The plump, apple-cheeked bathroom attendant hovering in the ladies’ powder room on the first floor of Sydney’s plush Sofitel Wentworth Hotel on May 18, 2010 looked to be in formidably good health.  But for anyone seeking, on that dismal Tuesday afternoon, advice about how to stay at work or return to work when injured or sick—or even, a little later in the day, anyone wanting to petition our tanned and relaxed looking Treasurer Wayne Swan for a job—the Sofitel Wentworth was the place to be.  

Outside, a gauzy rain was falling on traffic making its fitful way along the Phillip St dogleg in Sydney’s financial district. Inside, the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) was launching its position statement, Realising the Health Benefits of Work, to a small but appreciative audience comprising a Welsh luminary, business and union representatives, workers' comp authority heads, rehab professionals, occupational and environmental physicians, GPs, workers’ comp consultants and insurers.

As we’ve reported previously, AFOEM’s position statement attempts to initiate a paradigm shift in how government, business, workers and the general public think about the relationship between health and work. “The evidence,” AFOEM says, “is compelling: for most individuals, working improves general health and wellbeing and reduces psychological distress.”    

Despite the public policy implications of the position statement, there were no politicians at the launch. (Wayne Swan didn’t sweep through the chandelier-lit foyer until late in the afternoon.) Those who did attend, however, were in agreement: government needs to get on board with Realising the Health Benefits of Work.

The position statement has received substantial support from Comcare, WorkCover NSW and WorkCover SA, who all sponsored the launch. Representatives from each of these authorities--including Comcare CEO Paul O'Conner and WorkCover SA CEO Julia Davison--were in attendance. Federal policy makers, however, have been more reticent.

Getting politicians and policy makers onside, keynote speaker Professor Sir Mansel Aylward (the aforementioned Welsh luminary) told the audience, is a vital step in transforming public attitudes to the relationship between health and work—and he should know. Sir Mansel is Director of the Centre for Psychosocial and Disability Research at Cardiff University, Chair of Public Health Wales, and an international advocate of the health benefits of work. He has been lobbying the UK government for reform since the early 1990s, and says that eventually, Ministers responded to startling messages about the health consequences of unemployment.

“Long-term worklessness,” Sir Mansel said, “is one of the greatest known risks to public health. Worklessness:

• Has a health risk equivalent to smoking 10 packs of cigarettes per day;
• Increases the suicide rate in young men more than forty times;
• Increases the general suicide rate six times;
• Has a health risk and life expectancy reduction greater than many “killer diseases”; and
• Is riskier than the most dangerous jobs (for example, construction, or working on the North Sea).”

This information has since been supplemented by research that demonstrates the health benefits of work, and together these two principles have provided a solid evidence-base for the UK’s ongoing reforms around health and work.

In addition to changing how work disability is assessed, and implementing a raft of other work / health initiatives, the UK government has also considered the financial incentives / disincentives that influence decisions about work. Now in the UK people who leave benefits and commence or recommence work are paid a weekly allowance (between 25 and 100 pounds) for the first year of their employment. This measure has been very successful in reducing long term welfare reliance—and, according to Sir Mansel, people don’t tend to return to benefits once their extra payment ceases.

Sir Mansel was a member of the working group that produced Realising the Health Benefits of Work, and his enthusiasm for reform—fired by his observations of the effects of mass unemployment and social dislocation on what were once cohesive mining communities in South Wales—informed the development of the position statement. And the atmosphere at the launch proved that this enthusiasm is contagious.

In the panel discussion that followed Sir Mansel’s presentation, Dr Robin Chase, President of AFOEM, proposed that a cost benefit analysis of employer investment in health and wellbeing is urgently needed in Australasia, to assist businesses in making informed decisions about the implementation of health and wellbeing programs. (Overseas evidence shows that such programs intensify the health benefits of work, and reduce employer costs in the long run.)

Unions were onside. “We should be asking Wayne Swan for the money to get this analysis done,” Australian Council of Trade Unions (ACTU) Assistant Secretary Geoff Fary told the room. (Unfortunately, Mr Fary had already left by the time Wayne Swan showed up at the Wentworth Sofitel.)  

Other proposals included the creation of a “faculty” of stakeholders, who commit to advancing the cause of Realising the Health Benefits of Work, and a consideration of how the fragmentary nature of primary healthcare in Australia makes it hard to properly deal with the biopsychosocial issues that influence disability and work.

Not all work is good for all people. However, as UK researchers Waddell and Burton have shown, work is the most effective means to improve the wellbeing of individuals, their families and their communities.

This is a message that politicians need to hear; not just so that they can influence public perceptions of the relationship between work and health, but so that they can assist business, unions, the medical profession and other stakeholders to intensify the health benefits of work.

Which is why, noticing Wayne Swan and his entourage entering the Sofitel lobby on her way back out into the rain, Dr Mary Wyatt pounced. She gave Mr Swan a copy of Realising the Health Benefits of Work and told him that it would save Australia money by improving health and employment outcomes. Dr Wyatt has since written to Mr Swan, asking him to champion the cause. Time will tell whether Australian politicians seize the opportunity to realise the same health, wellbeing and economic benefits as their UK counterparts.

The full position statement can be downloaded from the Faculty of Occupational and Environmental Medicine’s website.