How do we solve our work and health challenges?
About 4 mins
Sacha Romanovitch, Chair of the Commission for Healthier Working Lives, on why we need to reframe how we think about work and health.
8.2 million working-age people report work-limiting health conditions – and that number has been rising. This was already happening pre-pandemic but has been thrown into a sharper focus in recent years.
We also know that 3.9 million of those people are currently in work. When the Commission for Healthier Working Lives started, it became increasingly clear there wasn’t enough focus on how to stop people falling out of work in the first place. We asked ourselves, if you’ve got 3.9 million people in work with work-limiting health conditions, and 300,000 falling out of work each year and reporting such conditions, what is happening in the system overall?
Of course, let’s be absolutely clear, some people will have a condition that means work just isn’t possible. We’re not saying work is going to be possible for everybody regardless of their conditions. However, many people are more than able to – and want to – work. And yet the system, the approach being taken at the moment, fails them because support and intervention come too late.
The importance of people’s experiences
Our work centred the voices of people living and working with poor health. These were often people who had received a life-changing diagnosis – and at the very time when they were trying to work out what that meant for them, were told by their employer they were ‘unproductive’. For many, their mental health started to suffer because their identity, in all aspects of their life, was suddenly under threat. Then, instead of being supported with adaptations to help them stay in work, they were taken out of their working life and put into a position of financial insecurity. Is it any surprise people in that situation find not only their physical health but their mental health suffering? Each year, only 3% of people with a work-limiting health condition return to employment after being out of work for 12 months or more. That is unacceptable.
Encouragingly, through our research, we found example after example of people and organisations trying to do things better. I hope our recommendations, and examples of good practice, invite people to think differently about health and work. After all, health isn’t binary. It’s easy to think in terms of people being ‘ill’ and ‘not ill’. But, actually, most of us experience feeling great some days and not up to doing as much on others. We need flexibility and to address the barriers to work, enabling people to have independence – and for that to make a difference to our economy overall.
There are people whose lives are desperately impacted by us not taking action right at the start, when people start to experience health challenges. The Commission thinks there is an opportunity for a fresh approach: to start with prevention through best practice. There are some brilliant employers – but there are also opportunities to do so much more. We heard a lot from employers that they want to do the right thing but don’t know exactly what support is appropriate for people. So, imagine if we could have a system that directs managers to the right support, at the right time, to guide people through barriers that could be overcome with appropriate adjustments.
We also need to think about the wider benefits system. We recognise it can be really hard for people trying to get back into work, with the financial jeopardy that they might be left in a situation where they cannot pay their bills.
These are the opportunities we want to explore.
Reframing the way we think about people and health
Einstein said you don’t solve problems with the same thinking that created them. Our report tries to draw out that the framing of how we think about work and health challenges is critical to forming a different approach. This starts with how we think about people as human beings, and how we think about health.
The way we talk about work and health, for example, can assume the very worst of people. We need to reframe this and say: people want to work, employers want to do the right things and governments don’t want to make things worse for people. If you start from that perspective, you can consider how to change the system of support to enable people.
We’re in an incredible world of possibility. Expert Inma Martinez talks about a privileged age where AI could enable us to rethink work so that human beings do the work they are meant to – and computers and AI can take on the labour of the repetitive actions that can actually damage us mentally and physically.
We saw some of that come through in our report, with how rostering and scheduling in health services, a high risk area, can fundamentally shift the stresses and strains put on people so that work doesn’t cause ill health. We also heard how flexibility can be brought through in pretty much any working role. But we also heard about some of the challenges in certain sectors, for example transport and logistics. We know it’s better if drivers can do shorter shifts with definite hours, but that needs to shift at a whole-industry level if we’re going to deliver those changes for people. That’s why our focused sector panels are going to be really important – some things that can’t be done at a company level are absolutely possible if you look at them from an industry level.
Finally, if we accept that health isn’t binary, we need to recognise that people will have different needs in the workplace and different barriers to overcome. If you centre your work on the experiences of people living day to day with conditions and simply ask them – and professionals – what’s needed, you can then understand what adaptations will support people. Some of those adaptations are very simple, but we need to take the time to ask.
It’s time for us to reframe how we think about work and about health. It’s time for us to adopt a new system. And the only way that we will do that is by employers, government and individuals being able to work together to make sure Britain really is working for everybody.
This blog is based on a speech given by Sacha Romanovitch at the report’s launch event.