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Human Capital Matters 2013/5: Health and wellbeing

Editor’s Note to Readers

Welcome to the fifth edition of Human Capital Matters for 2013—the digest for leaders and practitioners with an interest in human capital and organisational capability. This edition focuses on Health and Wellbeing.

Health and Wellbeing is a very broad area. In the workplace it is associated with Work Health and Safety (WHS), increasing productivity and reducing the costs associated with workers compensation and sick leave. Some effort is focused on prevention of illness and injury while other effort is directed towards rehabilitation.  In Australia there has been recent effort directed towards compensation schemes with a view to promoting early intervention and rehabilitation for the benefit of injured workers and their employers.

This edition commences with the review and modernisation of the Federal Workers’ Compensation Scheme undertaken by Mr Peter Hanks QC including Dr Allan Hawke’s report of Comcare Scheme’s performance, governance and financial framework.

The next publication featured in this edition is a study by Safe Work Australia The effectiveness of work health and safety interventions by regulators: a literature review. This examines the effectiveness of interventions by regulators, including international experience, noting that there is almost no published information available on the effectiveness of work health and safety regulatory intervention in Australia.

The International Labour Organisation (ILO) and the World Health Organisation (WHO) have sponsored international development in the area of OH&S. TheAsian-Pacific Newsletter on Occupational Health and Safetywas established in 1994, as a part of the ILO/FINNIDA Asian-Pacific Regional Programme on Occupational Safety and Health. It showcases recent developments in Asian and Pacific countries. This edition of Human Capital Matters highlights one of its articles on Healthy Workplace Initiatives in Brunei Darussalam.

There is a confluence between traditional areas of Occupational Health and Safety and more contemporary issues of sustainable employment. Sustainable employability refers to a person’s ability to gain or maintain quality work throughout their working lives, whilst maintaining good health and wellbeing and having the opportunity and the right work context to be able to transfer skills, knowledge and competencies to another job, company or other future roles. This edition features an article by Sabrina Pit in the Conversationalist that highlights a Dutch study that has shown that there are clear benefits to investing in programs that enhance the sustainability of employment.  Organisations found that investing in programs to improve staff’s physical and mental health, for example, reduced sick leave, increased productivity, and secured them a reputation as an employer of choice.

Work-related mental stress is a very costly workplace injury of growing importance across the ambit of prevention and rehabilitation. This edition highlights two reports that focus on this aspect of health and wellbeing: The Australia Workplace Barometer: Report on Psychosocial Safety Climate and Worker Health in Australia prepared for Safe Work Australia by Prof Maureen Dollard et al and Safe Work Australia’s, The Incidence of Accepted Workers' Compensation Claims for Mental Stress in Australia.

About Human Capital Matters

Human Capital Matters seeks to provide APS leaders and practitioners with easy access to the issues of contemporary importance in public and private sector human capital and organisational capability. It has been designed to provide interested readers with a monthly guide to the national and international ideas that are shaping human capital thinking and practice.

Comments and Suggestions Welcome

Thank you to those who took the time to provide feedback on earlier editions of Human Capital Matters. Comments, suggestions or questions regarding this publication are always welcome and should be addressed to: humancapitalmatters [at] apsc.gov.au. Readers can also subscribe to the mailing list through this email address.

Mr Peter Hanks QC, Safety, Rehabilitation and Compensation Act Review, Australian Government 2013, pp. 255

Dr Allan Hawke AC, ‘Safety, Rehabilitation and Compensation Act Review: Report of the Comcare Scheme's performance, governance and financial framework’, Australian Government 2013, pp. 112

The Safety, Rehabilitation and Compensation Act 1988 (SRC Act) provides rehabilitation and compensation support to injured Australian Government and Australian Capital Territory Government employees. It also covers employees of private corporations who self-insure under the Comcare Scheme.

The Hon Bill Shorten MP, Minister for Employment and Workplace Relations’ media statement of 24 July 2012 announced that the Federal Workers’ Compensation Scheme was to be reviewed and modernised. The aim of the review is to modernise the federal workers’ compensation scheme to ensure injured workers are given every opportunity to return to health, independence and work as quickly as possible after a workplace injury.

The report outlines over 100 recommendations to modernise the SRC Act and to increase the focus on early intervention and rehabilitation for the benefit of injured workers and their employers. It incorporates Dr Allan Hawke’s recommendations. The review’s recommendations reflect a number of principles including:

  • work is generally good for health and wellbeing and rehabilitation should be the number one priority of all claims.
  • improving the way in which permanent impairment is assessed will provide national consistency and ensure that injured employees are entitled to receive compensation in recognition of their whole person
  • modernising the provision of incapacity payments will provide for consistently fairer remuneration for injured employees and assist in reducing age barriers to work. Superannuation should only be considered in the context of savings for retirement, and the receipt of workers compensation payments should not affect an employee’s savings for retirement or increase the risk of reliance on social security benefits for compensation recipients in the later stages of life.
  • disputes should be resolved as quickly, economically and fairly as possible. Dispute resolution processes should be flexible and ensure equity for all injured employees. The focus should be on the issues and the outcomes rather than the process.

Dr Allan Hawke’s report contains 33 recommendations and covers issues relating to the Comcare scheme’s performance and ways to improve its operation; and financial and governance framework.

The material contained in this report has been developed by the Safety, Rehabilitation and Compensation Act Review.

Safe work Australia, The effectiveness of work health and safety interventions by regulators: a literature review, Australian Government (Safe Work Australia), Canberra 2013, 81 pp.

The aim of this review is to develop and refine explanatory models for why the set of activities undertaken by regulators leads to changes in safety outcomes. The interventions reviewed include:

  • introducing new regulations—Eleven studies of regulators were evaluated. For larger businesses and those businesses that pay attention to regulations and have a positive perception of the regulator, the introduction of new regulations is more likely to result in improved work health and safety outcomes. This suggests that rather than a one size fits all approach, regulators may want to consider providing different kinds of advice and support.
  • conducting inspections—Fourteen evaluations of inspections were reviewed. The pattern of outcomes in the studies reviewed suggests that inspections can improve health and safety outcomes. There is some evidence that inspections may reduce the severity of injuries rather than the overall injury rate. The initial effect of an inspection may be to draw a managers’ attention to safety overall. Mechanisms leading to changes differ depending on the size of the business. Characteristics of the inspection process including the approach taken and the communication between the inspector and the business can influence the likelihood of increased compliance with safety requirements.
  • prosecutions—Four studies were reviewed on the impact of prosecutions. The studies provide only very limited evidence as to whether prosecutions actually do deter others from offending.
  • guidance materials—Guidance materials are used as a way of raising awareness. There is little evidence of their effectiveness in producing changes in behaviour.
  • industry campaigns—Five studies were reviewed to help understand the effect of industry campaigns on work health and safety outcomes. Campaigns appear to work by providing information to enable improved compliance and increasing the perceived likelihood of enforcement. The evaluations suggest that campaigns that include enforcement and education are more likely to be effective than those using only enforcement or education.
  • enforceable undertakings—Enforceable undertakings (EUs) are negotiated between the business and the regulator as an alternative to undertaking court proceedings. In practice only the Queensland regulator appears to have made substantial use of EUs. There is currently very little evidence available regarding whether EUs are an effective way of changing work health and safety practice.
  • voluntary partnerships and incentive schemes—Voluntary partnerships and incentive schemes contribute an attempt by regulators to produce improvements in safety outcomes outside the standard model of introducing and enforcing regulations. Little is known about the kinds of incentives that would be valued by business in Australia and further investigation is needed.

Safe Work Australia is a national policy setting body whose key role is to improve work health and safety and workers’ compensation arrangements across Australia.

Sabrina Pit, ‘Sustainable employment and the ageing workforce: lessons learned from the Dutch’, ‘The Conversation’, 15 January 2013.

Sustainable employability refers to a person’s ability to gain or maintain quality work throughout their working lives, whilst maintaining good health and wellbeing and having the opportunity and the right work context to be able to transfer skills, knowledge and competencies to another job, company or other future roles. The article argues that government, employers, employees and society have an important role to play in promoting, debating and developing sustainable employability.

In the Netherlands sustainable employability is being embraced by a growing number of organisations and businesses. The Dutch Ministry for Social Affairs and Employment brought together 100 small and large employers from different industries – all early adopters of sustainable employability – and asked them what they do, what works well, and what the return on investment is. The findings, presented to the Dutch Parliament in October 2012 in the report Manifesto of 100 employers and sustainable employability, demonstrate a strong business case for sustainable employability. Some organisations recouped their investment in sustainable employability programs within one or two years. Organisations found that investing in programs to improve staff’s physical and mental health, for example, reduced sick leave, increased productivity, and secured them a reputation as an employer of choice.

Sabrina Pit is a Senior Research Fellow, Work & Healthy Ageing at the University of Sydney.

Norhayati Kassim, Brunei, ‘Healthy workplace initiatives in Brunei Durassalam’‘Asia-Pacific Newsletter on Occupational Health and Safety, Volume 20, Number 1, April 2013, pp. 14-17

Brunei Darussalam is a small country on the island of Borneo in the Western Pacific Region with a population of approximately 400,000. Non-communicable diseases (NCDs) such as cancer, coronary heart disease, cerebrovascular diseases and diabetes mellitus have been major causes of mortality and morbidity in Brunei Darussalam over the last few decades. To address this issue, the Ministry of Health (MoH) has undertaken several actions such as developing relevant policies and regulatory mechanisms; implementing fiscal measures; undertaking preventative measures particularly, education and information interventions; and ensuring clinical interventions in line with WHO recommendations.

The Health Promotion Centre (HPC) of the Ministry of Health is the lead agency responsible for NCD preventive actions and the promotion of a healthy lifestyle. It is responsible for the coordination and the monitoring of several objectives and initiatives set out in the Health Promotion Blueprint 2011–2015, as well as many different health promotion activities throughout the country.

In 2007, the Integrated Health Screening and Health Promotion (IHSHP) Programme for Civil Service Employees was launched by the MoH to assess the health status of civil servants in Brunei Darussalam.

Preliminary results of the IHSHP Programme for Civil Service Employees in 2010 showed that 38% of the employees had at least one health risk factor that placed them at increased risk of developing chronic lifestyle-related diseases, with more than 60% of them being either overweight or obese. Many of these risk factors were attributed to employees’ lifestyles including unhealthy dietary habits, physical inactivity, tobacco use and poor stress management.

Following the IHSHP programme’s implementation, various types of health promotion activities to promote healthy lifestyles have been increasingly requested from HPC by different organisations in both the public and private sectors.

These initiatives comprised a range of activities such as:

  • Consultations with and advice on healthy workplace initiatives to representatives from the organisation’s management;
  • Specific health talks on healthy diet, physical activity, weight loss and management, smoking cessation and managing stress;
  • Basic health screening comprising past medical and family history, smoking status, weight, body mass index (BMI), blood pressure and random/fasting blood glucose; and
  • Exhibitions on specific health issues and/or healthy lifestyles together with relevant leaflets for reinforcement.

Dr Norhayati Kassim, MB ChB, MMed PHM, MSc HP & HE is theSenior Medical Officer & Head, Health Promotion Centre, Ministry of Health

Prof Maureen Dollard et al. (prepared for Safe Work Australia) The Australia Workplace Barometer: Report on Psychosocial Safety Climate and Worker Health in Australia,(Safe Work Australia), Canberra 2013, pp. 94

Australia has very limited data for measuring psychosocial risk factors and working conditions. The lack of effective psychosocial risk surveillance in Australia has led to the development of the Australian Workplace Barometer (AWB). This research is driven by an emerging theory, Psychosocial Safety Climate (PSC). Psychosocial safety climate measures an organisation’s priorities and commitment in relation to the protection of worker psychological health and wellbeing, including psychosocial risk assessment.

The overall results for Australia show that there are no industries with PSC levels in the high risk range. PSC levels for the majority of Australian industries, including Government administration and defence, fall in the moderate risk range suggesting that these industries would be experiencing unfavourable levels of psychosocial risk including job strain, potentially leading to poorer health and productivity outcomes.

Other outcomes contained in the report include:

  • Urban workers report marginally higher psychological demands compared to rural workers, however, rural workers report more physical demands and work-family conflict and are more at risk for poorer mental and physical outcomes
  • The experience of job demands, job resources and their relationship with health and motivational outcomes differ across age groups. Workers aged 25-34 show the poorest psychological health, however, this was not strongly associated with job demands and resources. For older workers (65+) work pressure was strongly related to poor psychological health and decision authority was strongly related to engagement
  • Results from the AWB show that levels of bullying are at 6.8 per cent, which are substantially higher than international rates. Females report significantly higher levels of overall sexual harassment and bullying and experience bullying for significantly longer periods of time than men.
  • Work family conflict (WFC) is one of the major contributors to poor work health and wellbeing. The job demands most strongly associated with WFC included work pressure, emotional demands, harassment and PSC.
  • A major issue in the workplace is that 40 per cent of Australian workers are working more than the national standard of 38 hours and 18 per cent work longer than 48 hours per week. This places Australia as the fifth highest country for average working hours.
  • For all workers, factors including PSC, emotional demands, work pressure, bullying, justice, rewards, and decision authority were significant contributors to poor psychological health.
  • The cost of employee productivity loss is mostly due to workers showing mild symptoms of depression taking twice as many sick days compared with those showing no symptoms of depression.

The findings of the AWB project are consistent with the priorities of the Australian Work Health and Safety Strategy 2012–2022

Prepared by Prof Maureen Dollard et al, University of South Australia for Safe Work Australia. Safe Work Australia is a national policy setting body whose key role is to improve work health and safety and workers’ compensation arrangements across Australia.

Safe Work Australia, ‘ The Incidence of Accepted Workers' Compensation Claims for Mental Stress in Australia’, Australian Government (Safe Work Australia), April 2013, pp.25

This report explores various elements of work-related mental stress. Mental disorders arising from stress in the workplace have become an increasingly important concern for employees, employers and the general public as a whole. Mental stress claims are the most expensive form of workers’ compensation claim as a consequence of the lengthy periods of absence from work. Mental stress includes the following sub-categories:

  • Work pressure
  • Exposure to workplace or occupational violence
  • Exposure to traumatic even
  • Suicide or attempted suicide
  • Other mental stress factors
  • Work-related harassment &/or workplace bullying
  • Other harassment

Researchers have found links between work-related mental stress, particularly when it has been experienced for prolonged periods, and the development of a number of physical and mental illnesses. Despite the wide range of conditions associated with mental stress, workers’ compensation claims data show that almost 98% of mental stress claims were for mental disorders.

The acceptance rate for mental stress claims ranged from 69% in 2005–06 to 68% in 2010–11. For 2009–10 mental stress claims represented 3.4% of all accepted claims, making it the fifth most common mechanism, ranking well behind physical injuries caused by body stressing (37.6% of claims), falls, trips and slips of a person (18.8%), being hit by moving objects (17.6%) and hitting objects with a part of the body (9.9%). Over the period 2003–04 to 2010–11, there was a 7% decrease in the number of accepted mental stress claims. However, over this period claims in general decreased by 13% indicating a smaller improvement in mental stress claims than claims overall.

Over the three year period 2008–09 to 2010–11, the most commonly specified subcategories for mental stress were work pressure (33%), work-related harassment and/or workplace bullying (22%), exposure to workplace or occupational violence (21%), and other mental stress factors (14%).

For the combined years 2008–09 to 2010–11, female employees accounted for 58.6% of all accepted mental stress claims.

Mental stress claims were most likely among employees aged 40–59 years.

Around two-thirds of mental stress claims were from three occupation groups: Professionals (26.5%), Intermediate clerical, sales & service workers (21%) and Associate professionals (19.6%). The highest frequency rates of mental stress claims for both males and females were found in Associate professionals. The group includes police officers, prison officers, welfare associate professionals ambulance officers and paramedics and enrolled nurses.

Safe Work Australia is a national policy setting body whose key role is to improve work health and safety and workers’ compensation arrangements across Australia.