Has safety had its chips? * Worst ever protection at work

HSE is broke

The official safety watchdog is broke, can’t do its job and is haemorrhaging staff. Hazards editor Rory O’Neill predicts over-stretched and under-protected workers will soon get sick of being fed the government’s healthy lifestyle and “work is good for you” line. story continues below

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HSE is broke

Tony Mazzocchi, the US union leader and revered safety organiser who died in 2002, began more than one speech by saying, “Work is shit.” In the UK, the government is taking a different tack. It is telling the world “work is good for you.”

Many UK workers have good reason to side with Mazzocchi. Even by the Health and Safety Executive’s latest estimates, published on 2 November 2006, 2 million workers last year were suffering from work-related ill-health, over half of million of them developing the problem in the last year.(1) But the real numbers hurt by work are considerably higher. HSE’s estimates miss entirely major categories of occupational disease and grossly under-estimates much of the rest (Hazards 93). And under-reporting of accidents is an increasing problem.

‘An investigation of trends in under-reporting of major and over-3-day injuries in the manufacturing sector: Second survey’,(2) a 2006 report for HSE, found under-reporting of major injuries is increasingly dramatically in the sector. Researchers found about 30 per of major injuries and over 40 per cent of over three-day reportable injuries are not reported, and the situation is worsening. The report says “the present study shows that the level of reporting of major injuries across the sample showed a statistically significant decrease over the four year period studied. This is a surprising finding and suggests that the Revitalising Health and Safety programme has not raised awareness among stakeholders within manufacturing industry regarding their legal reporting duties.”

The findings of a London Metropolitan University survey of migrant workers in England and Wales, published by HSE in October 2006,(3) found “a relatively high proportion (one in four) had either themselves experienced an accident at work or had witnessed accidents involving migrant co-workers. This suggests a higher level of accidents than would be experienced by UK workers.” The report adds: “Migrant interviewees also said that they would often not report accidents that had occurred, as they were concerned that employers might view them as a risk and dismiss them. In the case of those who were working without documents, a fear of deportation was also given as a reason for not reporting accidents.” The findings have prompted an HSE promise to step up inspections and enforcement in sectors “where vulnerable workers are most likely to work.”

Dr Gary Fooks, and enforcement law expert and senior lecturer from London South Bank University told Hazards when “civil society mechanisms” like accident reporting schemes fail, “the state has conventionally intervened. Perversely, reductions in inspection and enforcement indicate that this is precisely the opposite of what is now occurring. Unfortunately, there is a real risk that a continued reliance on what increasingly unreliable reported data will provide the counterintuitive justification that HSE’s present regulatory philosophy demands.”

An 2005 analysis of injury rate trends for HSE “calls into question whether over-arching targets provide an objective measure against which to judge the performance of the regulatory regime”.(4) It found other factors, particularly changes in the economy and business cycle, could be more important factors.

Good job, bad job

You don’t need an accident report or a diagnosis to be a victim of bad work. A number of factors are contributing to a polarisation of the workforce between those with good jobs and those with bad jobs. Office for National Statistics figures published in August 2006 show there has been a dramatic decline in manufacturing. In 1986, there were 5.2 million working in factories, but deindustrialisation in Britain has seen this drop to 3.3 million. The service sector, meanwhile, now employs just under 25 million people. The shift has ushered in a new bread of insecure worker, less likely to have employment security, union representation and in many cases the protection of the full raft of legal employment rights.

A September 2006 report, ‘The hidden one-in-five ­ Winning a fair deal for Britain's vulnerable workers’,(5) written for the TUC by the independent Policy Studies Institute (PSI), estimated around 5.3 million workers are vulnerable to exploitation. It highlighted the risks to the UK’s 1.2 million temporary workers, including 226,000 agency employees, and to migrant workers and workers in the informal sector.

Studies have linked 'precarious' employment to higher rates of occupational accidents and ill-health and greater exposure to workplace risks. A report for global union federation ICEM in 2005 noted: “Researchers in Australia have found 76 expert studies from around the world that link precarious employment to lower standards in injury rates, disease risk, hazard exposures, and worker (and manager) knowledge of OHS and regulatory responsibilities.”(6) A January 2006 European Agency study insecure work was on the increase and was one of the factors leading to new types of occupational health problems at work.(7) A major international report published in 2005, ‘Occupational health and safety: International influences and the 'new' epidemics’, reached similar conclusions, adding globalisation was fuelling the trend.(8)

And UK workers still work some of the longest hours in Europe, an effect amplified by the government’s continuing refusal to drop the opt-out on the EU-wide 48-hour working week ceiling. The hours limit was introduced because of well established links between long hours and an increased accident and ill-health risks, including a greatly elevated risk of heart disease.

According to ‘Healthy work: Productive workplaces’, a 2005 report from the Work Foundation(9): “Even though there is persuasive evidence to show that there are more ‘good jobs’ in the UK economy than was the case 30 years ago, there is also strong evidence to show that quality of working life is declining.”

It concluded bad jobs are characterised by five key factors: insecure employment; monotonous and repetitive work; a lack of autonomy, control and task discretion; an imbalance between a worker’s effort and the rewards they receive; and an absence of procedural justice in the workplace. “All these are important contributory factors to the ‘status syndrome’,” the report said. “Employers and other stakeholders must address the root causes of ill-health in the workplace – they must launch a determined attack on the ‘status syndrome.’”

Work or else

The government, meanwhile, argues any work is better than no work at all. For evidence, it points to a September 2006 government commissioned review, ‘Is work good for your health and well-being?’.(10) The review, published in September 2006 and described by the government as a “comprehensive review of more than 400 pieces of scientific evidence”, concluded being out of work is bad for both mind and body, progressively damaging health and decreasing life expectancy.

It concludes that being in work is, overall, good for physical and mental health, adding adverse health effects of being out of work include higher rates of mental health problems than the general population, as well as increased likelihood of suicide, disability and obesity. The report said when people return to work from unemployment their health improves by as much as unemployment damages it. Launching the report, DWP minister Lord Hunt, who is responsible for workplace health and safety, said: “Work is good for individuals and their families,” adding: “This review reinforces our commitment to helping more people into work, improving the health of working age people and tackling the root causes of ill-health.”

The argument is central to the government's October 2005 Health Work and Well-being strategy (Hazards 93), to be led by Dame Carol Black, who took up her post as the first National Director for Health and Work on 29 August 2006. She said: “Very few doctors and nurses understand that work is health giving. Work is an intrinsic part of improving and maintaining health. It is crucial that GPs bear this in mind when offering advice and support to people with all types of health condition.”

Little attention was paid to the report’s note of caution: “The provisos are that account must be taken of the nature and quality of work and its social context; jobs should be safe and accommodating. Overall, the beneficial effects of work outweigh the risks of work, and are greater than the harmful effects of long-term unemployment or prolonged sickness absence. Work is generally good for health and well-being.”

In the fevered enthusiasm for an “any work” rather than a “good work” programme, the downside has been relegated to a “proviso”. GPs will be taught about the benefits of work. However, GPs have little training and scant knowledge of workplace hazards and related health effects. There must be a fear the new drive to see people back into work may see genuine workplace health concerns ignored or downplayed.

The report was commissioned to shore up a government policy to get workers off benefits and in to work. The three aims of the Health, Work and Well-being strategy are to get people into work, keep them in work and to use the workforce as a captive audience for workplace health promotion activities. The balance of this strategy is on lifestyle factors – using the workplace as an easy point of access to health promotion evangelism – with relatively little emphasis on measures to address occupational injuries and disease. As part of a wider policy, there is a move to get people who have been medically assessed as unfit for work, back into work.

If this was entirely to do with the provision of better rehabilitation and workplace support, it would on the whole be a good thing. But there is not and will not be a revolution in access to these facilities. Government initiatives to improve rehab and return to work measures are patchy and poorly resourced. And employers, seemingly, have little interest in occupational health, even where free advice is available.

Health disconnect

The government’s flagship programme to plug the occupational health information gap is Workplace Health Connect. Launched in February 2006 as a series of regional pilots backed up by a national phone advice line, its scope has already been curtailed as a result of the withdrawal of HSE’s £1m funding contribution. It was billed as a new service for small and medium sized firms offering “free and impartial advice on occupational health, safety and return to work issues.”

HSE chief executive Geoffrey Podger said “workplace ill-health is costing small businesses up to 10 per cent of their total payroll costs, which can put real downward pressure on their bottom line. We therefore want to help small business stop workers becoming ill at work and help them to get back to work as soon as possible, if they do, which is ultimately why we have launched Workplace Health Connect.”

An evaluation for HSE of its first four months of operation concluded “the early findings are extremely positive. Workplace Health Connect appears to be well received by Small and Medium Sized Enterprise (SME) employers and employees, and the service offer is appreciated because it is free, credible and does not adopt a punitive approach.”(12)

The problem is that small firms might not feel threatened and may appreciate the service, but they are show very little interest in advice on how to “stop workers becoming ill at work and help them to get back to work as soon as possible”. The evaluation notes: “Most commonly, individuals were calling for advice on general safety issues (63 per cent of calls) of calls, while another eight per cent requested advice on conducting risk assessments, and seven per cent required advice about a specific risk/hazard. Only a relatively small proportion of enquiries were health related: four per cent categorised as advice on a general health issue and three per cent were advice on a work related health issue.”

Most of the advice sought was on core health and safety matters, work that should be part of the Health and Safety Executive’s core activities. Only 7 per cent of calls were on health issues. Spending £20m on a service that for 93 per cent of the time duplicates a core HSE role seems a questionable use of resources. It also means HSE’s intelligence on workplace conditions is being diminished. If HSE is not the organisation called in to advise on a problem the employer has identified, it won’t be there to identify those the employer has not.

Workplace Health Connect may have been well received because of its non-threatening nature, but this is not sufficient reason to allocate it millions from the public purse to perform a function for which it was never intended. Nor is employer approval something unique to Workplace Health Connect. The Health and Safety Executive has one of the highest user approval ratings of all government agencies.

Savage cuts at HSE

At the same time ailing workers are being urged to get up and work, measures to ensure they return to safe and healthy workplaces are going down the pan. Earlier this year Hazards warned exclusively that HSE was “in danger” as a series of accounting blunders and cutbacks left it facing a funding crisis (Hazards 95). This warning was confirmed in a 10 August 2006 message to HSE staff from chief executive Geoffrey Podger which said HSE needed “to reduce in total by some 250-350 posts between now and March 2008.” Within two years, HSE will lose up to 9 per cent of its staff.

It is not just jobs that are being axed. To make £5.6m in cuts – the saving HSE needs to make over two years after it managed to move from a budget underspend to a considerable and unsanctioned overspend in just one year – it has cut £3m from its planned publicity budget, £1.3m from its science and technology spend and £250,000 from contracted out policy work. A £1m contribution from “underspend” to Workplace Health Connect was withdrawn after it became apparent HSE had someone managed to change this into a massive and unsanctioned overspend. The prospect of funding for further worker involvement initiatives like the Worker Safety Adviser programme has also evaporated.

HSE is facing a future with too few staff and too few resources to do its job. Sources within HSE have told Hazards, for example, that the 2006/2007 travel and subsistence budget for field inspectors is likely to run out in February. If that happens, they will only be able to inspect those workplaces in walking distance of the office.

An October 2006 TUC briefing(11) says: “HSE will by 2008 have lost around 17 per cent of the staff it had in 2002 when comparing like with like. On top of this, the pressure is set to get worse in this Autumn’s Comprehensive Spending Review if HSE’s parent department, the DWP, passes on its five per cent year on year cut to HSE (not including the impact of rising inflation on the HSE budget).” TUC adds that HSE can’t maintain its expertise because it can’t afford to recruit suitably skilled individuals. The impact on enforcement is considerable.

“Around 85 per cent of major injuries reported to HSE are never investigated (and there are known to be large numbers that never even get reported),” the report says: “There is only so much that the 500 or so inspectors in HSE’s Field Operations Division (FOD) can achieve. This means that very serious career-ending accidents go unpunished simply because there is no one to gather the evidence. The number of prosecutions is now half what it was in the early 1990s – this simply means that more employers are getting away with it, not that they are more compliant.”

HSE gutted

Even gutting HSE comes at a price. HSE has budgeted £1.5m to cover the cost of pushing 30 workers out the door on voluntary early retirement by the end of March 2007. If the costs are broadly similar for all the 250-350 jobs for the chop, measures to meet a £5.6m budget shortfall will cost the Treasury between £12.5m and £17.5m. Given the shortfall was the result of a serious but one-off budgeting cock up, many will think keeping much needed workers in post and just plugging the funding gap would have made better economic and organisational sense.

Even before the job losses hit, inspections, notices, prosecutions, convictions and contact time have all plummeted (Hazards 95). An August 2006 internal memo reporting the findings of an audit of HSE’s formal enforcement activity concluded “there was no evidence of over-zealous behaviour,” instead observing that if the Health and Safety Commission’s Enforcement Policy Statement had been followed, “then the number of prosecutions would have been considerably greater than was actually the case. The implications of this need to concern us all.”

Fewer than one in every thousand reported workplace accidents results in a prosecution. Figures released on 2 November(1) showed there had been a further dramatic reduction in enforcement activity. In 2005/06 there were 1,012 offences prosecuted, a 23 per cent drop from 1,320 the previous year.

The cutbacks also have implications for HSE’s work on occupational disease prevention. TUC reports very few cases of occupational disease are ever investigated. In the early 1990s HSE employed around 50 occupational physicians. Now has just seven, despite a legal duty to maintain an Employment Medical Advisory Service.

HSE is yet to provide full costings or explain, publicly or to the Health and Safety Commission, how the catastrophic funding blunders occurred or who is responsible. So far, no-one has been disciplined despite a number of HSE board members having been party to decisions which have seen HSE lose hundreds of staff and a large slice of its revenue budget for the next two years.

1. Health and safety statistics 2005/06, HSC, November 2006 • [pdf] • HSE statistics webpage.

2. An investigation of trends in under-reporting of major and over-3-day injuries in the manufacturing sector: Second survey, HSE, 2006. [pdf]

3. Health and safety and migrant workers in England and Wales, RR502 [pdf] • Hazards migrants webpages.

4. Trends and context to rates of workplace injury, HSE Research Report RR386, 2005 • [pdf]

5. The hidden one-in-five ­ Winning a fair deal for Britain's vulnerable workers, TUC, September 2006. TUC One-in-five webpage and report.

6. Contract/agency labour: A threat to our social standards, ICEM, 2005 [pdf].

7. Priorities for occupational safety and health research in the EU-25, European Agency, 2006. European Agency news release and full report

8. Occupational health and safety: International influences and the 'new' epidemics, 2005, edited by Chris L Peterson and Claire Mayhew. ISBN 0-89503-303-8. Baywood Publishing Company. Further information, price and purchase details

9. Healthy work, productive workplaces: Why the UK needs more good jobs. The Work Foundation, 2005

10. Is work good for your health and well-being?, DWP, September 2006.
Health, work and well-being webpages and new report

11. HSE funding – a case for more resources, TUC, October 2006.

12. Workplace Health Connect, July 2006 Progress Report (draft), HSE, August 2006