Occupational health reforms need proper regulatory oversight, warns BOHS

Government plans to expand access to occupational health will need to be backed by rigorous regulatory oversight and a legal framework to ensure they don’t lead to unscrupulous cowboys entering the market, the British Occupational Hygiene Society (BOHS) has warned.

BOHS has said it has “serious concerns” about the implications of the government’s proposals for occupational health, as laid out in its recent ‘Working Better’ consultation.

These include the development of a national “health at work” standard for all employers to provide a baseline for quality occupational health provision plus tax breaks to encourage more investment in the sector.

The government ran two consultations over the autumn on its proposals, and it is anticipated the next steps could be outlined by chancellor Jeremy Hunt in his Autumn Statement on 22 November.

However, BOHS has expressed concern in particular about the plan to provide tax breaks, with the government looking at the possibility of expanding the Benefit in Kind exemption for medical benefits to encourage greater employer provision of occupational health services.

While BOHS has conceded this sort of reform is likely to be popular, it has warned it will need to be accompanied by proper regulatory oversight, in particular safeguards to prevent potential fraud or employees being exploited.

“Unsurprisingly, the private health companies through whom occupational health has been provided, are very positive about proposals for a tax giveaway,” said BOHS chief executive Professor Kevin Bampton.

“However, BOHS is concerned that the scheme aims at giving money to provide the sort of services that are supposed to be provided by the NHS free through employer schemes, with potential direct impact on employee taxation and pay packets.

“There are many fantastic OH providers, but there are an increasing number who never ever step into the workplace and just take the money. There is no explicit legal duty to use qualified health professionals underpinning this proposal,” he added.

Key concerns raised by BOHS include:

1.  A lack of regulatory compliance. The schemes, as laid out, extend primary care into the workplace, provided by private health providers, without sufficient safeguarding, regulatory compliance and regulatory oversight. “This poses a serious risk of potential fraud and misuse of public funds by unscrupulous businesses. The plans do not outline adequate controls to prevent this,” BOHS said.
2. The National Health at Work standard. BOHS has questioned the necessity of a national standard, suggesting it may lead workers to believe they are receiving care from professionals when there is no legal requirement for OH provision to be delivered by regulated, qualified professionals to the same standards as the NHS. “BOHS feels that the emphasis should not be on diverting employer and taxpayer resources into providing private healthcare at work, but on preventing ill health in the first place,” it said.

Instead, BOHS has recommended that the UK should sign the International Labour Organization Convention 155 to meet the minimum international health and safety standards. The government should also update the Health and Safety at Work Act to improve the disclosure of workplace health risks.

It should implement a legal duty to use registered, qualified professionals for health and wellbeing advice. It should also establish a connection between occupational illness information and individuals’ NHS records, it suggested.

Finally, the government should enhance medical and health education by making occupational health protection a core part of training for doctors, nurses, and other health professionals, BOHS recommended.

BOHS intends to release a full review of the opportunities for the UK to protect workers from preventable workplace ill health next month. This will be “shedding light on critical issues that impact the health of employees across the nation”, it added.