Rosie Winterton – 2004 Speech to the Occupational Health and Safety Conference

Below is the text of the speech made by Rosie Winterton, the then Minister of State for Health, on 25 February 2004.

Thank you for inviting me to your first national occupational health and safety conference. I have heard that the first day was really successful and I hope those of you who were able to go to the dinner last night enjoyed the splendid meal. Deborah Veal’s story is truly inspirational and we can all learn from her attitude and approach.
I want to spend a little time looking at what has been done in Occupational Health. But rather more, I want to look forward – what does the future of Occupational Health look like?

But first I do want to say how important Occupational Health services are to delivering the NHS of the future. We employ 1.3 million people in the NHS in England, and recruiting more. The importance of an effective occupational health and safety service has never been more obvious. We value the dedication and commitment of NHS staff and we should be showing it by providing Occupational Health services which demonstrate that. Whether in preventing workplace illness or in ensuring staff are offered speedy rehabilitation back into work, Occupational Health services help deliver first rate care. It makes good business sense and meets our legal duties. But it is also it is simply the right way to support our staff.

But it is you and your colleagues, and the work that you do in hospitals and Primary Care Trusts, that makes the difference on the ground. I do want to congratulate you on the work you do, day in day out.

Let me turn to NHS Plus which was introduced two years ago. I know that many of you signed up to the NHS Plus initiative and the standards that went with it. Indeed, over half of you are currently involved with this project.

NHS Plus was based on improving standards. That is why one of the first steps was to set up an evidence-based guideline project. I am pleased today to announce that Dr Nadia Sheikh, from the Royal Free Hospital in north London, has been the first to be awarded funds from the project to develop such guidelines. Her proposal to review the evidence about risks to health at work for pregnant staff and nursing mothers returning to work – and how we can avoid these risks – was excellent. When the guidelines are produced they will make a crucial contribution to this important area.

This is only the first step in what I hope will be a series of guidelines that will ensure that we put quality at the heart of Occupational Health practice.

It is not only about developing new advice. I know that many of you have said that it can be difficult to find the existing information. From today, you will find existing guidance brought together for you in one place, on the NHS Plus website. The website is an integral part of NHS Plus, and was created to provide information for employers and employees. It continues to receive between 5,000 and 6,000 visitors per month. It is a cheap and accessible way of giving out health messages.

What should a high quality occupational health service for the NHS look like? Firstly, I want to see a service where there is equality of access for the entire NHS workforce. For example, like never before it is essential that those working in Primary Care are provided with comprehensive occupational health and safety services. PCTs have been provided with £8million to fund services for GPs and their staff in 2004/05. What’s more, an additional £3million on top of that, rising to £3.7million in the following year, has been given to PCTs for the provision of services to general dental practitioners and their staff. This means that from this coming year PCTs will have an additional £11million to fund services for those working in the primary care sector, which should ensure that they receive high quality occupational health care.

Providing services to our entire workforce is important. But so is the quality of occupational health care that is delivered. That is why I was pleased to see Louis Appleby yesterday launch ‘Mental Health & Employment in the NHS’. It is important that the NHS takes the lead in the field of good employment practice and no organisation is better placed to take the lead in the employment of people who have had mental health problems than the NHS itself.

Only 50% of people of working age with disabilities are in work and for those with a mental health disability, the figure falls as low as 15%. This is not just a tragedy for the individuals concerned and their families, but represents a waste of opportunity for the whole country.

The guidance launched yesterday has been lauded by the Disability Rights Commission as the biggest employer in Europe leading by example. It confirms the Department of Health’s commitment to anti-discrimination principles.

An example of how this can work in practice is being presented here at the conference. Norfolk Mental Healthcare NHS Trust and Meridian East, a local mental health charity, have entered into partnership to help previous service users back into work, and for some this means back into work in the NHS. For example, one individual with long-standing mental health issues is now employed as a care worker on an acute ward looking after very ill patients.

All of this follows on from the pioneering work carried out by Dr Rachel Perkins and her colleagues at the South West London and St George’s Mental Health NHS Trust and their Pathfinder Charter. This Charter sets out the principle that no one is discriminated against other than on their ability to meet the requirements of the job.

I know many of you contributed to the process of drawing up the new guidance, and I would like to thank you for your support and commitment to this important project. Stigma against mental health is still prevalent at work, even in the NHS, and anything we can do to counter that stigma can only be for the benefit of the NHS and for us all. One of the barriers to employment and job retention is the fear of managers. Often they feel they don’t have the skills to deal with staff who have a mental health problem. The Department of Health, together with the charity MindOut, published a managers’ toolkit a few weeks ago to overcome some of the imagined difficulties. Although written for managers in all workplaces, I am sure you will find it of value in the NHS.

Our work must be based on best practice. At an event a fortnight ago I was asked by someone working in a PCT whether we put unnecessary barriers in the way of employing people with disabilities. The tone of the question left me in no doubt about the questioner’s view! She was right to raise the question. We must constantly look at what we do and the consequences of our actions. Patient safety is of course vital. But it must not be misused as an excuse to stop otherwise good candidates from working in the NHS.

I am therefore pleased to announce that the Department of Health is to review the evidence base behind pre-employment health checks. Do they do what we want them to do? Do they put up unnecessary barriers? What do staff – and more importantly those who want to work in the health service – think of them? I want the review to report its findings this year and provide a basis for the development of an evidence-based system that is fit for purpose.

Some changes in Occupational Health practice have already been introduced. One example of such change is the occupational health smart card. Introducing the cards for NHS doctors in training provides a secure, streamlined and reliable system of recording health clearance for NHS Trusts and for the doctors themselves. Once data is on the cards and accessible to Occupational Health colleagues, this will act as a much-needed catalyst to closer inter-Trust co-operation and standardised clinical practices between Occupational Health units. For you, this ought to reduce your workload each time a new group of doctors joins your Trust.

Ministers are now committed to extending the scheme to all medical staff, including locum doctors, and this will link automatically to the GMC registration database to access current information on doctors’ registration and licence to practise.

Looking forward, what will Occupational Health look like in the next few years? I start with an Occupational Health service for the whole NHS workforce that is based on quality and with a strong evidence base. I understand many of you have been talking with Kit Harling about other changes – larger departments that can exploit economies of scale; more focused management; better career development opportunities; and increasing capacity. I am looking forward to seeing some proposals worked up shortly.

But in a sense, looking internally is the easy bit. What might the wider role be for Occupational Health? How can NHS Plus develop? How can your professional expertise – and that of your colleagues outside the NHS – benefit not only the health of our citizens but also the UK economy and the wider society?

There are nearly 3 million people who are not in work because of their health. Sickness absence costs the UK enormous sums of money – there may be arguments about precisely how much, but it is measured in billions. People falling out of the labour market suffer poorer health, increased illness and earlier death. But the good news is that regaining work reverses many of these problems. That is why workplace health is an important part of the public health agenda. The Secretary of State, John Reid, has recently announced a major consultation on public health, and workplace health will be part of it.

We in the Department are working with others. You will all have seen the new Health and Safety Executive strategy for 2010 and beyond published on Monday, and our joint work with the Department for Work and Pensions to help incapacity benefit customers back to work. So part of the vision is more joined up working. We have to find a way for the NHS to link with other providers of occupational health services in the voluntary and commercial sectors. We have to get clinicians thinking of ‘return to work’ as a specific outcome. There are innovative schemes out there at the moment, and I know many of you are involved with them. But we must do more and NHS Plus will, I am sure, have a key role to play.

We must also find ways to deliver occupational health support to all those who need it, not just those whose employers currently pay for services. This is what the Government will be doing over the next few months and we are committed to producing a framework for vocational rehabilitation by the summer.

Thank you once again for inviting me to your conference. I want to thank you for the tremendous work you all do in supporting our workforce. I hope you enjoy the rest of your day.