• Peter Bateman
    270
    In the July/Aug edition of Safeguard magazine we pose three questions based on stories in the magazine. One of them is this:

    Dr Alexandra Muthu proposes the eventual creation of a national occupational health service to which unwell workers could be referred by their employer or GP.
    Would this be an improvement on the current situation? Why, or why not?


    Feel free to respond here on the Forum, or privately here via a Survey Monkey form.

    An edited selection of responses will be published in the Sept/Oct edition, but with no names attached. One randomly selected person will receive a prize, namely a copy of the book Understanding Mental Models, by HOP expert Rob Fisher.
  • Andrew
    395
    I'd fully support one. Provided they aren't patient advocates. I'm so tired of GP's just signing people off work for 5 days without any enquiry on light duties.

    And it takes an age to get someone assessed for medical incapacity - we need a much faster and objective service.
  • Rowly Brown
    59
    In my opinion, no we don't need another agency/service. We already have one and it's called WorkSafeNZ. What is not clear now is what happened to all the occupational health nurses that transferred across from Health to Dept of Labour in 1990. I suspect most have retired and those that haven't are working in a private capacity. The fact that WorkSafe is underperforming on so many fronts has gone from disappointing to unacceptable. Establishing another service for occupational health separate from WorkSafe is simply unnecessary duplication of resources. There are 600 odd employees in WorkSafe in addition to the Inspectorate. H & S professionals I speak to know of the job titles of several of these public servants but none have a clear idea of what those people actually do. We have had a Notifiable Occupational Disease (NOD's) structure in place for decades. This was a system to facilitate the notification of occupation-related disease and health effects by GPs to the Health Ministry for follow-up by occupational health nurses and medical officers of health. That responsibility passed to OSH with the transfer of OHN's to DoL and the appointment of OSH Departmental Medical Practitioners. OSH OHN's began following up the few notifications received, and DMP's advised and assisted with investigations. Occupational hygienists and health scientists transferred from the Health Ministry HO to DoL HO at the same time. The system was fraught because OHN's were not empowered with rights of entry to premises available to H&S inspectors. They were obliged to accompany an inspector in order to investigate the personal health issues. The hygienists / scientists were dispersed from Wellington to OSH regional offices by the mid-1990s which severely limited their availability to the wider OHN cohort and H & S inspectors. This was an unbelievably poorly arranged and managed system with all manner of professionalism related issues.
    I have worked with several occupational medicine specialists / health practitioners and occupational hygienists over many years. In 2013 I presented a paper titled 'Where is the Health in "Health and Safety"?' to the ANZSOM Conference in Wellington. I exhorted OCC Health Specialists to engage with their GP counterparts at both individual practitioner and National Association levels to re-energise the level of collegial support for occupational disease reporting and investigation.

    I sincerely believe these operational models for addressing the country's occupational health / disease burden should have worked, and still could. I believe, from my experience, the problem has been the fragmentation of resources, largely brought about by uninformed public service ideologues restructuring government departments (DoL, Health, Commerce) to operate on a business model rather than a service model which has resulted in the loss of institutional knowledge and intellectual capital critical to the delivery of services for the public good.

    Rather than create another service that risks the same fate and becomes a top-heavy bureaucracy we should take the existing agency that is WorkSafe and get it performing. The first place to start is with the WorkSafe Board. The second point of focus is to establish a Health and Safety Executive (ala UK) that is staffed by career H&S Specialists, sets macro policy, overseas and funds research, and provides oversight and direction to the Operational Division which is WorkSafe. This will require removal of H&S functions / input from MBIE. Then occupational health might get the attention it requires.
  • Andrew
    395
    Food for thought.

    I've got similar views on ACC who I would have to say seem to have gone down hill hugely over the past few years. I've tried to engage a few times with early return to work / light duty programme and got essentially zero response. There seems to be a total disconnect between what I expect public servants to do with what I get back in exchange. I now have no idea what they do - except suck up our levies and premiums.

    I don't think I am being too harsh - I was singing Immigrations praises only a week or so ago - but was very disappointed to read they are now essentially a rubber stamp organization bereft of any due diligence abilities.
  • Peter Bateman
    270
    To help inform the original question, attached FYI is Dr Alexandra Muthu's piece in the magazine.
    Attachment
    SG200 Muthu (45K)
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