Occupational health will be the "new safety"

We examine the HSC's proposals for its enforcement priorities to 2010 and beyond.

The Health and Safety Commission (HSC) is inviting comments on a new draft strategy for workplace health and safety in Great Britain to 2010 and beyond¹. The Commission hopes to submit a final version to ministers by the end of 2003, so that work can begin on a detailed business plan to start putting the strategy into action in 2004.

The aim of its new strategy is to bring about a situation in 10 years' time where the targets set out in the Revitalising health and safety statement issued in 2000 have been met. The HSC wants to reach a position where the economic and moral case for occupational health and safety is agreed by employers, trade unions and the public at large.

The draft strategy is also designed to contribute to broader government policy objectives, including the employment and productivity agenda, by keeping those at work healthy, and the reform of the public services by helping to cut sickness absence in government departments and agencies.

"Stop doing what we've always done"

The context in which the HSC operates has changed significantly in the past five years. The new challenges it faces are almost all concerned with health, rather than pure safety, and public attitudes towards blame and compensation have hardened. The enforcement bodies have done a good job on safety, the Commission believes, but traditional safety interventions are less effective in tackling work-related ill health - 33 million out of the 40 million days lost to work-related absence are now due to ill health.

Liz Justice of the Health and Safety Executive (HSE) believes that the HSC and HSE must stop "doing what we've always done" and start looking at new ways of working. Research for the HSC suggests that it needs to respond better to new and emerging health issues, for example, and to stop thinking about health and safety as the remit of a single profession. Human resource managers need to be more involved, particularly when it comes to examining the factors behind sickness absence.

HSE can't do everything

The HSC believes that the targets and associated priority programmes set out in Revitalising health and safety are still valid. Hazards such as musculoskeletal disorders and tough sectors such as the NHS will remain priorities.

But it recognises that the HSE and the local authority enforcement bodies cannot do everything. Resources need to be better targeted, and more work should be done on evaluating the effectiveness of various HSC initiatives, the Commission believes.

The first point of a planned new seven-point strategy sets out how the HSE should only get involved in activities that it alone can undertake. In future, it will concentrate on activities directly related to work and steer away from areas better regulated by other means. This could mean that in future the HSE will steer clear of civil law, and will not be proactive in enforcing areas of public safety where others have regulatory responsibility, or where there is currently a gap in the law.

Organisations and employers, the HSC argues, are influenced by a host of regulators and investigators, some of which may be more appropriate bodies to take on a public protection role, leaving the HSE to concentrate on workers.

The HSC's draft strategy does little to console those concerned about future HSE resourcing, talking about "hard choices and priorities". It recognises that the Executive has finite resources, so will give priority in future to those activities that only the enforcing authorities can carry out. The relationship between HSE enforcement activity and that of local government will be reviewed, and evidence-based interventions introduced that reduce duplication and serve to focus its responses.

The Commission does not intend to back away from redesigning the roles of health and safety institutions to implement its new strategy. For example, the historical split in enforcement responsibilities between the HSE and local authorities misses the "opportunity to improve their collective contribution to health and safety".

It could mean that priority sectors, such as the NHS and some large employers, would be dealt with by HSE-led programmes. The remaining sectors, including small- and medium-sized enterprises and the issues within them, could be addressed by local joint decision-making and action among local authorities and HSE people.

The HSE's Liz Justice adds that local authority enforcement agencies need to spend more time getting into local firms and talking to employers and workers about preventative health and safety. However, she recognises that this change in working practices has potentially significant resource implications, and that the HSE has yet to "square this particular circle". The Commission is reviewing the work of the local authority unit within the HSE, because many emerging health risks are local-authority enforced.

Rehabilitation tops agenda

The draft strategy recognises that the big issues for the HSC in the past have tended to be safety ones, with clear remedies. The big issues of today and tomorrow are less clear-cut, and future gains in occupational health will require new evidence-based approaches.

The HSC should push for the development of mechanisms to widen access to occupational health services, and for guidance on sickness management: "We want to see much greater emphasis on rehabilitation as a contribution to the wider government agenda," the strategy states.

In a separate but related development, the HSC is looking at ways of moving the implementation of the national occupational health strategy - Securing Health Together - up a gear. A conference this month is set to examine proposals for a national occupational health support service. Details are sketchy, and little work has been done on how such a service might work, but the HSE is understood to be tracking a pilot OH scheme for the construction industry with interest (see Employers should be involved in rehabilitation pilots, says DWP committee for further details).

Enforcement and support

Research suggests that small- and medium-sized organisations are reluctant to contact the HSE for guidance and support because of its role as an enforcer. The draft strategy, therefore, expresses the need to separate the HSE's enforcement role from its support and advice activities, so that much of the latter will in future be produced or distributed by non-HSE bodies, such as trade unions and trade associations. These new channels of support can provide industry-specific advice and promote common standards among the members of these bodies, the HSE believes.

The support and advice still carried out by the HSE will be targeted towards areas of greatest need, so that SMEs gradually stop seeing the HSE as "experts talking to other experts in big firms". There is recognition at the Executive that all-encompassing guidance leaflets may no longer be a useful way of getting its message across.

Communicating the case that good health and safety practices are enabling rather than hindering will continue to be a priority for the HSE. The strategy recognises that the HSC has created a huge "information-giving machine", but that others may be better placed in future to provide information. On the defensive, the HSC suggests that the media will challenge "burdensome and heavy-handed regulation", and that the full range of media will need to be used to defend the HSC's reputation.

What do we think?

Hugh Robertson, head of health and safety at public services union Unison, comments that there is little to disagree with in the draft strategy, and that it is really "more of the same". Based on the sectors he is involved in, Robertson does not believe that the targets in Revitalising health and safety will be met unless "we really start making a difference", and he is not sure whether the strategy will do this.

The draft strategy goes some way to meeting several of Unison's concerns, particularly its emphasis on the role of employee consultation. Hugh Robertson believes that, in the past, the HSE has played no more than lip service to the role of employee representatives, pointing out that no published materials have been produced for safety representatives, compared with more than 30 publications for managers in recent years.

Robertson welcomes the emphasis on rehabilitation in the draft strategy, but adds that there are still fundamental issues to be tackled surrounding prevention, citing the example of building design. "There are hospitals being built where you can't change a light bulb without erecting scaffolding. We're creating buildings that are death traps, rather than using the opportunity of modern buildings to design out risks," he adds.

A spokesperson for the Institution of Occupational Safety and Health (IOSH) told us that the Institution is generally supportive of the draft strategy, but adds that some elements are still missing and that not all of its original comments have been addressed. The CBI is considering its views and will be feeding them through to the HSC during the consultation period.

1. A strategy for workplace health and safety in Great Britain to 2010 and beyond, HSC, 2003, www.hse.gov.uk/consult/condocs. Comments by 1 December 2003.

This article was written by Sarah Silcox, a freelance writer and trainer on employee health issues, sarahsilcox@waitrose.com.