AXA PPP healthcare's MD of occupational health services, Dr Mark Simpson , tells Johanna Gornitzki why occupational medicine is more than just an absence management tool
In July 1988, Kenneth Clarke was appointed Secretary of State for Health. During the next two years he laid the foundations for the biggest reforms in the NHS since its creation in 1948. For Dr Mark Simpson, a general practitioner in Somerset, Clarke's reforms turned out to be the ignition for a career change.
"I really have Kenneth Clarke to thank for my current role. When he first started to build the health service reforms in the early 1990s, I began to think that the future of general practice was not what I wanted to be involved in, so in 1993, I changed careers and retrained in occupational medicine," he says.
Dr Simpson's first role in his new vocation was as a practitioner for a family run firm called Medical and Industrial Services. However, following five successful years of growth, it was taken over by PPP Healthcare. A series of later acquisitions, by Guardian Royal Exchange and AXA, led to the creation of today's company, AXA PPP healthcare.
Acting as the managing director of the occupational health business of AXA PPP healthcare, Dr Simpson has strong views about the issues facing the occupational health market. "I think that a lot of the time occupational medicine is not done well and our purpose as occupational physicians is not being accurately articulated," he says.
Dr Simpson thinks one of the main problems is the lack of alignment between the various employee benefits offered by companies. "While a lot of organisations have bought a number of different health-related benefits, the problem is they all sit in silos. Some of them offer compensation and rewards, while others simply provide health and safety advice."
He thinks employers should try to bring those services together under one umbrella. By doing so, he also hopes that the perception of occupational health services will improve and that employers will realise that the services can be so much more than just practical solutions to help manage absence. "I certainly wish we would be used on a more strategic level that would create effective workplaces and help to maximise productivity rather than just fight absence," he says.
Key driver
Dr Simpson admits that an increased awareness of the cost of absence has been the key driver behind employers' awakening interest in the area. In fact, he argues, the occupational health market has started to grow due to the fact that more companies are focusing on absence.
A recent Mintel report reveals that the market is growing by about 15% a year. Although he strongly believes the sector is expanding, Dr Simpson admits that the Mintel figure is questionable.
He explains: "It is very difficult to say how big the sector is. If you ask companies whether they do rehabilitation, 80% would say they do. But 70% of that is probably when rehabilitation constitutes no more than asking somebody to come back to work on a part-time basis for a week or two. So asking companies what occupational health provision they have is probably a quite loosely defined question to ask."
Nevertheless, Dr Simpson says he has seen increasing numbers of companies beginning to invest more in occupational health. For example, three years ago AXA PPP healthcare's largest client, Barclays, decided to start integrating its service. This included putting into place an occupational health service for its 60,000 employees. The main driver was, unsurprisingly, to help manage absence at the bank.
However, to label occupational health simply an absence management tool would be to ignore many of this niche market's true benefits, says Dr Simpson. Another driver for companies should be the increased risk of litigation. "Obviously, there are some companies that suffer a higher risk of litigation, including where firms have to expose their employees to various health risks," he says. "However, all companies need to ensure they comply with the new Disability Discrimination Act."
Putting an occupational health service in place could also help employers manage productivity. Several companies have realised that prevention is sometimes the best cure and have started to look at managing wellbeing and early intervention for employees so they do not have to be absent before something is done to help them. Moreover, the benefit could prove essential for companies that take an altruistic or paternal stance towards their employees, and seek to reinforce the company's beliefs by making sure their staff are treated in the same manner.
Management tool
Looking at its wider remit, occupational health is also the only service that could turn private medical insurance (PMI) from an employee benefit into a management tool, explains Dr Simpson. "The only way employers could ensure that people are actually seeking appropriate treatment and at the appropriate time is by providing occupational health services," he says.
That said, Dr Simpson does not believe it should be an additional benefit to PMI: "The role of occupational health is to sit primarily between a company's management and its employees. Sometimes this role is quite uncomfortable because of employment relations, but ultimately we are there to help manage these cases as effectively as possible."
Intermediary interest
Until now, intermediary interest in the sector has been scarce. But Dr Simpson thinks this situation is beginning to change, with more advisers showing an interest in entering this market. "This is a relatively complex sector, but what we have begun to see is a different level of understanding within the broker community regarding occupational health.
"I think the opportunities here are primarily in retention. Companies are going to look both to providers and intermediaries to offer a wider range of healthcare products and advice, and will no longer be satisfied with just receiving advice on PMI. Offering occupational health service advice is going to have just as an important role for brokers wishing to keep their current clients as brokers wanting to generate new business. They have to make sure they are really bringing value to their clients."
He thinks the major challenge for the occupational health market lies within the profession itself. Not only do occupational healthcare specialists need to figure out what their future role in the UK will be, but they also need to communicate it a lot more effectively. Moreover, Dr Simpson warns that the sector needs to make occupational medicine a more attractive career option for those physicians and nurses who want to specialise in this field if it is ever going to thrive.
"Working conditions in the NHS have improved significantly over the past couple of years and the average GP's salary is now very competitive. Therefore, one of the challenges we face is to try to match the pay for occupational healthcare staff with the more generous salary provision provided by the public health sector."
So is there a future for occupational medicine? Dr Simpson thinks so: "I can see over the next 10 years more firms looking at private provision as pressure on the NHS increases. This, in turn, will see an increase in the use of occupational health services."
