05 September 2007

Lord McKenzie

Minister for Health and Work

BMA Conference – Work, Good for your Patient’s Health and Wellbeing

Wednesday, 5th September 2007

[Check against delivery]

I’m grateful for the opportunity to join you this morning and I very much welcome the leadership that Sam and the BMA are showing in holding this conference today.

One of the things I admire about the medical profession is that it never stands still. It’s never satisfied with the knowledge we have today – it’s always asking the questions – how we can improve treatments; how we can deepen our understanding of the causes of health conditions; how we can help patients to live healthier lives – not just to treat ill-health but to take steps to prevent it in the first place.

Sometimes your findings don’t just change medical practice – they challenge the very thinking and assumptions at the heart of our culture and society. They question the behaviour and attitudes of every individual, every organisation and every employer in the country. And they challenge the approach of Government too.

The idea that there is evidence that work is good for people’s health is, I believe, that powerful. Why? Because it means staying in work or returning to work could actually be part of the solution to ill-health – no longer be seen as part of the problem.

It says to us in Government that our ambition of full employment can not just be about getting people into work – but with 600,000 people coming out of work and onto incapacity benefits each year – it’s also got to be about improving the support for managing health conditions in work. And crucially, this evidence suggests that such an approach – combined with careful management of the risks of ill-health – could actually be in the best interests of the British people.

Similarly, it says to British business that making the adjustments to help an employee manage a health condition while staying in work could in fact help that employee get better – saving the costs of sickness absence or, worse, the recruitment and training of new replacement staff.

And, of course, it puts the question to the individual and to you as health practitioners about how you might adapt your approach – to help patients to think differently about the benefits and risks of work when confronted by a health problem – because people will always go to their doctor first and the advice they receive will greatly affect their outlook on coping with their health condition.

Today’s findings from a survey of 1500 GPs carried out by Doctors.net.uk on behalf of my Department reported that two-thirds of GPs were not aware of the evidence that work is generally good for health. But, perhaps most significantly, it found that almost 90% felt that such evidence would be important and would affect the way they practice.

And that’s why coming together today is so important. To examine the evidence and again ask the questions – about what this means for improving medical practice and offering ever greater support to patients.

I can’t answer those questions for you – nor is it my place to try. But what I can do is to underline our commitment as a Government to supporting you in addressing the links between health and work - and to encourage you to work with us – and with Dame Carol Black – on the development of our strategy to improve the health and well-being of every person of working age.

The Doctors.net.uk research found that only 40% of GPs felt confident about dealing with patient issues around returning to work; and over half thought that their sickness certification practice would change if they had better skills in dealing with these issues.

It highlights a desire from GPs for more support and I’m very pleased that my Department has been taking steps to try and meet this need.

Today we are publishing a new leaflet for GPs and other healthcare professionals highlighting the key evidence and offering practical support in their day to day dealings with patients.

We’ve just finished piloting a National Education Programme on health and work – developed and delivered by the Royal College of General Practitioners in six of their faculty areas. The evaluation is currently underway and we will make a decision about potential roll-out of this programme when it’s completed – but the early signs are positive with the proportion of GPs describing themselves as confident about dealing with fitness for work issues more than doubling post-workshop – and with all of them anticipating that the training would have some effect on their interactions with patients.

We’ve been working with the GMC to develop key messages on health and work to include in medical student training – I know that Graeme Catto is speaking to you later this afternoon and I’m very grateful to him and the GMC for their support.

We are currently working with the Academy of Medical Royal Colleges to consider ways of incorporating similar messages in postgraduate training of all doctors too.

And we’ve commissioned an online training module to support doctors in difficult consultations with patients about work. Again, I know Debbie Cohen is speaking to you shortly – and I’m grateful to her and colleagues at the University of Cardiff for all their work on this.

I hope these materials will prove helpful – and I’m keen that you continue to feed back to us about how we can improve them or develop them further.

There is, I believe, a pivotal opportunity for all doctors and other healthcare professionals to help people think differently when responding to a health problem. For people to see returning to work as something that could be part of rehabilitation not simply an end point that comes only after rehabilitation has been completed. For people to think not just about what they can’t do – but actually what they could do – and what support they might need to do it. And to help ensure that, wherever possible, treatments and interventions are provided quickly so that people are able to continue in work or to be away from work for as short a time as possible.

But we recognise that to meet this challenge GPs in particular need help and support. They are not occupational health specialists – and we shouldn’t expect them to act as though they are.

We’re already working to try and improve the demands made of GPs in sickness certification. Next year will see a revised FMed3 – more robust, simpler to complete and more helpful in discussions with patients on fitness for work. And we will also test the electronic transfer of FMed3 information to the Department through a pilot commencing in Wales later this year.

But all of us – whether Government, employers, the medical profession or even individuals themselves – must consider how we can go further in responding to the evidence of the links between health and work if we are to meet the challenges of tackling ill-health in the working age population.

That’s why Alan Johnson and Peter Hain have asked Dame Carol to carry out a review of the health of the working age population. Dame Carol will be launching her Call for Evidence later this month – and I very much hope the BMA and all of you here today will work with her over the coming months as she carries out her review.

Dame Carol’s recommendations will not be confined to GPs or to the medical profession more generally. From sickness certification to health support in the workplace – nothing can be off the table at this stage if we are serious about building genuine consensus around a long-term strategy for the health of our working-age people.

The future health and prosperity of our nation is at stake. All of us must rise to the challenge.