Government’s Response to Carol Black Review

On 17 March 2008, Dame Carol Black, the National Director for Health and Work, published her review “Working for a Healthier Tomorrow – an analysis of the UK’s working age population”. The review called for urgent and comprehensive reform of the work and benefits system in the UK, and declared that ill health costs the economy £100bn a year in benefits and lost productivity – equivalent to the annual running costs of the NHS.

The Government responded to the Review by publishing “Improving Health and Work: Changing Lives”, on 25 November 2008. The response welcomes both the conclusions drawn in Dame Carol’s Review and the recommendations made. According to Health, Work, Wellbeing – a cross-departmental partnership between the DWP, the Department of Health, the HSE, the Scottish Executive and the Welsh Assembly – the publication of the Government’s Response “marks another milestone in the journey towards our vision of creating a society where the positive links between work and health are recognised by all, where everyone can aspire to a healthy and fulfilling working life, and where health conditions and disabilities are not a bar to enjoying the benefits of work”.

The response is centred around three key aspirations which the Government hopes will enable the delivery of its broader vision, namely:

• creating new perspectives on health and work;
• improving work and workplaces; and
• supporting people to work.

With regard to perspectives on health and work, evidence has shown that in general, work is good for health, and that not working leads to poorer health. Despite this, (as Dame Carol points out in her Review) “the belief that we should always refrain from work when we have a health condition persists”. The Government hopes to reverse this mentality by introducing some key initiatives, including the proposed ‘fit note’. A new electronic ‘fit note’ is to replace the current medical certificate, or ‘sick-note’, and GPs will be required to switch the focus of their advice to what people can do rather than what they cannot. In order to “improve GPs’ knowledge, skills and confidence” when dealing with health and work issues, a National Education Programme is to be introduced.

Dame Carol also set out a number of recommendations to support employers in creating accommodating workplaces, and the Government plans to address those recommendations primarily through the “Business HealthCheck tool”. This tool should enable businesses to estimate the costs of worker ill-health to their organisation and identify the savings that could be made by investing in various health and wellbeing programmes.

It is intended that employment and occupational health services will be brought together through the “National Strategy for Mental Health and Employment”, and that an occupational health helpline will be made available for smaller businesses. Finally, a range of early intervention services, including the ‘Fit for Work’ service pilots, will be piloted in 2009 and run until at least 2011. The impact of the changes and initiatives will be measured by tracking changes across a range of indicators, which are set out in the Government’s response.

To view both Working for a Healthier Tomorrow and Improving Health and Work: Changing Livesclick here please