How much does your health cost?

Occupational health problems also cost the industry £500m a year. So it's not surprising that the government is considering a compulsory national occupational health scheme to tackle the problem in construction. The Health and Safety Executive is conducting a feasibility study for such a scheme, in an attempt to get it into the health and safety bill that will be put through parliament in the autumn.

Poor relation
Occupational health can sometimes be the poor relation to safety in construction. Falls attract big headlines; vibration white finger does not. But the HSE has been trying to raise the profile of occupational health in the past year. In October it hosted the first conference on occupational health in construction, which resulted in the feasibility study for the programme.

Kevin Myers, chief inspector of construction at the HSE, says there is a need for a co-ordinated occupational support system. "Due to the fragmented nature of the industry, many workers would end up falling through the net if this was run on a site-by-site basis. The scheme we are proposing [see factfile] would make sure everyone in the industry was covered, and it would have to cover the whole range of measures, from prevention through to rehabilitation. There are some company-based occupational health programmes running at the moment, but none that covers the full range of measures.

"With the skills shortage the industry is experiencing, it makes sense for it to look after its workers better," he adds, "and make sure they don't leave the industry unnecessarily."

But Myers points out that the industry has to take responsibility for running the scheme itself. "I don't see the HSE running this. We are facilitating it and we would contribute to it, but the industry would have to be responsible for it. The feasibility study is looking at the various ways that can be done."

The levy
The National Federation of Builders is keen on a compulsory levy to pay for the scheme. Chris McEwan, the NFB's representative on CONIAC, the joint industry-government safety panel, says a levy would be unworkable if it were voluntary. "You can't impose another cost on small and medium-sized builders without making it compulsory. Otherwise, the few companies that picked up the scheme would be at a disadvantage. A compulsory levy is the only fair way to implement it."

Grenville Weltch, director of the Federation of Building Specialist Contractors, agrees with McEwan. "This type of scheme would apply especially to specialist subcontractors, because they are the ones that actually do the work. It would have to be a compulsory levy such as the CITB one to be fair."

Tony Wheel, director of safety and project management systems at Carillion, favours the scheme, despite the fact that the contractor already has its own occupational health programme. "We are in the process of covering all our direct employees, but the subcontractors and transient workers won't be covered by us. A national scheme would cover everyone in the industry."

"It has to be compulsory," he adds. "If you look at countries such as France, where such a scheme is mandatory, it has worked very well. In Sweden, there was a very good voluntary scheme, which has petered out when other matters gained priority."

Wheel favours a charge on materials rather than payroll, such as the CITB levy. "A levy related to simple materials will catch the cowboys who would otherwise escape if it was raised through a levy on payroll. This way, everybody pays."

George Brumwell, general secretary of construction trade union UCATT, is sceptical about the proposals. "We have commissioned our own study to look at occupational health from the workers' viewpoint. Anything that is done for the workers in construction has a cheapskate approach, and a national occupational health scheme can't be done on the cheap.

"Our experience with the training levy tells us that employers will find ways round paying it or charge it back to the workers. The employment of casual workers also needs to be tied up before such a scheme can be successfully implemented."

But Brumwell agrees with Tony Wheel's idea that "a levy on materials would be the most effective way to raise funds and could provide a lot of money".

Bob Blackman, construction spokesman for the Transport and General Workers' union, favours a payroll levy, however.

"A levy on materials is a non-starter. It would be too complicated if everyone who bought a packet of screws in Woolworths was charged for a construction occupational health scheme. There will always be those in the black economy who will try and escape payment, but most responsible employers will see a national occupational health scheme as a good thing."

But Mike Roberts, chairman of the Confederation of Construction Clients, says that however the money is raised, the scheme will not work without client involvement. "Clients must be involved in the design stage of a scheme such as this, or you might as well not bother. Only if we use occupational health as a criterion for choosing construction companies will change really happen.

"The scheme has to be compulsory, but experience with the CITB levy shows that compelling companies by law to pay a levy is not enough on its own. Clients have to use it as part of their selection procedure, as we are now doing with competence."