Are OHS Professionals in the Healthcare sector being marginalised?

The current Victorian outbreak has resulted in more than 3000 healthcare worker infections, and as a result COVID-19 is likely to be among the top causes of workplace-related injury and deaths in Australia in 2020. For a moment in time, we are not talking about construction workers or miner operating in high-risk environments, instead, we are talking about doctors, nurses and aged care workers as being one of the riskiest occupations. The very occupations we [naively] assume or have been told 'they know what they're doing' when it comes to infection control in the workplace.

But the evidence suggests otherwise. The alarming rate of infection of healthcare workers has a direct relationship with the controls (or lack of), in the workplace, including the type of PPE used, whether workers are properly trained in the use of PPE, safe work and workplace design and the overarching standards set by the governing health authorities. Victoria has demonstrated each of these things in our healthcare sector are flawed and we, the health and safety profession, know that all of them can be improved. 

So where are the health and safety professionals?

Over the past couple of months, I have received numerous emails and messages from AIHS members about the state and status of health and safety in the healthcare industry. One of the most alarming, I can share with you:

“I work as an OHS Advisor in a large Melbourne hospital. What is going on is incredibly concerning. It has been for some time, total lack of commitment to OHS - even at the last hospital I worked at. Safety culture very low, lack of true commitment and OHS governance. In relation to COVID - we have this struggle cause we are surrounded by experts in the disease but they aren’t experts in risk management and workplace safety - so they won’t let us sit at the table. We’ve literally been told to ‘leave infection control to infection control experts’. It’s a very tough place to work right now.”

(Concerned AIHS Member).

When I read this message, I became angry. I cannot understand why you would employ a person to undertake a health and safety role in your business and basically lock them in their office. Then I read this quote:

“Governments should liaise with professional associations (such as the Australian Medical Association) and industry associations to highlight the relevance of occupational health and safety to their field.”

You’d be easily mistaken to think I read this quote from a recent article. This was actually written by Mr Jeffrey Rae, Presiding Commissioner of the Inquiry into Occupational Health and Safety on 11 September 1995. It would appear, not much has changed.

 This article is about trying to answer the question - Are OHS Professionals in the Healthcare sector being marginalised?

It would be a shame for me to try to answer that alone when I have faulted Infection Control Expert Groups of not engaging with others to ensure diversity of thought. Instead, I’ve engaged a Victorian and the recent winner of the Eric Wigglesworth OHS Education (Research) Award, Dr David Provan, Managing Director Forge Works, to help me understand are health and safety professionals being sidelined. David’ thesis is titled, ‘What is the role of a safety professional? The identity, practice and future of the profession’, so who better to help answer this.

Firstly David, perhaps we should clarify – what is the role of a health and safety professional?

The role of a health and safety professional is to facilitate the organisations understanding and management of the safety risks facing their workers and others. To achieve this, health and safety professionals require extensive technical knowledge, and arguably more importantly, expert communication and influencing skills. Rarely the health and safety professional is the one accountable to make the decisions that impact the safety of workers, that is the responsibility of management. Therefore, it’s the management of organisations that play a central role in how effective a health and safety professional is able to be, regardless of their individual level of competence.

So, if management are not empowering the health and safety professionals to be involved in developing risk-based approach to managing infection control in health and aged-care workplaces, is it fair to say they are being marginalised and is this unique to healthcare?

Health and safety professionals have a long history of being marginalised in many safety critical industries. The research suggests that in highly technical domains, for example, aviation, oil and gas, nuclear and healthcare, the management of these companies refer to others in the organisation whom they perceive to more technically proficient in relation to the individual safety risks. 

Take for example the current situation in healthcare, medical professionals and healthcare administration manage infection control every day and are specifically trained in this risk, it might make sense that they feel like experts when it comes to managing this risk. They may well be, historically, but the health and safety professional should be an expert the safety risk management process which should be able to proactively test whether the infection risk posed by COVID-19 is able to be controlled by existing measures. In what we are seeing, the health and safety profession didn’t, or wasn’t given the opportunity, to apply this process in this situation.

The perception that others are more technically proficient explains unconscious management bias in who they seek to advise them. If our role is to facilitate management of health and safety risks, are there other reasons why the we are being sidelined by management?

There are many reasons that the health and safety professional may not be adequately able to influence the management of safety risk in their organisation before people are harmed. Some of these factors are to do with the capability of the health and safety profession broadly, and some are to do with the organisational factors surrounding the work that the health and safety professionals perform. 

In regard the capability of the health and safety profession, it comes down to a few key areas, are they: technically proficient in relation to the science of health and safety, able to build influence without authority in their organisation, and understanding of the contextual drivers and processes within their organisation to get things done? 

However, the organisational factors, largely driven by management will always exert greater influence over the individual – which is why we use the saying “you can’t fight the system”. In this context, unless management provides the necessary prioritisation, expectations and resourcing for health and safety management then the health and safety professional will be marginalised by the other operational goals of management, like productivity, profit and customer satisfaction.

Reflecting on the quote (above) from the Inquiry into Occupational Health and Safety, it seems not much has changed since 1995. Do you think that’s the case?

For starters, the modern health and safety profession was created out of the need to comply with a raft of new legislation published in the 1980’s and 1990’s. For at least the decade after this period, the role of the health and safety professional was to create health and safety rules and processes so that their organisation could comply with these laws. That has put safety in its administrative and compliance box that in many ways still continues today and is why the profession has been referred to as “the fun police”. 

I don’t think that the health and safety profession has consistently been able to demonstrate its value in facilitating improvements to culture, work and most importantly significant health and safety risk reduction. And at the same time, I don’t think many organisations have let their health and safety professionals out of this box. I suspect in the healthcare industry, the health and safety professionals have been working away completing their safety processes and inspections, meanwhile in other rooms that they are not in, safety critical decisions are being made and hundreds of frontline health care works are contracting COVID-19 every day.

Over the years, we’ve seen organisations do some really strange things with management of safety and its functions, the most common is the employment of person with no health and safety qualification, and no surprise, things didn’t “work as imagined”. Do you think it’s time to regulate the profession, so we are given higher standing?

I strongly believe that it is time to regulate the health and safety profession. The fact that it is not regulated, means that technically we probably should be calling it an occupation rather than a profession. Some readers might be surprised to learn that there are no minimum qualifications required to become a health and safety professional, nor any legislation regulating their conduct. As far as I am aware, there is no other occupation concerned with the health and safety of people that has no minimum qualifications – they exist for: all allied medical specialists, personal trainers, and even security guards. 

Other professions that can impact the well-being of people and society are all tightly governed, for example accountants, solicitors and engineers. My message to managers of any organisation that wants to ensure that they are receiving appropriate advice and support from their health and safety professional is to employ someone who is appropriately qualified and certified. Then furthermore, create the conditions for them to do their job and be central to decisions that impact the management of health and safety risks in the organisation – even if it is an issue like infection control in a hospital.

Reader's Question: What conclusion did you come to?

Reflecting on David’s responses, the evidence both research and anecdotal demonstrates that the health and safety profession is and continues to be marginalised. And not just in healthcare. An important point David has highlighted is that for management (in particular Officers) is that 'adequately resourcing for health and safety', is not just about employing someone do fill a health and safety position in the business. Adequately requires the resource you employ to have qualification, knowledge and experience, and above all, it is essential that management empower that resource.

Another note to take from David's responses, is that as practicing OHS Professionals we should be continually developing our knowledge, the application of that knowledge and, most importantly our communication and influencing skills. The AIHS Certification and CPD programs provide the development framework to enable practitioners, professional and leaders to do just that. Then collectively, whether regulated or not, we can work together to influence and raise the perceived value of the profession in technical domains, and ultimately, create demand driven by industry with greater confidence of regulators, employers and employee bodies in the quality of health and safety advice.

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The Australian Institute of Health and Safety is the national association for the health and safety profession. Everything we do is about shaping workplace health and safety now and in the generations to come, because we believe that every Australian deserves to be safe and healthy at work. Our Vision is safe and healthy people in productive workplaces and communities. Find out more about the AIHS at www.aihs.org.au

Dr David Provan is the Founder and Managing Director Forge Works. A safety management and organisational change consultancy that combines evidence-based research with people-driven know-how, working internationally with organisations across all industry sectors to improve the safety of work. David has co-authored papers on Safety Work vs the Safety of Work and Safety Clutter which have become the key concepts that are shaping the safety narrative among the Australian OHS Profession. In 2019 David founded ‘The Safety of Work’ podcast with Dr Drew Rae.

Naomi Kemp is the Chair of AIHS Board, a Certified OHS Professional and Founder of Safe Expectations, a health and safety strategy business. She is a pragmatic leader who challenges ‘the way it has always been done’ to help leaders during pivotal times set safe expectations. Naomi is also a member of the Office of Industrial Relations, WHS Board (Qld Government) and Trieste Global Pty Ltd (Private Company) Advisory Board.