Health…as well as safety

There has been a marked increase in awareness of the problems across the industry, and some positive initiatives have been emerging that Mawhood is particularly pleased with:

“Network Rail has done a lot on ballast dust, in providing water suppression spray systems to damp down the ballast at their stockpiles. It has ordered a new ballast cleaning machine that’s going to have water sprays fitted, directly as a result of ORR pushing the silica dust agenda.

“London Underground has done some really good work on manual-handling, by doing things like putting conveyors down on the platform, rather than having guys walking downstairs onto platform level carrying huge loads.”

The ORR has collected plenty of other case studies demonstrating good practice and initiatives across the industry, and is encouraging organisations to share them through its website. Mawhood is keen that companies learn from each other, rather than ‘reinventing the wheel’ every time.

But how do problems in these areas get discovered? Are rail companies inspected for health compliance specifically?

“We tend to have a five-year overall inspection plan, so we don’t look at every aspect every year. Occupational health is built into that five-year plan for our duty holders, on topics relevant to them. 

“But also, if our inspectors are out and about looking at other stuff and they see something very significant on health, they’re not going to walk past it. So it’s a mixed issue of both planned inspection on health, plus when you’re out on site and you see something that needs attention and needs fixing, and you sort it - particularly if there’s an immediate risk to health.

“An example is isocyanate paint spraying. The spray can cause asthma. We use it sometimes on rail bridges. They also use it on train carriages when they refurbish them. 

“You need a really good standard of enclosure and ventilation for it to protect the worker. And full air-fed respiratory protection. If you don’t find that on an inspection, you stop the job and a prohibition notice is issued. It might not have been on the inspection plan for the day, but you’re there… you see it… you deal with it.”

By far the biggest challenge for the industry to improve workforce health is its data collection - a subject that is not exclusively reserved for health data. But Mawhood is convinced that realising a measurable improvement in occupational health is only possible if the industry is recording the data in the first place to measure against - and then it needs to report on it properly.

“They can’t report on something they can’t measure. I think one of the weaknesses in any part of the industry is that they haven’t been collecting consistent, reliable health data that they can then report.”

Mawhood says this is improving - over the past four years, more companies are publicly reporting their health data. But it is still well below reporting on safety.

“They’re quite keen to report on worker safety and passenger safety performance, but perhaps haven’t been set up to report on health because they have not actually been measuring it and monitoring it in a meaningful way.”

Do companies place more importance on the safety of passengers because of the public perception of railway safety?

“Absolutely. We’re a safety-critical industry, and until recently the focus has rightly been very much on safety-critical work. We need to rebalance it a little bit to ensure the health of the workers, which is not only causing ill-health among staff, it is costing money in terms of absence and productivity. We just need to shift the balance to get health treated equally with safety.”

However, understanding those costs is nigh impossible at the moment because of the inconsistent data collection. Currently, a guideline is the best the industry can hope for.

“We don’t have completely reliable data on the cost of work-related health, because large parts of the industry don’t actually know how much of their sickness absence is work-related. Four years on, two-thirds of the rail companies that we surveyed couldn’t distinguish work-related sickness absence from overall sickness absence.

“So we don’t have a reliable measure. But to the industry’s credit, it is very cost-sensitive, and when we mentioned this, RSSB did a really good piece of work looking at the cost of impaired health. 

“It’s not just work-related, it’s the costs to the industry of people either absent from work, or being in work but not productive (presenteeism). And it looked at all sorts of costs - pensions and National Insurance contributions. It came up with an estimate of around £316 million a year across the industry, and if you include presenteeism that goes up to nearly £800m. That is an estimate - we’re not saying that it’s absolutely spot on, but it’s in that order of magnitude.”

Is the lack of a reliable measure for health data one of the reasons why organisations aren’t as a rule reporting publicly on their progress?

“No, it’s all to do with maturity. It’s to do with when they first recognise and accept that they have to improve the management of health. The first thing they do is to put policies and procedures in place at the top level - at a senior level commitment from the chief executive or MD to say ‘this is our policy and procedure on health, we want to see better health and this is how we’re going to achieve it’.

“It takes time for that intent and that commitment to filter down to the guys on the ground, in terms of what they’re actually doing. So they might have a really good policy on vibration or noise, but until that has gone through every level of management, every line manager, every supervisor, every track worker, you’re not going to see that filtering down to the ground. So it’s to do with management maturity.”

Mawhood wrote in the Better health is happening report that the “rail industry is not sufficiently mature to reliably capture data on work-related ill-health absence”. She clearly wants the industry to take notice. But how do we improve that maturity?

“We need to send that message back up to the top, saying ‘yes, you’ve stated a really high level of commitment, you’re doing all the right things, but we’re not seeing it on the ground quite like that’.

“In a huge organisation, it’s down to the people. It’s going to take some time to become the culture. Because a lot of this is a change in the way things have been done for decades. We’re saying ‘now you’ve got to wait here for protection’, ‘now you’ve got to wear a mask’, ‘you’ve got to lift using this particular technique’.”

Mawhood laughs: “What do they say? You have to give a kid food ten times before they like it. People might have to be told a hundred times, and then escalate if they don’t follow the rules. They’re going to tell them gently the first time and then a bit stronger the second time. It’s going to take quite a while for that culture to get right down to operatives. You might be saying the right things, but we’re not actually seeing the right things. We are seeing improvements on the ground, but it’s not consistent.”

This is clearly not just about health management, but also about the culture within an organisation. Mawhood says it’s also about line managers knowing “what good health looks like”. That might seem like an obvious point, but if managers have not always been looking out for the right things, it will take time before they do.

So, returning to this issue of recording data, what should the industry be doing? What does perfect look like?

“We’re keen for the industry to develop a scheme something akin to SMIS , so that there is consistent health data reporting
across the industry. But it’s not an easy
job - it’s a big task.