Intended for healthcare professionals

Letters Demise of occupational medicine

Health and Safety Executive’s response to article on the demise of occupational medicine

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h6452 (Published 03 December 2015) Cite this as: BMJ 2015;351:h6452

Re: Health and Safety Executive’s response to article on the demise of occupational medicine

What is the poor reader to make of Anne Raynal’s assessment of the dire straits in which Occupational Medicine finds itself in Britain in 2015,[1] in the light of the responses to it?
Her erstwhile colleagues at HSE responded by assuring the reader, [2] much in the style of James in the chanson, ‘Tout va très bien, madame la marquise’. But then, in the words of the late Christine Keeler, ‘They would say that, wouldn’t they?’
While the response to Anne Raynal’s analysis by the Presidents of the Faculty of Occupational Medicine and of the Society of Occupational Medicine [3] was less insouciant than HSE’s, it concluded with the bromide: “Occupational physicians should be assured that their desire to prevent occupational illness, detect occupational disease and successfully rehabilitate those who are recovering from illnesses is no less noble a cause than it was in the 19th century - and no less important in the 21st!” In 1898 HMFI recruited its first Medical Inspector (the Chief Inspector of Factories was a physician) and in 1908 it acquired a second, their number increased gradually until an expansion with the birth of the Employment Medical Advisory Service in 1973. Today’s cadre of Occupational physicians seems to have regressed to the situation at the time of King Edward VII.
Any reassurance that your reader would have gained from these responses, contrast with Andrew Waterson’s condemnation of HSE [4]. In the same issue of your journal Matthew Limb cites Michael Marmot’s observations [5] ‘The positive downward trend in work related illness seen between 2009-10 and 2011-12 reversed in 2013-14. In 2013-14 4000 people in every 100 000 of workers reported a work related illness, around 10% higher than the 3640 in 2011-12.’
Your reader may be persuaded by Curran, Fishwick, Heron and Cordell, that pace Raynal, Waterhouse and Marmot, Britain’s Occupational Health is as robust as Monty Python’s parrot and all will be revealed by HSE’s new Workplace Health Expert Committee .
1. Anne Raynal.‘Occupational medicine is in demise. BMJ2015;351:h5905. (11 November.)
2. Andrew Curran, David Fishwick. Health and Safety Executive’s response to article on the demise of occupational medicine’. BMJ 2015;351:h6452
3. Richard Heron, Dr Robin Cordell. Presidents of Faculty of Occupational Medicine and of the Society of Occupational Medicine response to article on the demise of occupational medicine.BMJ 2015;351:h5905
4.Andrew Watterson.‘Health and Safety Executive’s failed record on occupational medicine.’ BMJ 2015;351:h6437
5. Matthew Limb ‘Poor working conditions in England pose threat to health, says expert’: BMJ 2015;351:h6445 (citing Institute of Health Equity. Marmotindicators2015.www.instituteofhealthequity.org/projects/marmot-indicators-201

Competing interests: No competing interests

06 December 2015
Morris Greenberg
Retired
Extramural
74, North End Road, London NW11 7SY