Far from being a national joke or indeed a restraint on the competitiveness of UK business, health and safety at work are a great British success story – but there is still a great deal to do to make these twin objectives a reality every day in every workplace in the UK.

Ministers are often wont to comment that Britain is probably the safest country in the world in which to work. While occupational accident rates have come down in recent years, they still remain much too high in sectors like construction, agriculture, forestry and waste. In 2014/15, 142 workers were killed at work (this excludes over several hundred killed in work related road crashes). About 90 members of the public were killed in accidents associated with work activities. There were 78,000 injuries to employees that were reported to health and safety authorities – although the Labour Force Survey revealed an estimated 629,000 work-related injuries in total.

But Britain is certainly not the healthiest country in which to work. Work related health damage in the economy is a much bigger problem than injury. More than 12,000 people die annually as a result of long latency conditions associated with past exposures to harmful agents in the workplace. These include work related cancers, COPD (cumulative, obstructive pulmonary disease) and asbestos linked diseases. In 2013 there were 2,538 registered deaths due to mesothelioma. In 2014/15 an estimated 1.2 million working people were suffering from a work-related illness. These included work related stress, musculo-skeletal disorders (MSDs), skin diseases and asthma due to respiratory sensitisation. Thousands of workers continue to suffer harm and distress as a result of violence from the public while carrying out their jobs.

Under both the Coalition Government and the present Administration, much emphasis has been placed on the idea that health and safety requirements represent ‘a burden on business’. Much less emphasis has been placed on the costs of accidents and work related ill health to victims, families, businesses, the NHS and the UK economy as a whole. HSE estimate that in 2014/15 28.2 million working days were lost due to work-related illness and workplace injury (over one hundred times the number of days lost over industrial disputes over pay). The estimated cost in 2012/13 of work related injuries and ill health from current working conditions was £14.2 billion – just under 1 per cent of GDP.

In contrast to the ideologically driven and anecdotally fuelled view of health and safety that emanates from many Government and small business spokespeople (and that is amplified in most of the broadsheet newspapers), the vast majority of industry associations, the trades unions and the professional bodies still support the idea that attention to ensuring good health and safety at work is not just good for workers but it is good for business too.

Sadly, this core message, which has been a dominant narrative in industry and in Parliament over many years, has been lost amid Government concerns (started under Tony Blair) about health and safety red tape ‘burdens’ and tackling stupid or overzealous health and safety decisions and excessive, disproportionate ‘risk aversion’. Some exercises such as HSE’s ‘Myth Busters Panel’ have been useful in exposing cases where health and safety have been used as a convenient excuse for organisations to ban things that might be inconvenient or too costly. Yet it can also be argued that the Government’s obsession with these kinds of problems itself has become disproportionate and unbalanced and has more to do with their desire to reinforce the perception that health and safety generally have become burdensome and restrictive.

Government commissioned ‘reviews’ of health and safety (first under the Prime Minister’s ‘adviser on health and safety’, Lord Young of Graffam and later Professor Ragnar Löfstedt), failed to find a system of health and safety that was out of control.

Nevertheless in-roads were made into the regime. For example, as a result of Lord Young’s review, the seriousness threshold for employers to report injuries to employees was raised from three days absence from work to seven. As a result of a Löfstedt recommendation to review the position of the self employed, the Government moved straightaway to take all ‘low risk’ self employed workers out of the scope of health and safety law. Greater difficulties were placed in the way of those wishing to prove negligence in order to secure compensation for workplace injuries.

In parallel with this, the Health and Safety Executive (HSE), suffering cutbacks along with the rest of the civil service, were instructed to cut back on their campaigning and awareness work, to tread more lightly and to engage in a costly review of all their guidance to ensure that it did not impose undue ‘burdens’. While quite a lot of useful guidance has been ditched or archived, HSE to their credit, have managed to preserve most of their material and have also retained their own very useful website, resisting a move to have it absorbed in gov.com. They have also survived and emerged with much credit from a further Government commissioned review of their operations undertaken by ex EEF chief, Martin Temple.

On the downside however, in order to make good cutbacks in their funding, HSE have had to agree to a regime of ‘fee-for-intervention’ (FFI) under which employers are billed for HSE investigation and enforcement time. While this accords with ‘the polluter pays’ principle, it has also introduced a toxic element into relationships with employers and has undermined, to some extent at least, HSE’s image as a friendly adviser as opposed to a hard-nosed policeman. FFI however has not been introduced in Local Authority (LA) health and safety enforcement – bearing in mind that LAs enforce in the majority of workplaces. Nevertheless, the amount of LA health and safety enforcement has reduced massively due to cutbacks in LA funding.

Lord Young’s review tried to suggest that health and safety was largely a matter of common sense. Among those who support this view, many of whom seem to lack direct experience of industrial work, there is often a failure to appreciate that understanding of risk and risk control requires first of all knowledge and appreciation of hazards – so many of which are either invisible or behave in ways we least expect. There are, for example, noxious gases that have no smell and are invisible, electricity and all kinds of stored energies, invisible dusts like asbestos, dangerous micro-organisms, explosive or oxygen deficient atmospheres, the creeping effects of apparently innocuous things such as bad posture, noise, and of course stress. Also, many things in safety are quite counter-intuitive, like understanding momentum (which increases as the square of the velocity), error (which is compound phenomenon); risk perception (which is highly subjective); or indeed accidents (which are generally complex concatenations of events and circumstances).

Safety requires knowledge and understanding – and the modern world of work, far from being inherently benign, is actually full of hazards about which people – above all, young people – must be taught. A ‘safe’ country has to go on investing to sustain this level of knowledge if it wishes to maintain the same level of safety outcomes.

What has not been examined in sufficient detail arguably is the extent to which the all Party consensus which underpinned the reform of UK health and safety started by Lord Robens in 1972, has broken down. In the inaugural Allan St John Holt lecture in October 2008, John Rimington, HSE’s second Director General, highlighted this consensus as an essential pre-requisite for maintaining and developing the Robens project, especially during the Thatcher years when, in the face of sceptics on the right of the Conservative Party, HSE under John’s leadership was able to develop its world class expertise in the control of major hazards as part of it raison d’etre. John saw threats to HSE on both the right and the left of British politics, although he judged the former to be more worrisome than the latter, since he had confidence in the role of the TUC to bind unions into the work of the then Health and Safety Commission and its advisory structures. And he had similar confidence in the ability of major companies, the CBI and major industry associations to convince ministers that all was safe in HSE’s hands.

In recent years however the dissenting voices of smaller business have become much more influential. And notwithstanding lack of substantial evidence to support their case, this constituency represented by the Association of British Chambers of Commerce and the Federation of Small Business has insisted that health and safety regulation has become intolerably burdensome. Indeed the words ‘elf and safety’ have become a synonym or catch all for regulatory constraint and loss of entrepreneurial freedom. In pressing this case, facts and evidence have taken second place to perceptions and the deregulatory narrative – to such an extent that the ‘Something must be done about health and safety’ became unstoppable.

Of course all public bodies must be prepared to render account and it was to HSE’s credit that it emerged so well (relatively unscathed) – fitter even – as result of the last three reviews. (There been at least a dozen other such exercises since the introduction of the Health and Safety at Work Act in 1974).  But notwithstanding some of the benefits of the Löfstedt review (which was much more evidence based than the Lord Young review) such as simpler guidance and so on, it still represented a diversion of considerable HSE effort away from other pressing priorities and from publicity and campaigning.

Among all the regulators in developed domains of safety in the UK (food, fire, drugs, rail, maritime, air, vehicles, infection control, and so on) HSE stands out as pre-eminent. It is a great national asset and its future must surely lie in not only enhancing all the related assets in its own safety domain (all the players the UK H&S system) but in helping to sustain and grow other such systems such as in water, home and leisure safety.

When the health and safety system is considered holistically, it is clear that many bodies and organisations contribute to the delivery of safe and healthy working conditions every day, right across the UK economy. These include employers first and foremost, unions, trade bodies, training bodies, insurers (to some extent), professional and standards setting bodies, consultants, charities, sector bodies, local safety groups, and colleges and universities. (The whole map of influencers and providers is actually quite extensive.) Nevertheless to help drive it, this system of players needs a prime mover in the form of a strong, independent, respected and well-funded lead regulator. That body is the HSE.

A minimalist future for HSE as a specialist public body to be put on a care and maintenance basis to deal with ‘industrial’ safety, will be no guarantee of its survival.  And it will not allow its skills, knowledge and wisdom to be put at the disposal of others whom they would so greatly benefit.

Formed at the time that the Health and Safety at Work Act was introduced in 1974, over four decades it has developed a world-wide reputation for excellence. In consequence ministers are now requiring HSE to exploit this commercially to underpin their overall funding. There are strong arguments in favour of HSE exporting its expertise globally to help offset the massive but easily avoidable toll of injury and occupational disease in developing countries – but this really ought to be organised as part of the UK’s overseas development effort, not as a way of compensating for Government cuts.

And if HSE funding really cannot be fully sustained by central Government, then, rather than commercialising HSE and diverting it from its main purposes of education and enforcement, a new strategic partnership could be established with the insurance sector to support it. If all are agreed that prevention is better than compensation then logically UK prevention and insurance agencies need to work more closely together as they have done historically in other countries.

It would be in everyone’s interest, for example, if only a small fraction of the billions of pounds which are collected annually in Employers’ Liability Compulsory Insurance premia (and which are related to the level of risk in a business) were redirected to help stop accidents and diseases happening in the first place. Insurers however, many of whom are major donors to the Conservative Party, have never been keen on acting, as they would see it, as ‘tax collectors’.

Obviously, like any organisation faced with serious challenges, decisions have to be made by HSE about priorities. It is fairly clear that they will continue to focus their efforts on the control of industrial major hazards and on poorer performing businesses with higher risk profiles. And they will continue to pursue prosecutions and where appropriate, the imposition of penalties, the level of which has recently been increased substantially due to public pressure. Yet important as justice is in the aftermath of accidents, it has to be accepted that HSE cannot ‘inspect’ their way to better UK health and safety performance. Effective enforcement is now less about detailed checking than it is about ensuring that businesses have got the right leadership, policies, systems and culture in place, underpinned by real workforce involvement, to ensure that routinely hazards are identified, risks are properly assessed and the right controls are in place – and that this happens whether or not an inspector is on the horizon. But on the downside of course, with the bulk of HSE’s field force having to react to accidents and incidents, the amount of resource for proactive inspection is very limited indeed.

So rather than HSE ‘doing their health and safety for them’, even if there were a major re-injection of resource into HSE, it needs to be accepted that companies should be required to make greater use of competent internal and third party professional support to meet performance benchmarks. They need to be required to put their audit findings/achievement levels in the public domain – not just to be more publically accountable but to enable greater client scrutiny of their corporate social responsibility profile.

Besides just being able to carry out enforcement, HSE needs to be resourced to have a much more dynamic role in mobilising the combined strength of competent practitioners, key professional bodies, training and examination bodies, employer associations, unions and local networks across the UK – both to raise awareness and to leverage and maintain improved standards. To help HSE become this sort of ‘development agency’ for the health and safety system as a whole there is a very strong case for them to establish a new Stakeholder Council of key players to bring this about, building on the experience of their Small Business Trade Association Forum as well as bodies like POOSH (Professional Organisations in Occupational Safety and Health).

Modern health and safety started in Britain with early factory legislation in the 1830s. Alongside the people’s struggle for education, political rights, housing, health care and many other basic things, the slow, ‘three-steps-forward, one-step-back’ evolution of health and safety at work has been a fundamental (but not very well understood part) of our overall social development. Much progress has been made. But contrary to view of those like Lord Young, who might see health and safety as an archaic residue of limited relevance in a so called ‘post industrial society’, there are very many topics on which the UK needs to make major progress if more lives are to be saved, injuries reduced and people’s health safeguarded.

Accidents need to be properly investigated so lessons can be learned within businesses and sectors. Occupational road risk needs to be managed and regulated as part of the health and safety mainstream; harmful exposures to dust and fume at work must stop; asbestos in schools and all public buildings must be made safe (and eventually removed); stress and MSDs must be cut; noise and vibration damage must become a thing of the past, and intractable problems like slips and trips and accidents with site vehicles, machinery, equipment, substances and electricity need novel solutions. Education about hazards, risks and staying safe needs to be woven into our education system, from nursery school to business school and it certainly needs to be embodied creatively in the training of all apprentices, many of whom will go onto be managers and thus health and safety leaders in the future.

And health and safety at work need to be woven more effectively into the wider tapestry of UK public health, with new opportunities opened up, for example, to allow occupational health and safety knowledge and skills to flow out into the wider community to promote better health generally and help prevent the much greater volume of accidents that are happening outside the workplace.

Good health and safety are vital for workers, businesses and the wider community. Ongoing efforts to achieve these goals remain an important part of the struggle to build a more humane and more civilised society. It should come as no surprise therefore that they have not just been downgraded but parodied and even vilified in neoliberal austerity Britain. It’s time it stand up and regenerate some anger, pride and a sense of conviction that there’s much more that can and must be done if people who are alive and well now are not very shortly to be killed, maimed or robbed of their health simply as a result of going to work. We can and will get there quicker if we have leadership from a Government which accepts these fundamental truths and makes it possible for all the key players in health and safety to work better together and in closer partnership.

Roger Bibbings MBE CFIOSH

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