Intended for healthcare professionals


Occupational health should be part of the NHS

BMJ 2017; 357 doi: (Published 23 May 2017) Cite this as: BMJ 2017;357:j2334
  1. Ian Torrance, consultant occupational physician1,
  2. Richard Heron, president1
  1. 1Faculty of Occupational Medicine, London, UK
  1. Correspondence to: I Torrance ian.torrance{at}

Integration would benefit people in and out of work, and the UK economy

Occupational health was not included in the NHS when it was formed in 1948, and this has not changed despite successive reports arguing that work is important for overall wellbeing.12 The growing shortage of occupational health doctors adds urgency to calls for the specialty to be integrated fully within the NHS.

In 1948, funding for occupational health and the development of the specialty were driven principally by health and safety legislation. Workplaces were more physically hazardous than they are now. Many workers developed diseases caused by exposure to agents such as asbestos and coal dust, prompting targeted, specialist health surveillance of those at risk. The duty to manage work place hazards, including provision of health surveillance, rested then, as now, with the employer.

In the past 70 years work has been made safer and the prevalence of occupational illnesses caused by exposure to specific workplace hazards has fallen. At the same time, emphasis …

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