Employers benefit from a healthy workforce

Saturday 21 December 2013 12:35PM (view full episode)

For some years it was thought the only interest employers had in the health of their workforce was to comply with regulations. The thinking now is that it goes much further. A healthy workforce performs better. There is less sick leave. Moral is better. Everybody wins. Some employers are offering free health checks and improved design to encourage walking about the workplace.

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Robyn Williams: And so to someone to see how well you are when you actually do get to work. Professor Dame Carol Black is head or principal of Newnham College in Cambridge. She has also led most of the medical bodies in the UK, and chaired an inquiry into health at work with the late David Frost.

Carol Black: The aspect that I've been looking at really over four or five years is how do you ensure that the working age population is healthy, and that's both physically and mentally healthy, that they have resilience, that they are engaged in their workplace, and that they are well managed. Unless you get those things aligned, then you are very often going to have unhealthy workers who will not be able to perform well. And whether you are in the United Kingdom or whether you are in Australia, these things matter to governments. And whether they are state governments or the central government, people are interested at government level in a really high-class workforce.

Robyn Williams: Well, many workforces have got facilities that come in for flu vaccinations, bits of this, bits of that, you can also donate blood, but you rarely see people in the building where you work who are concerned about your health. Why doesn't it happen?

Carol Black: I think it hasn't happened because we've all thought health belonged in our primary care with our general practitioners. I think in workplaces people have been very concerned about safety but haven't realised that you are a safer worker if you are a healthier worker, both physically and mentally healthy. And I think what has been happening in the workplace is that people have done add-on…the things you've just said, like a bit of immunisation, perhaps a flu jab, perhaps helping you stop smoking, but it's only more recently that people have decided that you must develop proper programs so that these things are integrated. And in the really great organisations they integrate conventional occupational health and safety with all these extra things about well-being, about engagement. They start to have a program that is together.

Robyn Williams: So there's a difference between the compliant culture where the firm or the institution is protecting itself in case there is asbestos in the ceiling or in case you lift up your package in the wrong way and they've got to pay out, as opposed to trying to keep you healthy in a way that is going to make a difference for them.

Carol Black: Employers have always thought that your health is a very personal matter. There's this great worry about are we getting too close to the private things in a person's life, as opposed to thinking if we offer it…of course it will have to be voluntary, you can't insist on any of these things…it's quite likely that a worker would be very pleased. My experience of five years of doing this in the United Kingdom is that when workers are offered for example a cardiovascular health check, these are incredibly popular. And if they are dealt with in a confidential and proactive way, then people are very pleased, and usually they will take any information…let's say you were discovered to have high blood pressure, you'd go back to your own doctor, you've got this piece of information, usually a printout, and it's starting to develop a culture that 'I, the employer, do care about your health, but I also want you to be a productive worker'. That's perfectly reasonable.

Robyn Williams: So where have you seen it working well?

Carol Black: When I started this work for the UK government I really had to go abroad, and it was actually to North America, to see it really working well because there the employer pays your health cost and indeed your drug costs, so they are driven in a different way to ensure that they have a healthy worker, and indeed the worker's family matters to them as well. So I used to take examples from North America.

I then found that companies that were global companies, BP is a good example, AstraZeneca is a good example, GlaxoSmithKline is a good example, the big global companies were often starting programs where in this country we saw the benefit because they developed them here.

The place where it has been rather slow to start but I'm really pleased to say is changing is the public sector. And because I have a particular interest in the National Health Service, one of my roles has been to help drive the health and well-being agenda for those who work in the NHS.

Robyn Williams: What was your impression in Australia?

Carol Black: In Australia I found that safety was terribly important. I found your trade unions to be slightly suspicious of this softer…they saw it as fluffy. But over the years I have seen both at the state level but also at the federal level a really increasing interest in linking health and well-being into productivity and engagement. For example, I've worked closely with Professor Niki Ellis who is in the University of Melbourne and who really gets this, I mean, is a fantastic advocate for it and a pleasure to work with.

Robyn Williams: And of course it can be so much in the firm or the institution's advantage.

Carol Black: Making the business case is crucially important. One of the things I learnt very early in doing this job is I should never approach anybody with the soft and fluffy, that wasn't going to work, and I needed to make the business case. And one of the things that has been quite tough over the last three or four years has been collecting the case examples where you've actually got figures, where you could say you invest this, you will see this sort of return. But that is now happening.

And just something that's really good that is happening in Australia through the Royal College of Physicians there, there is a section that is devoted to occupational and environmental medicine, they have been doing in the last two years some particular work on enabling a business case to be made so that people who want to make this argument have got some help and some case histories, and they've also done some very good work more generally in this area.

Robyn Williams: And what you find lacking in Australia in the experience? Because if you've been to Australia five times in the last 12 months, you must have got an impression of some things that aren't quite going well.

Carol Black: I've found very often people were developing their health and safety in the conventional sense along one track, and then they were sort of in a different part of the company or an institution trying to develop a health and well-being proactive preventative program, but never the twain shall meet. And so one of the things that I wanted to see happen was this coming together so that it was one program.

The other two things that I felt really needed further emphasis was the ability to talk about mental health because people find that very difficult, it's much more touchy than your physical health, gets pushed under the carpet. So being able to talk about perhaps resilience or positive mental health…because what people fear is being labelled as being mentally unwell when it's perfectly reasonable to feel you are stressed at work sometimes. So, the ability to talk about mental health. And I've been to lecture on two mental health and work projects and programs in Australia.

And the other thing, the really difficult task of getting companies to understand that if the CEO and the board are not brought in, really brought in, I don't mean just paying lip service to this, and if they have not trained their line managers, this will not happen. The fresh fruit and veg won't do it. You can't just put fresh fruit on the table or a bicycle scheme, it is much more embedded than that.

Robyn Williams: I happen to know the figures for fresh fruit and vegetable consumption in Australia; 5.6% of the population actually have fresh fruit and veg. Which yes, you scowl with amazement, is quite extraordinary. But the other thing is to do with time. If any of us want to go and see a GP, first of all it is hard to get an appointment. Second, you always have to wait too long, and so you're talking about at least something like three hours, which is nearly half a day out of the work commitment, which is crazy, whereas if you go downstairs and see, well, even a nurse or a medical person who's not necessarily GP qualified, that would make a difference too, would it not?

Carol Black: And I think some companies have done this. Some places in the city of London, they actually do also bring in a GP session. But I think to have, again, the idea that your occupational health facility will have people who are concerned about your health in its broadest sense, so you could get your blood pressure checked, your diabetes status or your cholesterol checked, would be so much of a good thing, because a man particularly will not go to his GP to find out if he is well. You can do this in the work context, it doesn't have to take long, and I think where it is happening it is greatly appreciated.

Robyn Williams: And she returns to Australia in 2014. Dame Carol Black, head of Newnham College in Cambridge.


Carol Black
Adviser on Work and Health
Department of Health
England UK


Robyn Williams
David Fisher

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