The Bermuda Triangle of Society

2020health launched their latest report this morning Health, disease and unemployment: The Bermuda Triangle of Society with a salient reminder that sick people require quick and appropriate health-care in order to keep them in or get them back to work. It’s a two-way street: you need to be healthy to be in work – but work usually has a positive impact on people’s health as well. People with chronic conditions who have not had the necessary support then get caught in a downward spiral of unemployment, deteriorating confidence and poorer health. At our round table round-table debate we discussed the vitally important mindset change that needs to take place amongst the NHS workforce: getting people back to work as quickly as possible should be a measurable clinical outcome of successful treatment.

Dame Carol Black has been the pioneer in this field and continues to lead the joint working between the DWP and DH on Health,Work and Wellbeing.  The ‘Fit note’ that replaced the ‘sick note’ was her idea and it is a really positive way of encouraging GPs to think about what work people can do, rather than just signing them off work. However there remains a gulf between most clinicians at the frontline and any employment services. The high level joint working approach achieved by Dame Carol needs to reach those actually working closely with those who become ill, many of whom are desperate to get back into work.

There is no silver bullet, but the transformation of occupational health, a progressive approach from company’s HR departments, inclusion of occupational training in the post-graduate medical curriculum and ensuring existing Health and Safety rules on stress reduction in the workplace are enforced are all steps in the right direction. Public health needs to reach the workplace if we are going to have the workforce we need and spending on welfare-to-work must be partly funded by the health budget if health professionals are going to take a ‘healthy workforce’ seriously.

On the publication Debbie Scott, Chief Exec of Tomorrow’s People commented, “Tomorrow’s People have seen the transformational effect of a return to work on the lives of people who have been out of employment long term due to ill health.  In our view, the social return on investment of getting people back into the workplace is clear, but we have been frustrated to date by the lack of support for innovations which focus on the work and health arena.  The message of this report is loud and clear that we must make every effort to help people overcome their personal barriers so that they can turn their lives around through work”.

About Julia Manning

Julia studied visual science at City University and became a member of the College of Optometrists in 1991. Her career has included being visiting lecturer in clinical practice at City University, visiting clinician at the Royal Free Hospital, being a founder member of the British Association of Behavioural Optometrists and working with Primary Care Trusts in south east London. She was a Director of the UK Institute of Optometry for 6 years, took post-graduate studies in diabetes and founded Julia Manning Eyecare, a specialist optometry practice for people with mental and physical disabilities which was bought by HealthcallOptical Ltd in August 2009. Julia is a founder and Chief Executive of 2020health.org which she launched at the end of 2006 as the first web based, clinician-led, independent Think Tank for Health and Technology. It uniquely focuses on bottom-up policy development by front line professionals focusing on the themes of technology and management. Publications include Not Immune: vaccination policy in the 21st century; Practice-based commissioning: not what it says on the tin; Responsibility in healthcare: changing the culture; NHS IT: A plan of action for a new government; Implementing value-based pricing in the UK; Cutting the costs without cutting the services and Health, disease and unemployment: The Bermuda Triangle of Society. She has blogged on many health and technology issues and wrote on the history of her profession in ‘60 years of the NHS’ (St. James’s House, 2008).
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