Category Archives: Work and health

Doctors in the Neonatal Intensive Care Unit - always there for your baby

Doctors in the Neonatal Intensive Care Unit – always there for your baby

We’ve all been hearing a lot about the need for the 7-day NHS since Jeremy Hunt started to conflate the issue with the Junior Doctor Contract. As a piece of rhetoric, claiming that the NHS shuts down at the weekend or implying that all the lazy doctors just head home for Saturday and Sunday is an interesting one, being demonstrably untrue, but its repetition seems to be changing public opinions.

At this week’s Socialist Health Association AGM, both Andrew Gwynne MP and a GP member were enthusiastic about how progressive the idea of a 7-day NHS is, and how the Labour Party should support it. The phrases ‘the NHS should be there when people need it’ and ‘it will reduce health inequalities’ were used.

I believe those arguments are false. I believe that the weekend is different, special, and that supporting the Conservative government’s ideas is regressive for both staff and patients.

The first issue is about what we mean by ‘7-day NHS’. It is quite obvious to anyone who has been in or visited hospitals at the weekend that the NHS is up-and-running 24/7/365. Emergency and urgent care is provided around the clock by doctors and other healthcare professionals already. You will never find an Emergency or Maternity Department closed because it is the weekend. People in hospital over the weekend do not languish alone without medical care. So we already have an emergency 7-day NHS. The NHS IS THERE when people need it.

What the government are talking about is elective care. Routine appointments. Non-urgent surgery. Diagnostic services. The figures used to back this are claims that the lack of these services at the weekend causes higher death rates and unsafe care for patients – the ‘weekend effect’. This inequality needs addressing. Other people have debunked these figures more successfully than I can.

So what arguments are there against the new 7-day elective service?

Implementing the plan for 7-day elective services would in theory require more doctors, nurses, diagnostic and admin staff. Without more staff magically appearing fully trained, or more money to employ those staff, the work must be done by existing staff – either moved across from weekday care or working longer hours. Neither option is safe and forms one of the core issues in the junior contract dispute. Another key issue is the push to make Saturday ‘plain time’ – ie cheaper for hospitals.

However, if the ‘weekend effect’ isn’t real, we must ask what the motivation for creating cheap weekend elective services is. Two possible explanations which have not received much air time are the reduction of paid sick leave for 9-5 weekday workers, and the concept of ‘sweating the assets’.

Evening and weekend elective services are explicitly aimed at ‘hard-working people’ who currently have to take time off for routine appointments at hospital during the working week. Removing this type of employee sick leave from the books would result in large savings for some employers. Some would pressure employees to only accept weekend appointments. More would give positive bias to employees who managed to leave health maintenance outside the workplace, changing the culture of what it is acceptable to miss work for. Our patients with chronic health problems and disabilities would be worst affected, finding their lives outside work shortened by the need to attend appointments in this time. This time that otherwise they might spend with their friends and family, crucial social support.

Sweating the assets is the act of extracting the largest possible amount of work from your existing resources, whether they be human, financial, space or equipment resources. With hospitals currently providing very little elective care at the weekend, there is plenty of room for lucrative work to be done in this time. The hospital’s resources are not being used most efficiently unless they are operating 24/7, like a factory. With hospital trusts now allowed to make 49% of their income from private practice, there is opportunity to bring in wealthy customers in this time. With the private sector circling above our NHS like vultures, already picking off the more profitable bits, this could be the windfall that allows viable takeover.

Neither of these reasons is progressive.

Weekends are special and do deserve different treatment – unions have fought for them over centuries and we should not give them away so easily. For health workers, this is the time that would otherwise be spent with children or friends. It is the time we miss weddings in. It is the time when childcare is far more expensive. To work at the weekend is to give up more of yourself than during the week, and that should be recognised.

If we want to address health inequalities, then it is the social determinants of health – poverty, poor education, poor housing quality – that we should be attacking, not NHS staff.

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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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If you’re about to set off on a long car journey – and we’re talking more than a trip to the out of town shopping centre here – there are a few routine checks you need to make to your car before you set off.

So either get a mechanic to give your car a quick going over or just carry out a few simple checks yourself, including: making sure the tyres are in good condition and inflated properly, all of the car’s lights and electrics are working properly, and all fluids are topped up, including engine oil.

sochealth

And once you finally hit the road, there are five must do’s to keep you going…

  1. Take regular breaks

If you’re trying to get to your destination as quickly as possible, you might try to do the trip in one go and put off any pit stops along the way – and you wouldn’t be alone in that as a study from the Institute of Advanced Motorists (IAM) found almost two-thirds (65%) of drivers don’t stop to take a rest break on the motorway when taking long journeys – saying that they don’t feel the need to.

The fact is though, regular pit stops are really important on long journeys as tiredness can impair your driving ability as much as drink driving – a 2010 study from Cardiff University found driving for more than three hours without a break at night is the equivalent of being drunk behind the wheel.

For those involved in commercial travel such as van or lorry drivers, this message isn’t always easy to obey, especially when there are such high delivery demands. To help with this conundrum, webuyanycar.com teamed up with Costa Coffee providing vouchers for those who contributed to their competition in an attempt to increase alertness and reduce fatigue.

So when planning your journey, make sure you factor in regular breaks and if you’re feeling really tired it may be worth bedding down for the night.

  1. Stay topped up with foods and fluids

It’s also important to keep yourself fed and watered as driving without enough fluids on board can also impair driving as much as drinking alcohol.

A recent study from Loughborough University tested drivers who had just 25ml of water an hour and found they made double the number of errors compared to those who kept themselves properly hydrated. And more worrying still, the number of mistakes made were roughly the same as someone who had 80mg of alcohol per 100ml of blood (the legal limit in England and Wales).

So when you take that pit stop, make sure you top up with water, perhaps coffee or a caffeinated drink if you’re feeling a little lethargic.

  1. Keep your car topped up with fuel

And it’s not just yourself that needs regular top ups, it’s obviously vitally important to keep your car topped up with fuel.

Empty fuel tanks are in the AA’s list of the top ten causes of breakdowns, so make sure you fill the tank at the start of your journey and try not to let it drop below the halfway mark, that way you can be sure you’ll never be caught short.

  1. Keep your passengers entertained

According to Brake, the road safety charity, a study of in-vehicle video footage suggested almost a quarter (22%) of crashes could be caused, at least in part, by driver distraction. And while we’re all aware of the dangers of driving while using a mobile phone or eating, an Australian study found having children in the back is 12 times more distracting to a driver than talking on a mobile phone while at the wheel.

So make sure you take enough books, DVDs, game consoles or whatever you need to keep the kids, or any other passengers, occupied.

  1. Have fun

If you’re heading off on a road trip then the journey is just as much a part of the holiday as your destination is – so make sure you leave plenty of time for the journey so you can take regular breaks and stop-off at points of interest. If you rush your road trip, you’ve done it all wrong. Sit back, relax and have a smooth ride!

Comment below with any helpful tips and let us know your absolute must-do’s before taking on a long car journey!

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Back pain affects many of us at some point in our lives and it can brought on by bad posture while sitting or standing or occur as a result of lifting a heavy object incorrectly.

Bad posture and incorrect lifting are two prime examples of how it is possible to sustain an injury whilst at work.

There are situations where your employer should have taken better steps to ensure you did not suffer an injury to your back and this is often the point where firms like Claims Direct are called in to provide help in getting you compensation for their negligence.

Common injuries

Prevention is better than cure, and therefore it makes sound sense to understand how back injuries occur in the first place and how accidents and injuries can be avoided in the workplace.

Millions of work days are lost each year due to employees having to take time off to recover from a workplace-related accident or injury and although less than 1% actually suffer a fatality, about 2 million believe that their work has caused them to suffer an illness or injury.

Back injuries rank highly amongst the most common injuries and the most likely accident you are going to suffer at work is a trip, slip or fall, followed by an electrical incident or an injury sustained due to manual handling or lifting.

The most typical complaints are sprains and strains and workers also regularly suffer from back, head and neck injuries. Repetitive strain injuries are also common ailments that workers are likely to suffer as a result of carrying out their required duties.

Manual handling

Almost one third of accidents at work involve some form of manual handling.

Estimates suggest that over one million people suffer from a work-related musculoskeletal disorder (MSD) as a result of lifting, pushing or moving a load.

Your employer is obliged to carry out adequate risk assessments of manual handling tasks to ensure your safety is not put at risk and every effort has been made to avoid you becoming an MSD statistic.

There are laws in the UK that are enforced by the HSE and their Manual Handling Operations Regulations give clear guidelines and advice for employers to follow before allowing their employees to carry out any manual handling tasks.

Risk assessment

The principle behind carrying out a suitable risk assessment is reduce the prospect of an injury caused by manual handling to reasonably practical levels.

In order to do this, the employer needs to look at four key aspects that combine to create the major handling risks that you face. An assessment needs to look at the size of the load, the person carrying out the task, the suitability of the working environment and the task itself.

What this means is that size, weight and shape of the load needs to be considered and with regard to the person being asked to do the lifting, whether their age, physical ability or other factors have been taken into account.

Many things can be done to prevent injuries like MSD happening at work and if you are asked to carry out a task that you think might cause you an injury, ask your employer if they have carried out a suitable risk assessment.

Samuel White is an occupational therapist. He enjoys sharing his experiences on the web. His articles appear on many health and lifestyle articles.

Image credits: wikimedia.org

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Starting your own business is an exciting endeavor. You’re chasing the dream of running your own company, controlling your own destiny, and it all started with an idea. You’ve worked hard to cultivate that idea and form a company that can successfully provide a product or service to the consuming public. Now, have you missed any steps along the way when forming your company?

If you haven’t thought about the health and safety of your workforce, you should turn your attention to workplace safety immediately. You are responsible for the safety of the employees in your building, customers visiting your facility, and anybody using your products and services. If this seems overwhelming, it doesn’t have to be. Below you’ll find a list of health and safety must-haves for your startup.

Register Your Business

If your new business works in a hazardous industry, the UK government needs to know about it. Most businesses operating within a hazardous industry require a license to operate and must be registered with the Health and Safety Executive, or other local authority. Learn more about those guidelines and registration steps by visiting the official HSE website.

Risk Assessments

Regardless of the industry youoperate in, you need to meet minimum health and safety standards. With that said, it is always a good idea to go above the minimum health and safety levels. A risk assessment is the best place to start. The assessment identifies hazards within the business, such as cables, loose floor tiles, and other obstacles that pose trip/fall potential. Other risks include hazardous substances, excessive noise, and moving vehicles.

Review the findings of the assessment and determine what actions (if any) should be taken. It is a good idea to reassess the risks in your business environment every six months or when significant changes take place to ensure you still meet standards.

Employee Health and Safety Rights

Your top priority should be the health and safety of your employees in the workplace each day. Simple things you are required to provide include access to clean toilets, hand basins, soap, and means to dry their hands. Additional requirements include fresh drinking water, sufficient space to operate comfortably, and proper lighting and ventilation.

Serious Issues

Beyond the simple health and safety rights mentioned above, you also need to plan for the occurrence of serious incidents. These incidents can involve both your employees and your customers, and insurance coverage is a good way to provide protection to your business, as well as support to employees and customers. Employers’ liability insurance is a good place to start, but you should also consider access to first aid and a system for handling and reporting serious incidents. For more information about employers’ liability insurance, read this guide at Make It Cheaper.

Your Business and the Community

Finally, you need to keep in mind the impact your business may have on the local community. Everything from the waste your business generates to the electrical and electronic equipment used in business operations could have a negative impact on the environment in your local community. Familiarize yourself with EU and UK regulations which layout the steps you must take to deal with these potential hazards, and others.

Steve Talbot is an export business owner and avid environmentalist. When he’s not working in his yard, he’s writing about his experiences on the web.

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Mesothelioma – a form of lung cancer caused by exposure to asbestos – kills twice as many people the UK every year than motor vehicle accidents.

It’s a shocking statistic considering that asbestos has been banned in the UK since 1999, and the most dangerous form of asbestos has not been used since the 1960s.

But more people than ever are suffering its effects, and because asbestos is no longer used in construction, it’s devastating effects are rarely thought about – let alone discussed.

This has prompted local personal injury specialists Johnson Law to raise awareness of asbestos exposure, and in particular asbestosis, a lung condition which almost 1,000 people are diagnosed with in the UK each year.

Asbestosis  infographic

Despite what you may think, exposure to asbestos is not limited to those in the construction industry. Homes, shops and offices built between the 1930s and 1970s are likely to have asbestos in the insulation, and at one time the material could be found in over 3,000 household appliances.

This means that most of us have unwittingly been around asbestos, and it’s proving a dangerous hangover of our recent industrial past.

Asbestosis

Asbestosis is caused by inhaling asbestos fibres. This causes inflammation and scarring of the tissue in the lungs. The condition seriously affects everyday life and any complications can prove fatal, with around 2,000 deaths annually linked to asbestos-related lung cancer.

Symptoms to look out for are:

  • Shortness of breath
  • Persistent cough
  • Fatigue
  • Laboured and rapid breathing
  • Chest pain
  • Swollen fingers.

Sadly there is no cure for asbestosis, however there are ways to treat the symptoms and help prevent cancer developing. If you’re diagnosed with asbestosis, your doctor can provide vaccinations to protect your lungs against other infections, and may recommend oxygen therapy which is also known to be beneficial.

While anyone can get asbestosis, certain professions are more strongly associated with asbestos exposure. Insulation workers, plasterers, boiler makers, shipyard workers, sheet metal workers, plumbers, pipefitters, heating and refrigeration mechanics and chemical technicians are all considered at risk.

If you think you may be exposed to asbestos within the workplace it’s vital you raise the issue with your employer. They have a duty to protect your health and safety.

It’s likely to be 2050 before the epidemic of asbestos-related illnesses in the UK comes to an end. Until then, all we can do is educate ourselves on this silent killer.

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Exposure to loud noises can lead to hearing loss. This might not be while you work but studies show that people in these professions have a higher chance of hearing loss as they get older compared to the general population.

If you’re concerned about hearing loss and the condition of your ears, take a look at Hidden Hearing.

Racing driver

Some motorsports are louder than others but continued exposure to these kinds of engine sounds can damage your hearing. It could be through tinnitus or loss of hearing at a later stage. Anyone working in motorsport – not just the drivers – needs to wear noise cancelling headphones to protect their ears. We can learn from this, even spectators should protect their ears in some way. Ear plugs are readily available and a lot of races have them for sale or even give them away for free.

Construction workers

Loud noises from machinery can really affect your hearing. It doesn’t matter if you’re a carpenter, plumber or road worker. If you are around loud machinery, it’s important to protect your ears with ear plugs or headphones. Construction workers who work for large companies usually have these provided but for workers who are self-employed, this can often get overlooked. Around half of construction workers report some kind of perceived hearing loss and this shows just how important it is to protect your hearing around machinery.

Musicians

Musicians such as Chris Martin from Coldplay and Will.I.Am have reported hearing loss in the form of tinnitus, caused by performing and listening to loud music. This isn’t just a problem for the musicians themselves but for roadies, security, producers and anyone else who works in the music industry. If you are in close proximity to speakers (even as a music lover attending a gig) then you should protect your ears. There are earplugs you can get that won’t affect your listening experience but will protect your ears from the vibrations that will damage your hearing.

Factory workers

This is another job where there’s a likelihood of being exposed to loud machinery. When on the factory floor, ear protection should be worn. Even factories with lower decibel sounds can damage your hearing. It’s the constant exposure to noise that can cause irreversible damage. If you work in a factory and your employer doesn’t already provide you with ear protection, you need to ask.

Airline ground workers

A lot of people working in the transport industry are affected by hearing loss and exposure to loud noise. Those who work with planes are most susceptible as the sound of a jet engine is much louder than with buses, cars or motorbikes. The airline industry is generally pretty good with giving staff the right protection but if you’re new to the industry or just working with planes as a one off, you need to make sure you get the right ear protection and training. It doesn’t matter what industry you work in, if you’re regularly exposed to loud sounds, you’re at risk of some kind of hearing loss. Make sure you protect your ears and adhere to all safety standards as set out by your employer or governing body.

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In his most famous live performance, comedian Bill Hicks pulls out a packet of cigarettes, lights up and, in his typical furious tone, says, “Hey, non-smokers, I’ve got news for ya – you’ll die too!” letting out a fierce laugh as he takes his first puff.

And he’s absolutely right. No matter how much we invest in our good health, the slightest accident can still halt you for months, causing injury and a loss of income.

But if an accident occurs in your workplace, the outcome isn’t completely out of your hands. While smoking killing you is your fault, a major hazard in your employer’s office or warehouse most certainly isn’t.

Whether it’s a slip, trip, fall or something far more dangerous, you’re not alone – more than 600,000 other workers suffered an injury in the workplace in 2013.

So what can you do to stop the blame being placed at your door? For a start, you can try a few of these tips.

Get the law on your side

If you’re considering legal action against your employer, then it’s no good to take the law into your own hands, like some sort of badly injured Judge Dredd.

Indeed, if you want someone to say, “I am the law” it should be your personal injury claim solicitor. By contacting them, you’ll gain expert advice on what the legal system can do for you, and find out if your accident is worth making a claim against.

A solicitor should be your first port of call after an accident, and they’ll keep you in good stead for any future legal wrangles with your boss.

Get a trade, son

Back before the leadership of Margaret Thatcher, trade unions were as strong as bulls, flaring at the nose at the mere mention of the term pay cuts. But now they’re a weakened bunch, and few workplaces even bother with a trade union to protect them from their bosses.

However, you can still rally the troops if you feel your working environment is putting your health at risk.

A group of agitated employees is far more likely to pique an employer’s fears, rather than a single dissenting voice, so make sure you have an employee support framework in place before a health mishap occurs.

Know your rights

Employment law can be a complicated business, hinging precedence on previous cases and obscure jargon. However, the basics can be easy enough to get to grips with and would be recommended if you’re entering any kind of health and safety dispute with your employer.

The most important measure when discussing severe injuries with your employer is to speak on an even footing. After all, when your safety is at hand, it’s important to chat in a responsible and rational manner.

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The Association is entitled to propose 10 amendments to the Labour Party’s proposed policies.  These are the amendments we are planning to propose after discussion at our Central Council last week. (there are 12 listed as we hope to cooperate with another affiliated society).  Suggestions for improvements are welcome, but each amendment is limited to 200 words, and they have to be submitted by 13th June.

Amendments to Health and Care

1. Social Care

Page 8  line 18  In Section entitled – The future of social care.
After second paragraph add:-
“Labour believes that it is time to accept that social care should be placed on the same basis as health care; cover for all, contributed to by all and free at the point of need. The case for all care being free is the same as the original case for free health care.   Labour will work towards delivering on the aspiration of free care building on the Care Bill provisions which extend social free care to some.

Policies which take away the independence of the disabled and cause deteriorating health as a consequence are costly and cruel.  An incoming of Labour Government will not implement the current Government’s proposals to end the Independent Living Fund (ILF) in June 2015 and will instead initiate a full review of disabled people’s independent living. As part of that review Labour will look to use National and local government purchasing power to drive down prices of disability related equipment and services, including insurance. Labour will also look at ways of reducing the cost of social care for disabled people and their local authorities without reducing the quality of services delivered.”

2. Mental Health

page 10 line 38 add: “ Britain’s mental health is at its worst since 1997 with increasing morbidity and a worsening suicide rate, because of  recession and savage cuts to public services which disproportionately affect the most vulnerable. A clear focus on enhanced well- being and the promotion of mental health within schools, workplaces and general hospitals is needed to reduce the economic and social burden of mental ill health. A new National Service Framework, with a robust set of clinical and social outcomes based on a model of early identification recovery and optimism, delivered in partnership with service users and carers will be established. Labour will instruct the Care Quality Commission to make sure that all providers of mental health and social care services comply with the Equalities Act meeting the access needs of disabled people and the cultural needs of  BAME communities. In addition, Labour will demand that all relevant authorities play an active part in improving the integration between physical and mental health services and deploy community development resources with the clear objective of strengthening the community and voluntary sector to deliver on our aspiration for better mental health and spiritual well-being for all local populations.
Children’s mental health is paramount if psychomorbidity in the adult population is to decrease. CAMH services need to be adequate for the speedy identification and treatment of mental disorders in children in the least stigmatising way.”

3. NHS

Page 4 line 7 Delete second paragraph and replace with:-

“Labour will restore the duty of the Secretary of State to deliver a comprehensive, universal NHS overwhelmingly publicly provided and entirely publicly managed and will give the Secretary of State the power to give directions to any part of the NHS.
Labour will deliver an NHS that values and promotes collaboration and cooperation. Labour will remove any legal or other barriers which prevent or deter cooperation including any which seek to require NHS services to be competitively tendered.   Labour will replace the system of procurement through commissioning with a system where publicly funded care services are planned and decisions about services and funding are made through open and transparent democratically accountable processes drawing on experiences in Scotland (and Wales, where health outcomes on a par with England are delivered for about 10% less cash than comparable English regions).

The NHS will no longer operate as a market or pretend that Foundation Trusts are free-standing competitive corporations.  The private sector will only be allowed to offer patient services as an alternative to the NHS by exception, where it evidences enhanced care and innovation.. ”

4. Accountability

Page 4 line 30 delete sentence beginning “Instead, we need…”  Insert “The health service must ensure collective and individual accountability throughout. Care must be delivered with as much participation in shared decision-making as the patient wishes at the time. Planning functions must be democratically accountable.  We will ensure the engagement of patients and family / carers in the care process as co-producers of health outcomes and the provision of good information to patients to enable them to be actively engaged. Values important to patients like dignity and respect should be demonstrated in every service provided.  This should be informed by widely available and meaningful information about the performance of and outcomes from health care services.
Nationally, UK comparative performance in terms of health inputs, care processes and patient outcomes (both patient and clinician reported) will be used to ensure the NHS matches the performance of the best European systems. The average length of life both attained and forecast at national and sub national levels, the number of life years lost, and the quality of life in key respects (especially for the last decade of life) will inform these measures. The Chief Medical Officer (England) will be required to submit an annual report directly to Parliament charting progress in these areas.”

5.  Public Health

Page 10 Line 15 insert “We will make healthy choices easier by ensuring that the financial incentives and taxation system supports affordable healthy products such as fresh fruit and vegetables while making unhealthy products high in fat, salt and sugar better regulated and relatively more expensive.
We will remove the VAT exemption from sugar, which has little nutritional value.  We will ensure that the quantity of sugar, salt and fat in manufactured food is easily apparent to customers wherever it is sold. We will ban the use of trans fats in food products (as done in Denmark) – and push for the ban to be extended throughout the EU.We will introduce minimum unit pricing and encourage lower alcohol products.  We will reduce the hours during which supermarkets are permitted to sell alcohol and make it more difficult to buy dangerous quantities of alcohol following the successful example of reducing damage caused by paracetamol poisoning. We will progressively raise the age below which it is unlawful to supply tobacco to young people.  We will bring forward proposals to reform the law on misuse of drugs to balance the penalties against the harm done by different drugs including alcohol and tobacco.”

Amendment to  Stability and Prosperity

6. A healthy society

Page 4 line 8 insert “We want to see a community in which power, wealth and opportunity are in the hands of the many not the few and where the rights we enjoy reflect the duties we owe. This will not happen in an unhealthy society where wealth is primarily inherited and the benefits of economic growth go to those who are already rich.  Labour’s long-term goal is to break the link between a person’s social class and their health. We will work across government, using the power and influence of all government departments and agencies, to achieve this. All Labour’s policies in government will be subject to an assessment of their impact on the public’s health.

We will use a new tax on wealth to finance the NHS and social care system to achieve a level of spend as a percentage of GDP on a par with the best in Europe, aided by the removal of tax rules that currently allow tax avoidance by international companies earning  untaxed profits in the UK. We will safeguard the NHS from the TTIP which will otherwise act as a means of a commercial takeover of our healthcare provision. ”

Amendments to Work and Business

7. Health and work

Page 6 line 25 insert: “Employees of all grades with higher levels of control over their work (in terms of content, pacing of tasks, decision-making, etc.) have better health. Low control at work is associated with higher rates of heart disease, musculoskeletal pain, mental ill health and mortality – even when other risk factors (such as smoking) are accounted for. Interventions to improve control at work (for example rotating tasks, flexible working, employee participation in making company decisions, employee ownership/shares) have been found to improve health – with no detrimental effects on productivity. We will introduce measures to ensure that firms are  involving employees in the business so that job control is increased. In other European countries, such as Germany, “workers’ councils” are common place in businesses and they could be introduced here.”

8. Benefits for disabled people

Page 11  line  6 add at end “Labour will ensure there is a non means tested benefit to meet the additional costs faced by disabled people, and place them on a level playing field with non disabled people.  Pending the benefit redesign Labour will immediately revert to the 50-metre distance test in respect of the higher rate mobility component of PIP. There should be a disabled person on each tribunal considering appeals where award of the benefit has been refused.  The assessment must be accessible, fair and transparent, carried out by NHS workers, must use evidence obtained from Occupational Therapists,  doctors and other healthcare professionals, use existing assessment data held for people’s entitlement to disability living allowance where held, entitle a recipient of DLA automatically to PIP and be carried out once to result in a lifetime award unless the impact of a condition can be expected to change. There should be no cap on the budget for the benefit, so that all disabled people who meet the criteria receive the benefit.  We welcome the report of the Disability and Poverty Taskforce and will work with disabled people and their organisations to examine how its recommendations can be taken forward.”

Amendment to Living Standards and Sustainability

9 Transport and health

Page 3  Line 48  Insert new heading “Transport and health ”
Insert “Traffic accidents are higher in more disadvantaged and urban areas (particularly amongst children and outside schools), and are the leading cause of death in children over 5. We will encourage widespread introduction of 20 mph limits in urban areas to encourage the reclaiming of our streets by pedestrians.
The Active Travel (Wales) Act 2013 will be extended to England so every local authority will be required to publish details of expenditure on transport measures divided between walking, cycling, public transport and motor vehicles.   We will rebalance the transport budget so that 10% is spent consistently over the length of the parliament on the needs of pedestrians and cyclists with the aim of building networks of segregated cycle tracks in every major city.  We will remove VAT from bicycles.
We will take urgent steps to reduce the air pollution caused by road traffic, and in particular by diesel engines. We will reconsider the taxation of vehicles and motor fuel in the light of the evidence of damage to health caused by particulates.
We will reduce the level of alcohol which is permitted for motorists”

Amendment to Education and Children

10. Healthy Children

Page 10  Line 4 insert “In 2013 the UK had worse rates than nearly every other Western European nation for early neonatal deaths especially among socially disadvantaged groups. More investment in employing trained midwives to provide one to one care is crucial and shown to be effective in reducing still birth. We will ensure that sufficient support from midwives and health visitors is available for women and babies to tackle the appalling level of death among young children. We will increase benefit rates for pregnant women so that they can afford a healthy diet. All children are vulnerable and schools need to do much more to promote both physical and mental health. Every school must have a school nurse and a school counsellor. Childrens mental health services need to be adequate for the speedy identification and treatment of mental disorders in children in the least stigmatising way.”

Amendments to Better Politics

11. Community Development

Page 4. line 24 insert. “Taking part in community activity is a vital way of protecting and improving mental health. Health providers will be directed to support the growth of local voluntary and community groups as a whole, cooperating with the other services which have a mutual interest in this. We will ensure that health agencies play an active part in deploying community development, with the clear objective of strengthening the constructive role of the community and voluntary sector in relation to health.  NHS agencies and providers will therefore be expected to play their part in ensuring that every locality has a thriving third sector largely funded by grants rather than contracts. NHS organisations will be expected to take an active part in neighbourhood partnerships and to encourage users and carers groups to do so. There needs to be a shift so that we look at the most disadvantaged people regaining a sense of hope control and optimism over their lives, working on the strengths, (assets), of people, their families and the communities in which they live – this will impact positively on mental health and well-being and is evidence based from the recovery framework that is gaining credence in mental health”.

12. Age discrimination

Page 8  line 46  insert new section “Age”…”We will ensure that there is parity of treatment in health and social care services in respect of both youth and  age.  This implies

  • equal access to effective, safe care
  • equal efforts to improve the quality of care
  • the allocation of resources on a basis commensurate with need
  • equal status within healthcare education and practice
  • equally high aspirations for service users
  • equal status to the measurement of health outcomes”
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You may know it as Vibration White Finger, Raynaud’s Syndrome, Raynaud’s Phenomenon, or you may not have heard of it at all, but it’s a condition that affects over 300,000 people in the UK and over 2million are at risk.

If you use certain power tools in the workplace, then you are among them.

Personal injury specialists Johnson Law Solicitors have produced this infographic to raise awareness of the condition among employers and employees, as well as to help people to recognise the symptoms and remedies.

Vibration White Finger (VWF) is a form of repetitive strain injury where the small blood vessels in the fingers periodically spasm causing them to go bluish-white, cold and feel very painful.

Attacks can last from a few minutes to several hours and once the spasms subside the fingers turn red as oxygenated blood returns to the finger tips.

Using vibrating equipment and power tools is the primary cause of VWF, if you use pneumatic drills, jack hammers, sanders, concrete vibrators, chainsaws, compactors or lawn mowers at work, then you are at most risk of developing the condition.

Symptoms of VWF include:
• Tingling and numbness in your fingers
• Inability to feel or pick things up using your fingers
• Loss of strength in your hands
• Fingertips turning white and then red in cold, wet weather

It may however take months or even years for these symptoms to appear, so if you are at risk it’s important to take early action.

Using certain power tools for just 15 minutes at a time is enough to expose you to VWF. The absolute maximum (for a non-hammer action tool) should be 4 hours, and your employer should enforce limits on using vibration equipment as a health and safety measure.
For your part there are steps you can take to prevent VWF. Try to keep warm at work and wear gloves when in cold temperatures and exercise your hands and fingers regularly to help to maintain good circulation. It is also essential to use vibration equipment for short bursts of time rather than long periods and for no longer than is necessary.
If you do develop symptoms they can be treated by improving your fitness and circulation, avoiding vibration equipment, stopping smoking and wrapping your hands as soon as an attack occurs.
The effects of VWF cannot be underestimated. It is a painful condition that in severe cases can cause permanent damage and ulceration of the tissues which requires hospital treatment.

If you feel you are at risk of VWF within the workplace you must raise the issue with your employer. They have a duty to protect you and keep you informed of relevant health and safety issues.

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It may not be the most attractive clothing, but wearing personal protective equipment (PPE) is a statutory requirement and is an important preventive measure for employee safety in the workplace. PPE refers to protective clothing, helmets, goggles and other garments designed to protect the body from harm, for job related occupational health and safety purposes. Employers have a responsibility to provide PPE clothing. Items such as hard hats and work gloves can be purchased at a reasonable rate on http://www.ebay.co.uk. As an employee you have a legal right to a safe working environment, and also a responsibility to take reasonable care of your own health and safety, this includes wearing protective clothing when required.

Employer Responsibilities

Your employer has a responsibility to assess any risks to employees, customers, partners and any other people who could be affected by their activities in the workplace and put appropriate protective and preventative measures in place. Where risks are identified, personal protective equipment must be provided to manage this risk and safety procedures designed for its use. Employees must have access to competent health and safety advice and be consulted about their risks at work and protective measures, including adequate training. All organisations with more than five employees must have a written health and safety policy. The PPE provided to you must fit correctly and be in a good state of repair. You can refuse to wear clothing that puts you at risk because it does not fit properly.

Employee Rights

As an employee you have a legal right to work in a safe and healthy environment, this includes being provided with suitable safety equipment and clothing by your employer and having procedures in place to manage identified risks. If you feel that your workplace does not fit this description and you have reasonable concerns about your safety, you have the right to stop work and leave your work area without undergoing disciplinary action. It is important that you attempt to discuss any concerns you have regarding health and safety in the workplace with your employer to attempt to resolve these. If your employer is not complying with health and safety law, you should contact the Health and Safety Executive for further guidance.

Why it is Important to Wear PPE

In some professions, failure to utilise PPE correctly can be grounds for disciplinary action or even dismissal, not to mention a risk to your own wellbeing. Protective equipment is there for a reason, for example hard hats are used to protect the head from injury from falling or flying objects, failure to wear them can result in head trauma. PPE is considered the last line of defence in preventing workplace injury and ill health.

Taking Responsibility For Your Own Safety

Even if a task will only take a few moments to complete, if it requires PPE, it requires it for a reason. Ensure you always wear your protective clothing and take all other safety precautions.

You must ensure that PPE is properly cared for, including storing equipment in a safe, dry place. Any wear and tear must be reported so that it can be replaced promptly.

Ensure that your health and safety training is up to date and that you follow and comply with your organisation’s health and safety policies and procedures.

You must inform your employer of any medical condition that you have that could be affected by the use of the PPE you have been provided.

In accordance with the requirements of the Personal Protective Equipment Regulations 2002, any PPE provided by your employer must be ‘CE’ marked. CE marking on a product ensures that the product conforms with the essential requirements of the PPE Directive 89/686/EEC.

Further Information

If you would like further information then a brief guide to PPE compiled by the Health and Safety Executive, including additional reading on the subject, can be found here.

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As the 2010 Marmot Review (and before that the 2008 WHO report on Closing the Gap) makes clear, significant improvements in population level health, as well as reductions in health inequalities, require actions that tackle the social determinants of health. However, traditional public health policy has tended to focus on modifying individual lifestyles, rather than addressing the more fundamental causes.

The suggestions so far put forward as the SHA’s submission to the Labour Party’s Public Health Policy review also largely focus on these downstream determinants. This review process is an ideal opportunity to put forward more upstream, social determinants based suggestions.

Based on the social determinants of health, and my knowledge of the public health evidence base, I would like the following policy suggestions to be considered by SHA council on 26th April, with a view to including them in our submission to the NEC.

Whilst not all of these policies will be seen by everyone as being “politically possible” in the current climate, however, the SHA is a broad coalition and a range of ideas should be put forward in our submission to the NEC. As Maggie Winters pointed out in her recent post – the NHS and the welfare state were set up in much harder circumstances.

The evidence supporting these interventions can be provided to Council on request.

1. Improving control at work

Studies have shown that employees of all grades with higher levels of control over their work (in terms of content, pacing of tasks, decision-making, etc.) have better health. Low control at work is associated with higher rates of heart disease, musculoskeletal pain, mental ill health and mortality – even when other risk factors (such as smoking) are accounted for.

Interventions to improve control at work (for example rotating tasks, flexible working, employee participation in making company decisions, employee ownership/shares) have been found to improve health – with no detrimental effects on productivity.

The last Labour government introduced flexible working for parents and carers, and Ed Miliband has talked about potentially having employees represented on company boards to influence the remuneration of executives. The health literature suggests that these ideas should be extended to involving employees in other areas of the business so that job control is increased. In other European countries, such as Germany, “worker’s councils” are common place in businesses.

2. Enhancing access to public transport

Access to public transport is an important social determinant of health as it is vital in terms of enabling access to employment opportunities, health care, and other services such as leisure services, food banks etc. However, it has decreased since privatisation due to the costs of travel, and the reduction in bus routes. Local government budget cuts have also led to reductions in the subsidies paid to support less popular routes. This is particularly an issue in rural areas, and for lower income groups.

The last Labour Government introduced free bus passes for the over 60s. These should be extended to the unemployed and workless to enhance employability and job search. Central government should provide funds to local authorities to ensure that public transport is continued to be made available in rural areas to connect communities with services.

3. Introducing 20mph zones

Traffic accidents (non-fatal) are higher in more disadvantaged and urban areas (particularly amongst children and outside schools) – perhaps due to the higher volume of traffic in such areas. There is a strong evidence base that shows that reducing traffic speeds from 30mph to 20mph results in a reduction in accidents. Such interventions are relatively low cost (changing signage) but can lead to a 15% reduction in injuries. Targeting interventions outside schools with high accident rates may be particularly beneficial.

4. Creating healthy places

Geographical research has shown that communities with higher rates of obesity also have a higher prevalence of fast food outlets. Gambling is associated with higher rates of debt, as well as with mental ill health. Betting shops, as well as high-cost credit shops, are more prevalent in poorer areas. There have been big increases in the prevalence of betting shops, fast food joints, and high-cost credit shops in local high streets and town centres since the 2007 financial crisis.

Current planning law does not enable local authorities to properly control the number of such businesses in their local areas because health is not currently a reason to turn down planning requests. A Labour Government should increase the power of Local Authorities to shape local high streets by adding health as factor in planning decisions.

5. Implementing a Minimum Unit Price

The connection between ill health and high levels of alcohol consumption are well known. The Marmot Review advocated a minimum unit price to reduce mortality and morbidity associated with high levels of alcohol consumption. Econometric modelling as well as comparative data from countries such as Canada suggest that a Minimum Unit Price could be a very effective intervention and one that is proportionate – impacting most on the consumption behaviours of those most at risk.

6. Reducing Ill-health related worklessness

Rates of receipt of incapacity-related benefits (e.g. Employment Support Allowance) have increased rapidly over the past three decades and approximately 7% of the UK working-age population is now in receipt of such benefits. Policy has traditionally focussed on reducing the benefits paid to such groups, tightening up eligibility criteria or making employability programmes compulsory. There is almost no evidence that such interventions have been effective. This is because policies have seldom tackled the route cause of such worklessness – ill health.

People in receipt of health-related benefits have multiple and complicated long term illnesses and so tackling underlying health issues could be the first step to successful return to work. NICE guidance recommends a ‘health first’ approach (combining traditional vocational training approaches, financial support, and health management on an ongoing case management basis) to improving the health and employment of people with a chronic illness. The evaluation of a pilot ‘health first’ intervention in County Durham, also suggests that taking a more health focused approach can be beneficial in improving the health of Incapacity -related benefit recipients and thereby putting them in a better place to engage in mainstream job-search activities.

7. Healthy Housing Policy

Housing is one of the major determinants of health – indeed in the Atlee Government, Bevan was Minister for Health and Housing. The quality of housing (e.g. damp) impacts on health, as does tenure (with private occupiers usually exhibiting better health than renters). The cost of housing – both in terms of purchasing and renting – has increased well-above inflation in the UK since the early 1990s. Rents are now considered to be extremely high and in some areas simply unaffordable for large swathes of the population. Much of this increase has been taken on by the tax payer in terms of housing benefit – a subsidy to private landlords.

Evidence suggests that making homes warmer can lead to improvements in health. Improved energy efficiency can reduce fuel bills, freeing up extra money to spend on essential items such as food. High rents also take money away from households. Rent regulation could also improve the wellbeing of vulnerable households by again increasing the amount of money available to spend on other items such as food and clothing.

Restoring rent controls would be an efficient way of reducing the housing benefit bill, whilst protecting tenants. Other policies, such as the welfare cap, merely penalise benefit recipients and have no impact on landlord behaviours.

The quality of private rental properties varies widely, but also follows a social gradient with the poorest renters inhabiting the lowest quality properties. Proper local regulation of housing standards would reduce the ill health burden of substandard housing conditions.

The Labour Party has already made a commitment to abolish the Bedroom Tax – these further housing reforms would make a fuller healthy housing policy.

8. Making work pay

Low income is the most important determinant of poor health. One of the great achievements of the last Labour Government was the introduction of the minimum wage. Despite cries from the opposition, there have been no detrimental economic effects, and for a significant minority of the workforce, it represented a large increase in pay. However, it is well known that the minimum wage is not yet a living wage and that in work poverty is still significant: 46 per cent of adults in working families in poverty are in families where at least one earner is paid below the living wage. There is little scope for these adults to work more hours to escape poverty; they will need higher pay. A Labour Government should pass legislation that sees the minimum wage become a living wage.

9. Minimum Income for Health Living (MIHL)

The Marmot Review proposed a minimum income for healthy living so that everyone – whether they are in work or on welfare – would receive enough money/vouchers/support to ensure a healthy lifestyle. This was the only recommendation of the Marmot Review that the Coalition government did not endorse. Research has shown that the value of out-of-work benefits paid to the unemployed can be important factors in whether unemployment leads to an increased risk of ill health. This means that there is a need to improve the value and accessibility of benefits from a health perspective. This has led to calls for a minimum income for healthy living (MIHL) which will ensure that there is a right to a certain standard of living for those on benefits. A Labour Government should examine how to implement the MIHL.

10. Decreasing debt

Although unable to access mainstream credit, many people on low incomes require credit to ‘get by’ and therefore turn to alternative lenders, generally high-cost credit sources (e.g. doorstep lenders, pawnbrokers, and payday loans). In low income households, credit is used to get by as welfare benefits and/or wages are not sufficient.

Debt has also been linked to suicide, poorer self-rated physical health, long term illness or disability, back pain, obesity and health related quality of life.

Credit unions offer low-rate, small loans, and can have a positive influence on the financial capability and wellbeing of their members. To decrease the health problems associated with debt, the Labour Party should look to supporting Credit Unions as well as capping the loan rates of commercial providers.

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