July 2006 – Measuring health

To what extent should companies take responsibility for the health of the people they employ? I ask the question for two reasons. The first is that a survey of family doctors last week pointed to a big rise in the number of people obtaining sick notes as a result of work related illness.

The second is that during a discussion on human capital measurement within a sub-committee of the Human Capital Standards Group hosted by Investors in People last week there was some debate about the usefulness of recording days of absence.

My own view is that counting absence days alone can neither diagnose nor prevent the root causes of absence. It only gives some measure of the size of the problem.

The family doctors questioned in a survey by Norwich Union Healthcare were overwhelmingly critical of employers. Nine out of ten said employers were failing to take responsibility for the health and well being of the employees.

Accepting the self-serving nature of such research - I wonder if the company would have rushed to publish findings that revealed the opposite – it does highlight a significant area of workplace neglect. A third of the doctors said they had noticed a big increase in the number of people needing to be signed off work for more than seven days.

Significantly, perhaps, not much more than a third of HR directors questioned in the research regarded it as a priority, and 40 per cent of the companies surveyed admitted they had no system of health management. A big majority of companies said they did not regard the health of their employees as their responsibility.

Yet typical health issues facing employees, according to the study, are stress, back problems and depression, all of which can be caused or exacerbated by conditions in the workplace.

“These figures show that the system is failing workers. Greater co-operation is needed between GPs and employers to find a solution to rising illness caused at work,” said Tim Baker, director at Norwich Union Healthcare.

He may have a point but it doesn’t take summit meetings between mangers and doctors to make a difference. The first thing to do in designing any workplace health programme is ask employees what they think. How are they? What are their health issues? In taking such steps it must be recognised that health is not an occupational or a personal issue. It is both. It runs between work and home.

As an employee I never took my health too seriously and certainly no manager ever attempted to persuade me to do so. I worked for a good company that provided subsidised gym membership, had an in-house doctor and encouraged staff to be equipped with all the inoculations necessary when spending time abroad.

When taken ill, particularly during any protracted or serious illness, the company would generally display admirable levels of concern. But sometimes – and I know this from experience – company expectations were instrumental in causing an illness. I don’t blame anyone for this. Some jobs, by their nature, are demanding.

As a freelancer, however, I can no longer afford to neglect my health. The consequences of taking unscheduled time off are clear cut – I lose business and income. There is no safety net.

This means that today I look after my health, my diet and my fitness. I make time - that never seemed to be available when in full-time work - for going to a gym. When working for yourself such issues are sharply defined. But people at work are protected by social safety nets established to ensure the continued welfare of a permanent workforce. Unfortunately these safety nets can breed complacency.

Another problem is the nature of occupational health practices that tend to have been shaped by health and safety laws. A typical workplace health and safety handbook will be packed with advice on risk assessment but most of this is focused on physical hazards and employer liability.

One such book open on my desk devotes no more than three pages to stress. As might be expected most of the advice is linked to case law, specifically the case of Sutherland v Hatton four years ago that led to comprehensive guidance from the Court of Appeal on the extent to which employers should have knowledge of an employee’s vulnerability to pressure.

In what appeared to be a coverall provision, the guidelines stated that an employer who offers a confidential counselling service is likely to have a complete defence to a stress related claim by a worker.

If such a counselling servicing has appeared in your workplace during the last four years, now you know why. It has little to do with employers suddenly getting in touch with their paternal tendencies and everything to do with liability protection against stress-related claims for damages.

Again, however, these services are about remedies. They do not involve an employer making that first enlightened step of accepting that its work regimes, management expectations, staffing provision and constant attention to the bottom line may have created a working environment in which people are struggling to cope.

When that happens, a management can build in to any proposals for workplace change, a simple health survey designed to highlight areas of concerns. Asking a few questions of employees might highlight all kinds of hidden concerns, some of which, such as the installation of air conditioning in a stuffy office, might make a big difference at little cost.

But companies should not wait until people complain. That only highlights the grumblers and fails to include the silent majority who might reveal more relevant issues. The idea is to gather knowledge of your employees. How much sleep are they getting on average, how many times do they visit their doctors, have they had any illnesses in the past year and, if so, what? Do they feel overweight? Do they have
access to healthy food in the office?

Only when equipped with a body of information is it sensible to tailor health and fitness advice and other interventions for employees relevant to their circumstances. Going so far as to show that a company cares can be enough to create measurable benefits in absence reductions. This was the lesson learned at BT when it launched a health and fitness programme for employees last autumn.

So measuring absence has its uses, but not in isolation. I sometimes wonder whether managers want to face the consequences of their actions if poor deployment of work has increased stress among their teams. Sampling employee opinions can highlight such issues, raising concerns before they get out of control. The most useful measures are those that stimulate change for the better, not those that lead to stop gap remedies. If all they reveal is a poorly conceived strategy, the answer is to change it.