employment, building safety and fire safety. These can set the UK legislative framework for much of what IOSH wants done, so there should be nothing stopping them.’