27 March 2007

The Rt Hon John Hutton MP

Secretary of State for Work and Pensions

Institution of Occupational Safety and Health (IOSH)

Welfare Reform and Rehabilitation

Tuesday, 27th March 2007

[Check against delivery]

I’m grateful to the Lord Mayor, to Lisa (Fowlie) and to IOSH for the opportunity to join you this morning.

The right to work is fundamental to any decent modern society. And so is the right to proper minimum standards of health and safety in the workplace.

Yet despite over a century of legislation in specific sectors such as in factories, docks and agriculture, before the 1974 Health and Safety at Work Act, there was no universal minimum protection. As many as 8 million employees still had no legal safety protection at work. Some faced the most appalling conditions – many lives were at risk whether from physical injury or from the long-term effects of the environment in which they worked.

Thankfully, we’ve come a long way in recent years. Fatalities at work have fallen by two-thirds since the 1974 Act - and the number of non-fatal injuries is also down two-thirds since then.

Since 1997, there’s been a 10% reduction in accidents at work – and absence from work due to occupational ill-health and injury has fallen by over a quarter in just the last three-years alone.

Today the UK has one of the best health and safety records anywhere in the world. This achievement is a tremendous tribute to all those who have fought to improve the conditions at work – from the foundations laid by the early trade union leaders; to the leadership of professional bodies such as yourselves in IOSH and the evolving partnership between employers, Government and health and safety practitioners across the UK.

Yet despite this progress, 30 million working days are still lost every year to workplace ill-health and injury. 164 million working days are lost to sickness absence at a cost to the economy of £13 billion. Around 1 million people report sick every week; 3000 of whom will remain off work for more than 6 months – and 80% of those will still be off work 5 years later.

At a time when rising dependency ratios and the effects of ever greater global competition place seismic pressures on our economic and welfare systems, doing all we can to prevent people from becoming ill at work – and acting to support and rehabilitate those who do become ill - is not only right for individuals, but crucial for the success of business; for a strong economy and a strong society.

The Health and Safety Commission’s case studies have shown that occupational health and safety is a fundamental part of effective business management.

The businesses in these studies developed programmes to promote good health and safety management – and in return enjoyed benefits to the tune of £11 million of savings though reduced sickness absence and a reduction in health insurance spending of £200,000 a year.

Today, thanks to record investment in the New Deal and our groundbreaking Pathways to Work, the numbers on incapacity benefits are falling not rising. But too often people with health conditions and disabilities are still denied the right to work because the system presumes them incapable.

Our Welfare Reform Bill, which today completes its passage through the House of Lords, will change that. Built on the foundation of a national extension of Pathways to Work, it creates a new Employment and Support Allowance which will replace Incapacity Benefit and Income Support based on incapacity.

This will eradicate the entrenched concept of incapacity, on which the current system is based, instead promoting rehabilitation with a new focus on the concept of capability.

Rather than an assessment purely focussed on benefit entitlement, the new Personal Capability Assessment will examine not only what an individual can’t do; but also what they can, and what help they may need to improve their capacity to work at some point in the future.

For the majority of people, this will mean additional responsibilities to be actively engaged in preparing for a return to the labour market - in return for additional tailored support – achieved by embedding the values and principles of the successful Pathways to Work pilots within the benefit structure itself.

For those whose health condition or disability has the severest impact upon them, there will be a higher rate of benefit, which will be rightly exempted from work related conditions. But even this group will still have the opportunity to access support voluntarily. Because a modern welfare state can not afford to leave anyone behind. And no-one will be written off under our reforms.

The importance of early intervention can not be over-stated. We know that after two years on incapacity benefits, people are statistically more likely to die or retire than return to work.

Furthermore, research shows that after only six weeks’ sickness absence, a person’s ability to return to work falls away rapidly – with almost one in five people who reach this point staying off work and eventually leaving paid employment altogether.

We’ve been working closely with GPs and other medical professionals in developing a stronger emphasis on early intervention. We’ve piloted ground-breaking initiatives such as placing employment advisers in GPs surgeries and taking steps to support GPs and their teams in improving the quality of advice they give patients on fitness for work, as part of good medical practice.

I very much welcome the recent Commissioning Framework on Health and Well-Being published by the Department of Health with its clear focus on the importance of local commissioning of services that meet the needs of working age people.

This will be important in helping us to go further in more effectively encouraging GPs and Primary Care Trusts to work with other public agencies locally and to support individuals to remain in or return to work.

Currently, for example, someone in their early forties going to their GP with lower back pain is more likely to be given a sick note - or even worse become eligible for Incapacity Benefit - rather than be given a clear prioritised course of treatment to get them back into work.

Failure to intervene early, to resource and prescribe a clear recovery process for that individual is likely to lead to a longer term disconnection from the labour market. This in turn can trigger mild mental health conditions and a further downward spiral of the individual’s health condition. The ultimate human cost to the individual and their family – as well as the financial cost to the State – can be come colossal.

And yet many health conditions initially reported – such as back and neck pain, depression, heart and circulatory problems – shouldn’t make long-term inactivity inevitable.

In fact we know that work can actually be good for people – both in staying healthy and as a critical part of rehabilitation.

An independent report published last year on the value of work concluded that employment is central to individual identity, psychosocial needs, physical and mental health and of course, economic wellbeing.

It found that unemployment can lead to higher mortality rates, poorer physical and mental health, and higher hospital admission rates; and returning to work from unemployment could actually improve health by as much as unemployment damaged it.

Sometimes, it can be relatively simple steps that can make the difference in allowing employers to retain and rehabilitate trained and experienced staff – instead of facing otherwise unnecessary recruitment and training costs.

For example, there was the case of a street lighting co-ordinator who had to have his leg amputated because of a long term medical condition. By making adjustments to his working environment including altering the height of his desk and allocating him a company car with automatic transmission, his employer enabled him to make a structured return to work only three months after his operation.

Another company estimated that in financial terms, the benefits of a new rehabilitation scheme – which reduced average absence after injury from 26 days to 4 – outweighed costs by 12:1

But delivering such change in the workplace can only be achieved with your support and expertise. Health and Safety practitioners have a crucial role to play in mentoring and supporting those joining or rejoining the workforce.

IOSH are playing a critical role in leading from the front. The “Wise up 2 Work” initiative in partnership with the National Youth Agency, Learning and Skills Council and British Chambers of Commerce is helping to improve safety for young people when they start work or apprenticeships.

And the “Safe Start up” website, alongside our own Workplace Health Connect  programme, is helping new small and medium-sized businesses to reduce accidents and comply with the law – providing not just generic health and safety information, but specific guidance for over 35 occupations and business sectors: From cleaner to builder; and from child minder to hairdresser.

The first stage of IOSH toolkit for work-related stress and musculoskeletal disorders being launched today is another important step forwards in giving health and safety practitioners easy access to the information and guidance that will help them play a greater role in tackling illness and absence caused by occupational health issues.

But we need to go much further if we are really to change attitudes towards health and safety in the minds of the wider public.

In the 1950s, Adelle Davis – the author of some of the first popular books on healthy eating - wrote:

“Thousands upon thousands of persons have studied disease. Almost no-one has studied health.”

Today we can’t seem to escape from the media headlines with the latest thinking on the impact of certain foods and diets on our health. The public appear to have an insatiable appetite for such information.

But by contrast issues around work and health often draw very negative media coverage. Too often safety regulations are portrayed as an inflexible, impractical and sometimes seemingly illogical set of rules – which do nothing but frustrate people going about their daily lives.

I believe we have to find a way to change this negative perception. A good health and safety record will not be maintained by belittling the work of the health and safety profession. Indeed the complacency which is implicit in this attitude should be of great concern to us all.

But equally, the answer doesn’t lie in simply extending the current rules based approach.

There’s a strong parallel with our welfare reforms. Earlier this month, David Freud published his report of the future of welfare in Britain. His recommendations represented a significant overhaul of the way in which we support people to get back into work – including an expanded role for new providers from the public and private sectors – and greater flexibility and simplification within the benefit system.

As we’ve moved away from the monolithic one-size fits all welfare of the 80s and 90s to develop the New Deal, we’ve created a multitude of programmes with ever more specific and tailored welfare support. But we’ve also produced a system which is sometimes complex and difficult to navigate.

The next stage of welfare reform is not to add yet more rules and processes on top of the existing framework – but rather, with these foundations in place, to seek greater flexibility and simplicity – allowing new providers at local level the space to innovate and develop new and ever more tailored approaches.

I believe we need a similar approach for health and safety. With the right foundation of rules and legislation in place – so we can look to a more holistic approach with new partnerships and sharing of best practice – built on a commitment and understanding that health and safety is critical not just for the health of individuals; but the health of business and the health of Britain as a whole.

The Government’s Health Work and Well-Being Strategy seeks to build such a partnership - working across Government and with partners from across business, unions, medical and health and safety professions.

All have signed up to a charter for improving workplace health – and are now committing to specific actions that they will take within their own areas.

In taking this forward, I’d like to ask IOSH to work further with Bill Gunnyeon, my Department’s Chief Medical Adviser, to consider how to maximise the contribution that health and safety practitioners can make; ensuring that Government provides them with the right support; and encouraging a real cross-cutting partnership between all those with an interest in public and occupational health.

Patricia Hewitt and I are today also commissioning Dame Carol Black – the first ever National Director for Health and Work - to undertake a detailed review of the health of Britain’s working age population. I’d like to see this become an annual report that can provide a real evidence base – not just to help change public perceptions about the importance of work and the links between work and health – but also to help us refine our approach and maximise the impact of the Health Work and Well-being Strategy.

We must all now rise to the challenge ahead. To build a society that supports people in fulfilling their potential; that pioneers the prevention of ill health and injury through more effective management of risk; and that breaks the link between ill health and inactivity by rehabilitating not rejecting people when they experience illness or disability.

The prize of success could not be greater. For the lives of our people; for the success of British business; and for health our economy and society as a whole.