27 February 2007

Lord McKenzie

“Good Work”: The case for healthy work and productive workplaces.

Tuesday, 27th February 2007

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Last year the Department for Work and Pensions published an independent review of the links between work and health. Titled ‘Is work good for your health and well-being?’, the review concluded that work is generally good for health and well-being as long as it is “good work”.

Which begs the question what exactly is good work?  Parents often worry about their children and encourage them to work hard at school so that they can do well and get a “good job”. But what do they mean and would their conceptions of good work necessarily be consistent with views held elsewhere?

At present, there is no widely accepted definition of a “good job” and these seminars build on the excellent work already undertaken by the Work Foundation to develop a dialogue on what constitutes “good work”.

The evidence review showed that being in employment is good for your health and well-being and that worklessness is bad for your health and well-being. We know that unemployment has a negative impact on health and well-being, and there is strong scientific evidence that being out of work is associated with adverse health outcomes such as:

• Increased obesity and reduced activity;
• Increased risk of heart disease and decreased life expectancy;
• Poor mental health and increased psychological distress;
• Double the normal rate of depression and three times the normal rate of anxiety

Returning to work can reverse the adverse effects of being out of work and for most people with common health conditions returning to work can have a beneficial effect. In addition to the health benefits, we know that work leads to greater social and financial inclusion, enabling us to:

• meet people, interact and to build relationships;
• play a larger role is society, bringing communities together;
• feel valued and have self confidence;
• and bring in income and provide for our families – work is the best route out of poverty, especially for those with children

And work is not just good for individuals, their families and society, it is good for the economy too.  A strong labour market allows for successful and prosperous businesses.  We currently have one of the best labour markets in the world – almost record high employment combined with very low unemployment.  But ill health is still having a major impact on our businesses and their productivity. We can and must do better.

The CBI estimates that the UK loses around of 164million working days every year due to sickness absence. Official figures suggest that 30 million working days are lost due to injury and ill health attributed to the workplace and HSE estimate that the cost to the economy of this absence is somewhere between 12 and 23 billion pounds a year.

This sickness absence has contributed to the 2.68 million people currently claiming incapacity benefits – almost three times the number of people claiming Jobseeker’s Allowance.  This is a very depressing figure, especially as we know that nearly nine out of ten customers coming onto the benefit want and expect to work again, if only they can get the help and support to do so.  Yet in reality, once a claimant has been on the benefit for two years, they are more likely to die or retire than work again.

And the demographics of the country are changing.  People are living longer and in many cases are retiring earlier, as they can increasingly afford to do so.  As such the proportion of people of working age compared to those in retirement is decreasing year on year. But there are also an increasing number of people retiring due to ill-health. Of the 8.8 million people currently between the ages of 50 and 65 1.4 million have been forced to retire early because of ill health.

In 1950, for example, there were 10 people of working age for every person in retirement.  Today this ratio is 4 to 1, and in 2050 it will be just 2 to 1. 

While this change is for very positive reasons, it is not a trend we can sustain and we must increase the number of people in work further to respond to the challenge.  We know that the only way of meeting this challenge is by making a reality of employment opportunity for all. We have set ourselves the aspiration of achieving an employment rate of 80% amongst those of working age.

Having more people in work is increasingly important for our communities and our economy. Can we afford to be denied the skills and contribution of those who have the potential to work? Put simply, no.

The importance of the health and well-being of working age people is shown by an interesting study in the Netherlands which was carried out among 23,400 employees. It looked at the factors influencing workers to continue working until retirement age. It concluded that about 40 percent of Dutch employees report that they are able to work until the age of 65 years, but only around 20 percent of all employees are willing to do so.  Furthermore, only 13 percent are both willing and able to work until they are 65 years old.

It was found that an individual’s health and working conditions play an important role in the decisions made regarding work continuation.  About 20 percent of employees with excellent health want to continue working and 16 percent want to stop. Among employees with bad health however, only 4 percent want to keep working and 42 percent want to stop working. Health appears to be a major predictor of the likelihood of workers to stay in work.

These seminars have been set up to discuss issues around “good work.” Healthy and productive workplaces are central to the Government’s Health Work and Well-being Strategy.

The Health Work and Well-being Strategy is a joint initiative between the Department for Work and Pension, the Department of Health and the Health and Safety Executive. It has evolved out of the work of all three Departments, and reflects goals touched on in the Choosing Health White Paper, the Welfare Reform Green Paper, and the HSC’s Strategy for Workplace Health and Safety. It builds on the existing work of these three departments and the extensive work done in both Scotland and Wales, where health is a devolved responsibility and they have been pushing issues forward

The Strategy recognises that if we are to meet the challenges we face and help people with health conditions and disabilities to remain in or return to work, we need to pay more attention to the health and well-being of people of working age. In particular it is about:

• Improving general health;
• Preventing work related illness and injury and using the workplace as an opportunity for general health improvement;
• Intervening early when health problems arise, providing appropriate investigations and treatment, providing them quickly and providing them locally to our customers;
• Providing appropriate rehabilitation support for those who have been long term sick;
• And ensuring workplace adaptations and return to work support are available.

What are we doing to meet the challenge?

We know that the challenge is a complex one and that to address it will require a number of strands of work.. We have appointed Professor Dame Carol Black as the National Director for Health and Work. Her role is to oversee the implementation of the Health, Work and Well-being Strategy; raise awareness of work and its relationship with health and well-being and to lead the debate on health and well-being.

But we know that many of the key themes of the strategy can only be implemented through collective effort, not just between the Government departments involved, but also with a number of stakeholders whose commitment and support will be key.

We have set up a National Stakeholder Council, to bring together a number of eminent stakeholders to champion and drive forward the strategy. The Council are working together and will be focuses on driving forward the strategy in a number of areas including:

• engaging employers as leading advocates of change – we know that health and work are intrinsically linked and the drive to create healthy and productive workplaces has to be led by employers
• shifting GP attitudes and practices -  we want to educate healthcare professionals on the links between health and work so that they can provide more comprehensive return to work advice for their patients.

Healthy workplaces are essential if we are to reduce the number of working days lost due to work-related ill health and injury.  We know that 40% of the working days lost due to work-related ill health are due to stress and anxiety.

Many people misunderstand the stress in the workplace agenda. People think we must eliminate all stress, anxiety or depression. We know this is not possible. What we must strive toward is reducing the levels of stress so that people do not become ill

HSE is focussing its efforts in the workplace upon bringing about a reduction in the number of employees who go off sick / who cannot perform well at work, because of stress and has run over 60 workshops in the last year to educate managers on how to implement their stress management standards,

HSE have also launched a Pathfinder service, Workplace Health Connect.  This confidential service provides free, tailored, practical advice and support to SMEs on any workplace health and safety issue.

The service provides small and medium size businesses with specific advice and support. We want this to tackle ill health and encourage the businesses to manage sickness absence and return to work. When a business wants to tackle stress in its workplace they are there to help.

I’m sure that many of you will say “Well, what about government’s record as an employer?”  And I think that’s fair.

 One in five workers in Britain are currently employed in the public sector and we know that we have to practice what we preach. The civil service is leading the drive toward the Government becoming and exemplar employer.

While there are many cases where the public sector is delivering healthy work places for our staff, we do not – as a rule – set a very good example. We know that we have much to learn from the private sector about healthy and productive workplaces. But equally, we can and must share our good practice in return.

Any business that wants to deliver a first class service needs that staff to be happy and healthy, and the civil service is no different. We know that the well-being of staff can be improved through tackling outdated work practices, introducing flexible working, reducing the frustrations of internal bureaucracy and creating an effective and open work culture.  All have successfully improved life in the workplace, and have reduced absenteeism into the bargain

Peter Housden, Permanent Secretary in Communities and Local Government has taken on the mantle of Health Work and Well-being Champion across the Civil Service.

This work builds on that of the Joint Ministerial Task force on Health Safety and Productivity which I chair. The Task Force is designed to ensure that ministerial and management effort is devoted to securing culture change in the management of sickness absence in the civil service and wider public sector.

There have been some excellent examples of parts of the Civil Service implementing better management of sickness absence. One example is Her Majesty’s Prison Belmarsh which in July 2002 had absence rates of 25 days per member of staff. The Governor overhauled the way that sickness absence was managed and introduced a number of measures, including improving the Occupational Health services available on site. By June 2004, absence rates had almost halved. 

The Port of London undertook a similar approach want to support staff during sickness absence. They reduced staff absence by 70% in four years. 

I understand the importance of recruiting the right person for the right job. It is essential to match the individual skills of the person to the discrete tasks to be achieved. But we must be clear this does not mean that the individual is left on their own to look after their health no matter how capable they are. Appropriate support and coping mechanisms, workplace adjustments are all essential.

The case for healthy workplaces, improving the health of working age people and helping them to remain in or return to work is easily made. Quite simply it is morally, politically and intuitively the right thing to do.

I believe that a good job is one that does not cause ill-health. I’d like to see people retire in the same state they entered work – fit to enjoy their retirement. I realise that everyone here will probably have a different opinion and I look forward to hearing your views this morning.