Good Work: keeping health in the picture

The health of the working age population and its relationship to good work is a core interest of ours here at the Work Foundation. Health and work are inextricably linked, and we are pleased to see this recognised in the Taylor Review’s “seven steps”:

“The shape and content of work and individual health and well-being are strongly related. For the benefit for firms, workers and the public interest we need to develop a more proactive approach to workplace health.”

It is fantastic to see such an overt commitment to workforce health and wellbeing in this paper; too often discussions around business and economic growth fail to recognise its importance. Indeed, though it should go without saying, in order to improve productivity you need a healthy, engaged workforce, we still need to keep saying it.

Sign posts showing work, career, health and family

The relationship between work and health is complex and multi-faceted. For example, when we think about the vital area of workforce skills – another major area of our work (see our recent report on skills in the film industry) – we also need to recognise that, in order for our workforce to gain and apply those skills, they need to be healthy enough to do so. Those with health issues face barriers everywhere – not only to jobs, but also to access to education and training. These barriers can be where you least expect them. How many of us have thought about how having a disability affects the likelihood of a young person getting to do work experience? How willing and able are schools and employers to make adjustments to accommodate a two week visit? This is just one of the many small ways that disabled people can miss out on the opportunities that many of us take for granted.

We also need to think about the many workers that acquire disabilities or become ill while in work, and how we are supporting them to not only remain in work – to maintain their skills in the labour market – but also to progress and build on their skills. Though improving the opportunities for better quality work is an imperative across the agenda, there may need to be an application of ‘proportionate universalism’ to ensure that those who most need attention are getting it; this should be targeted in policy evaluation. This is a cohort that is likely to grow; the workforce, and the population are ageing, and chronic diseases – including those related to mental health – are increasingly common. Indeed, more and more people will be working with multiple long-term conditions, tied in with a range of social barriers.

Clarifying employment status allows people with disabilities to know where they stand, and what their options are – and in formally recognising where these lead to gaps in support we can take action to address them. In our paper on small business, we recognised the specific concerns around dependent contractors, in terms of health and wellbeing. Despite being largely, if not solely, dependent on a single contracting body, their limited access to sick pay and support through services such as Fit for Work, and access to even basic health and wellbeing advice through occupational health, puts those working in this way at a disadvantage compared to traditional employees in large organisations; who may have access to all of these services and more. This may be as true for Uber drivers as it is for people working on building sites. The imbalance needs to be addressed if we are to continue to build a healthy, able workforce. The many complex, and often ignored, issues around self-employment, worker rights and health will be further explored in our forthcoming series of papers from our Health at Work Policy Unit.

Health is just one part of this, and we need to make sure that all people, whatever their barriers to working – be they related to disability and health, caring responsibilities, being ex-offenders, English language skills – are also able to access and reap the benefits of ‘good work’. This will require flexibility, as may be offered by some of the new models of work we are seeing – but with appropriate support to make it sustainable. It will require targeted upskilling and investment to fill in what employers see as ‘gaps’. Increasing local devolution is presenting us with new potential for building healthy working economies – allowing economic growth and health, social care and community partners to work together to achieve outcomes that are relevant for them. We fully support the Taylor Review’s call for a cross-government approach (including BEIS) to supporting and incentivising local action on working-age and workforce health.

As happy as we are to see health and work recognised in economic discussion, this is not just an economic issue; being in work, and the quality of that work, predicts health. It is vital for the health of the UK population that we improve the quality of work, and access to it, as part of sustainably improving health, and reducing demands on our NHS. We have strong longitudinal evidence that work which is continuously stressful, presents unreasonable demands and doesn’t reward efforts poses considerable health risks – particularly for cardiovascular and mental health. While we have made considerable progress addressing the more obvious causes of poor health at work, e.g. accidents, we have still not sufficiently addressed the psychosocial and less visible risks that work presents.

Health and work is a large agenda all on its own, and we applaud the efforts of the Taylor review team to incorporate and understand this agenda. It does not give us all the answers, but it provides us with solid ground from which we can leap into these issues – making a strong case to business and to government about the importance of seeing health and wellbeing in the picture. We hope that the response to the Green paper on Work, Health and Disability (in whatever form that takes) will continue this story, and help us on the journey for a more inclusive dialogue about economic growth, and the way we work.