Health in the workplace
Hong Kong could learn a lot from Britain about how to keep its ageing workforce fit, happy and productive, a visiting expert tells Jeanette Wang
What's the cost of poor health? For EDF Energy, one of Britain's largest energy companies, ill health among employees costs £13 million (HK$164.4 million) a year.
In 2006, the company decided to introduce several initiatives to improve workplace health by promoting good lifestyles and encouraging staff, their families and the wider community to boost their general well-being.
As part of an employee support programme, psychological support (cognitive behavioural therapy) was offered to employees and more than 1,000 managers were trained to recognise psychological ill health among staff.
A team of "health advocates", made up of staff volunteers, started an engaging health and well-being programme, including physiotherapy services, ergonomic assessments, and stress and resilience training.
Efforts were also made to enhance the workplace based on good work principles, such as strong relationships, fairness, flexible working arrangements and meaningful work.
The result was a large reduction in sickness absence and a boost in productivity, which has saved EDF Energy about £4 million since 2006. Job satisfaction has risen from 36 to 68 per cent.
Professor Carol Black, expert adviser on work and health at Britain's Department of Health, cited EDF Energy as a positive example during a recent presentation on workplace health to representatives from about 25 local organisations at Hong Kong's British Council.
"There are basic principles about how you can keep people healthy and well and in work, and I think they apply to Hong Kong as much as they apply to Britain," says Black, 73, who is also the principal of Newnham College at Cambridge.
With sickness absence and worklessness associated with ill health costing Britain more than £100 billion a year, Black says the key issue facing the British workforce is how to keep people who are fit for employment at work, not taking sick leave, and how to enable them to work for a longer period of time.
There are 27.5 million people employed in Britain, 2.4 million without jobs and nine million inactive. People with common health problems are 60 per cent less likely to be employed and 40 per cent more likely to be inactive, says Black.
The two most common causes of sickness absence in Britain and in many other countries, such as Australia, New Zealand and the US, are mental health (stress, anxiety, mild depression) and musculoskeletal conditions.
Poor health - sickness absence, disability and workers' compensation - costs the US economy US$576 billion a year, according to research published last year by the non-profit organisation Integrated Benefits Institute.
Hong Kong statistics are sparse. A government audit of 141,000 civil servants from 79 government bureaus and departments in 2001 found that the staff cost of sick leave amounted to HK$718 million. The 682,000 days of sick leave were equivalent to 1.3 per cent of the working time of the officers.
With an ageing population, keeping the workforce healthy will become ever more important. The Census and Statistics Department has projected the ratio of dependents to workers (age 15 to 64) will increase from 333 per 1,000 in 2011 to 562 per 1,000 by 2031. Over this period, the median age of the population would also increase from 37 to 51.
Britain faces a similar challenge. Black, a rheumatologist, was handpicked for her current role in 2006 by the government to improve Britain's workplace health and reduce the burden and costs of sickness absence. She has published two review reports: on the health of the working-age population in 2008, and on sickness absence in 2011.
A key point in her reports: work is compatible with less than perfect health. "For most people of working age, work - the right work - is good for their health and well-being. For most people, worklessness is harmful," says Black. "Much sickness absence and inactivity follows common health problems which, given the right support, are compatible with work - although sometimes it means a different kind of work."
The first step in stemming sickness absence and inactivity was by improving sickness certification in Britain - or the sicknote system.
Based on Black's recommendations in her 2008 review, the "fit note" was introduced to replace the old sick note in April 2010.
Instead of advising their patients that they were completely fit or completely unfit for work, doctors now could advise that their patient has some functional limitations but could return to the workplace - with appropriate support. Possible support included changing roles or office location, reduced or flexible hours or a phased return to work, providing additional training or supervision, arranging a mentor or work buddy, or arranging for an occupational health assessment.
Another initiative Black launched is the Fit for Work Service, a pilot project that provided case managed, multi- disciplinary support for SME employees in the early stages of sickness absence (about four weeks) who were at risk of spending long periods away from work with health problems. The project, which ran from 2009 to March this year, is under review and could be rolled out nationwide if found to be beneficial.
Black has also recommended that expenditure by employers targeted at keeping sick employees in work (or speeding their return to work), such as medical treatments or vocational rehabilitation, should attract tax relief. "We estimate that this will cost around £150 million a year, but will result in gains to employers of up to £250 million," she says.
The promotion of health in the workplace, Black says, should be a team effort between the government (through verbal and visible support), health professionals and employers.
"At the moment in Britain, we have a great interest in improving people's resilience and mental health - proactively, rather than waiting until people become sick."
Often, the best medicine for productivity is simply support from the manager or employer.
"It's all about people being in good work; work in which you feel you have a sense of control and autonomy, where the leadership is empowering and you feel appreciated," she says. "The biggest thing is knowing how to look after people. These things don't cost money - they cost attitude and a bit of time."
In a study published last year in the European Journal of Work and Organisational Psychology, researchers from the University of Haifa in Israel examined a group of 241 workers at a manufacturing company in China. They found that support from a supervisor - for example, lightened work load or stress management training - when an employee is experiencing psychosomatic symptoms of stress, such as stomach ache or headache, is more likely to keep the worker from taking sick leave.
The researchers say this is because the worker feels more inclined to reciprocate the supportive treatment by keeping their work effort high.
More employers are taking workplace health more seriously, Black says. "Over the past five years, certainly in Britain, I've seen many more companies understand the economic equation, what they would gain financially and what they would gain in an engaged workforce. The bottom line: a healthier workforce is a more productive workforce."