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A review commissioned by our Prime Minister revealed 300,000 workers lose their jobs annually due to mental health.
But why are so many losing their jobs and what would be the effect of ridding the workplace of the mental health taboo?
Could it be an employer’s increased use of Occupational Health Services ?
70 years ago Clement Atlee set up a committee which concluded the Ministry of Health as a public independent body should be the provider for British Occupational Health Services.
But this was ignored, and today Occupation Health is a multi million pound private industry.
With the Department of Work and Pensions alone spending over £3,147 m on it annually.
The Committee’s wish was for the services to be completely independent of employers.
But they are still today paid for and commissioned by an employer, and such services owe their paramount duty to that employer, and this is confirmed in the Occupational Health Professionals’ Codes of Conduct.
Yet, there is clearly a conflict of interests between an employer’s interest to make profit and the health of his employees.
And such an employer’s control over Occupational Health destroys a patient employee’s right to medical confidentiality with the service.
But despite this, Dame Carol’s Black’s 2008 Review of the Health of Britain’s working population, put Occupational Health provision at the centre of the then Brown government announcing a
”new vision for the health of the working age population”,
” in which the relationship between health and work becomes universally recognised as integral to the prosperity and well-being of individuals, their families, workplaces and wider communities”.
But this review appeared to radically change the very nature of the occupational health service, from that of ensuring an employee’s duties did not adversely affect his health, to ensuring that his health did not adversely affect his duties.
And health concern, particularly mental due to its vagueness can be a useful, paternalistic tool of control of an employee.
As it allows management to silence whistle blowers, ensure collaboration, avoid constructive dismissal , and stress, discrimination and harassment( including sexual harassment )claims.
Line managers are encouraged to refer employees to occupational health, as soon as they have any concerns about their physical or mental ill health.
If an employee refuses a referral, he may be suspended in his own and the employer’s interests, and even disciplined for insubordination.
So effectively an employee can’t refuse an assessment.
Yet that assessment is paid for and remitted by his employer and therefore for his purposes, primarily at best to ensure health concerns are not and/ or will not interfere with an employee’s work duties.
But it can be used as a tool to control employment and to discover an employee’s health history and present issues, despite doctor patient confidentiality.
And worse still, an employer can refuse to allow an employee to see the whole ,or any part of an Occupational Health Assessment.
As whilst s. 2 (1) of the Access to Medical Reports Act 1988, gives an individual a right of access to any report relating to his physical or mental health, prepared by a medical practitioner, who is, or has been, responsible for his clinical care.
‘Clinical care’ is being, interpreted narrowly, so as not to include occupational health care, resulting in an employee having no right to access their occupational health assessment.
Further, section 7 (1) of part 3 of the Education (Teachers’ Qualifications and Health Standards) (England) Regulations 1999 provides that,
‘ A person in relevant employment shall not continue in that employment if, he does not have the health and mental and physical capacity for that employment.
Section (2) (b) providing that when deciding this capacity, employers can consider information,
‘such has been furnished in confidence on the ground that it would not be in the best interests of the person concerned to see it’.
So any information, occupational health, line manager ,another employee or indeed any information on an employee’s health ‘furnished in confidence’ can be withheld from an employee in his best interests.
This is a beyond terrifying extension of employer paternalism which managers but few employees will be aware of.
This Regulation refers specifically to teachers including academics but similar regulations and/or contractual terms probably apply to most occupations.
Rights of access to assessments can be similarly refused under
The Data Protection Act 1998 Sch 8 part 3 para 3 (a),
‘where permitting access to the data subject would be likely to cause serious harm to the physical or mental health or condition of the data subject’ .
So employees can be assessed ,as unfit for their present duties, without ever knowing why, or being allowed sight of assessments, despite the devastating consequences on their present and future employability.
In addition, the excuse of confidentiality can be used by management in respect to other employees, making it impossible to ascertain targeting, and the fairness of the process.
And ‘fit notes’ give occupation health and line managers control over an employee’s ability to return to his former duties.
As rather than just certifying an employee is fit to return to work GPs are now required to certify, that he may be fit for work if certain stated concerns are addressed by his employer.
This change forces an employee’s GP to be part of the Occupational Health system, as this is the body responsible for recommending work related changes .
Thus imperceptibility eroding doctor patient confidentiality, and a GP’s ethical need to act in his patient’s best interests.
‘Fit notes’ replaced the old written GP sick notes in 2009 and are computerised statements so easily subsumed into an employee’s National Summary Care database, which embrace an individual’s complete health profile.
Despite opposition, the Coalition government rolled out this Data Base nationally, but surveys show most public do not even know of its existence, let alone its purpose .
And it has been rolled out to more agencies and professional services with pharmacies now gaining access .
Technically an employee’s express consent is required to access his medical records, including his summary care database record.
But consent may be expressly and/or impliedly provided for in a contract of employment, and a dismissal for unreasonably refusing consent can be fair Caplin v Howard Kennedy Solicitors AT 20/1/09.
It is likely, occupational health providers are able to access to the summary care record database.
As an independent academic study of the summary care system back in 2009, revealed that there was widespread confusion about the method of obtaining consent, and to whom such consent is extended, at present it extends vaguely to all specialists, who are providing care or treatment, which could extend to Occupational Health Care.
Documents obtained under the Freedom of Information Act, provide evidence that NHS Connecting for Health , ( now NHS Digital managers of the system), changed a written assurance to patients that non clinical staff,” will not” have access to ”may not”, allowing non- clinical staff to gain access to the summary care record database.
An individual has a right to be ill, and a right to private consultation with his own chosen independent medical practitioner.
And a Human Right to Privacy.
Whilst an employer has a duty to ensure that an individual’s work does not adversely affect his health, which was why the Occupational Health Service was created, this should not be subverted and then used against an employee.
Many people’s livelihood can be destroyed by the present use of Occupational Health as it can be made a tool of management to control workers present and future employability.