Organised crime

TUC Occupational Health

Welcome to the course

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Theme of Workers Memorial Day 28th April 2008

‘Good occupational health for all workers’

Introductions

• Name• Union and union positions(s)• Job and workplace• Previous health and safety courses• Outcome of ‘things to find out’ pre-course activity• Issues and concerns related to the course

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A new priority?

‘Government, healthcare professionals, employers, trade unions and all with an interest in the health of the working age population should adopt a new approach to health and work in Britain based on the foundations laid out in this review’.

Recommendation 1 in the Carol Black Government Review on Occupational Health: March 2008

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Definition of occupational health

‘The state of complete physical, mental and social well-being and not merely the absence of disease and infirmity’.

World Health Organisation 1946

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Scale of the problem

• Long history but short on results• Primary focus has been on safety• 175 million working days lost to illness in 2006• 2.2 million a year suffer from work-related ill health• Costs to the taxpayer approx £60 billion• Overall costs approx £100 billion

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Scale of the problem

• ILO estimates that 2.3 million people killed by work worldwide every year

• Official figure: 241 killed by work• Hazards campaign estimate: 1,600-1,700• Official figure: 10,200 dying from work-related

diseases• Hazards campaign estimate: 50,000 dying from

work-related illnesses

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Scale of the problem

Breakdown of Hazards 50,000 figure

• Cancer: 8-16% work-related. 12% mid-point gives total of 18,000

• Respiratory illness: 15-20% work-related gives total of 6,000

• Heart disease: 20% work-related gives total of 20,000

• Other illnesses: 6,0008

Government targets

• Revitalising Health and Safety Strategy Reduce the incidence rate of fatalities and major

injuries by 10% Reduce the incidence rate of cases of work-related

ill health by 20% Reduce the number of working days lost by 30% The last 2 targets are not on target!

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Identifying issues – the union role

• Long history of involvement• Range of techniques available• Employer’s duty to monitor• Union rights to monitor• Prevention the priority• At risk from under-funding

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Enforcement

Problems HSE and LA cuts Average inspection once every 14 years IOM ‘HSE under resourced to meet its core

responsibilities’ Only 100 out of 410 Las secured any convictions in

2006-7 Average fine £8, 723

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Enforcement

Opportunities Construction blitz initiative Corporate Manslaughter and Homicide Act 2007 Sentencing Advisory Panel Union effect

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Identifying the problem

• Inspections• Ill health investigations• Checking records• Surveys• Participation in safety committees• Mapping techniques – hazard and body mapping• Outside assistance – SRSC GN31

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Rights to OH information

• MHSW Regs 1999: Reg 5 places a duty on the employer to have effective ‘monitoring and review of the preventive and protective measures’

• SRSC Reg 7.1: SR right to ‘inspect and take copies of any document’

• SRSC CoP 6: Details of Reg 7• SRSC Reg 9/GN41: Safety Committee functions

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Occupational Health Services

• Only 3% of employers provide a comprehensive service

• Approx a third of workers are provided with basic support (estimates between 20-34%)

• Failure to meet duty under the Framework Directive

• Failure to sign up to ILO standard

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OHS – legal position

• Range of laws have some relevance• Some examples of enforcement action (ref. page

44)• Functions delivered through:

Employers own schemes Commercial providers State services

• Consultation16

Range of services

• Keeping medical records• Involvement in risk assessments• Involvement in risk control measures• Health screening and surveillance• Environmental monitoring• Accident investigations• Health education and counselling

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Range of services

• Rehabilitation and return to work• Supervising first aid• Examining trends in ill health• Assessing fitness for work• Sickness absence monitoring• TUC Safety Rep Survey 2006 – indicated that

preventive role often neglected

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Equality of access

• Gender• Disabilities• Migrant workers• Older workers• Categories of worker

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Health issues – are they work-related?• Onset• Do any other workers have the same problem?• Is it a known risk of this job?• Is there a known risk from exposure?• Has the exposure been enough?• Family history and past medical history• Does it have special marker features?

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Rehabilitation

• No statutory right• Provided by approx 25% of employers

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Rehabilitation

• Policies should be: Consistent with any related policies on return to work/sickness

absence/capability Separated from the disciplinary procedure Linked to OH provision Provide for the appointment of an independent case manager Medical advice should be followed Consideration to the full range of options like change of

task/phased return/reduced hours etc Pay protection if earnings affected by the above options Workload reduced in line with cut in hours

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Disability Discrimination Acts

• ‘Physical or mental impairment which has a substantial and long term adverse effect on her/his ability to carry out normal day-to-day activities’

• Case law and 2005 amendments mean that can be based from point of diagnosis

• ‘Reasonable adjustments’ to employment practices and premises

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Sickness absence

• Number of days lost has fallen• Higher rates in public sector mainly due to long-

term absence cases• Sickness absence procedures increasingly linked

to capability and discipline• Operation of ‘trigger’ formulas aimed at short-term

absences• Exclusion of work-related sickness from absence

achieved in some workplaces24

Occupational Health Strategies

• 1980 Sir Douglas Black Report• 2008 Dame Carol Black Report• 28 years separating 2 ‘Black’ reports and yet on a

number of measures the health gap between he rich and poor has widened

• Securing health together 2000-2010 – government policy document has targets and references to safety rep involvement

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Occupational health strategies

• The Black Review ‘Working for a healthier tomorrow’ – main proposals are: Establishing a Fit for Work Service GPs to refer to patients through an electronic

fit note to the FfW Service The fit note to replace the GP paper-based

sick note Review proposals criticised by unions and

Hazards campaign as being inadequate26