Corporate Health – Occupational Health Innovators – History Part 3

14 Apr

The Origin

In 1938 the need for a hospital in Slough was becoming acute. At the instigation of Mr Noel Mobbs, and under the auspices of the Slough social fund an appeal was launched to raise the required sum. Over £20,000 had been collected and substantial donations promised when the start of the Second World War made it impossible to proceed with the project.

After the war Mr Mobbs realised that the responsibility of providing a hospital would be taken over by the NHS, which was then being planned. He turned his thoughts to the possibility of some form of health centre to meet the immediate need, and discussed this with his fellow trustees of the Nuffield Provincial Hospital Trust.

The Trust and Foundation chose Industrial Health (Occupational Health) as one of the fields in which it wished to assist development. In addition to providing facilities for industrial health studies in universities, the foundation hoped to find an opportunity for encouraging the establishment of an industrial health service in and area in which there were a number of small firms. This interest in industrial health was part of a wider interest known as ‘Positive Health’. The idea developed that the health centre in which Mr Mobbs was interested might in effect be a centre for Industrial Health.

Early in 1946 it was announced that the experiment would begin by developing a combined industrial health, rehabilitation and research service in Slough. It was hoped that from the experience of the proposed service answers could be found to certain fundamental problems in industrial health, particularly in so far as these affecting small firms.

It was arranged that the official sponsors of the project should be the Nuffield Foundation, the Nuffield Provincial Hospital and Slough Estates. Slough was thought to be a favourable setting for the experiment of this nature, because of the concentration of industrial firms. As we have seen, there were a number of factories, both large and small, but the great majority were small. Another important factor in the selection of Slough was that Mr Mobbs, the chairman of the committee, was also chairman of Slough Estates.

mobbs

The next task  of the committee was to appoint a Medical Director for the scheme, and this was done in June 1946. He had been in private practice for some 20 years and held a number of appointments including Local gas and light companies and the Coke company. He gained his administrative experience in the army, and was subsequently given the task of commanding the Airbourne Medical services from their initiation in 1941 to the end of the war.

It was known that the NHS was to be instituted in 1948 and it was felt that it would be and advantage if the proposed industrial health service could be established as soon as possible.

At this time there were some 200 firms on the trading estate, with a total of 20,000 workers, and it was estimated that there were another 100 firms with 10,000 workers within a 3 mile radius. In effect, the population at risk was in the region of 30,000. Environmental conditions in the factories compared very favourably with those found in small firms in other parts of the country. Fifteen of the larger firms had medical departments, and three of these firms employed full time medical officers, but two of these doctors were mainly concerned with production.

Out of a total of 300 firms, 285 made no provision for the medical care of their workers at the place of work apart from conforming to the statutory requirements of providing a box stocked with first aid equipment.

The objectives, as defined by the sponsors, were to provide a service which would meet the industrial needs of both large and small firms in the area. Particular attention was given to the provision of facilities for the recognition, investigation and control of hazards to health and safety in the working environment, and for the rehabilitation and resettlement of workers after illness or injury.

The service was registered as a charity and as a non-profit making Limited company, with a council of management setting the strategic direction of the service.

A pamphlet describing the objectives of the service and the methods which it was proposed to adopt to attain them was circulated to all the firms. This was followed by a personal visit by the Medical Director if an appointment could be made with the firms Managing Director. It was regarded as important that the first official contact with any firm should be through the Managing Director. There was various reasons for this, but in the main this policy was adopted to establish the status of the service from the beginning. If a firm joined the service the personal interest and support of the Managing Director did much to ensure the goodwill of all concerned.

The reaction was a mixture of enthusiasm, apathy and antagonism, sadly very few were enthusiastic. The majority of employers accepted they had a responsibility for the provision of safe working conditions and facilities for emergency treatment. The main arguments which were produced against joining were that there was no proven need, that any need that did exist would be met by the NHS. Some considered that anything more than compliance with the Factory Act savoured of pampering employees, and that the cost was more than any small firm could be expected to afford in the absence of any reliable proof of any financial benefit.

In Great Britain one million were known to be absent from work each day because of illness or injury, and this represented 5 percent of the labour force. Some 270 million working days were lost in a year of which 50 per cent were due to minor injuries or illness. If all industrial accidents were recorded and not just those which entailed absence the figures would exceed 50 million working days lost in one year. It had been established that the average cost to industry of working days lost through injury was £300 per incident and minor injuries cost around £25. It was pointed out to firms that the NHS would make no provision for the treatment at the place of work, and was solely concerned with end results, and not with the prevention of injury and disease.

No attempt was made to produce a anything in the nature of a balance sheet by suggesting that there was a ROI model which could show the benefit. Experience in larger firms suggested that industrial health facilities did favour good working relationships. All agreed that there were hidden benefits which were not revealed in the balance sheets. Many firms claimed that accident and sickness rates were negligible, but on enquiry it was found that, intact, no accurate records were kept, particularly for uncertified absence. The need for the investigation of the working environment was rarely appreciated.

The Chairman and Medical Director, attended meetings of the Slough Trades Council to explain the project, and to seek the support of the trade unions in the area. At the first meeting the discussion revolved round the question ‘What are the Bosses going to get out of this service’ It was explained that it was hoped the ‘The Bosses’ would get a great deal, namely, the promotion of the health and welfare of individual workers, for whose benefits the scheme was solely intended. The trades council eventually decided to give the service full official support.

The Medical Officer of Health for the county of Buckinghamshire agreed to join the advisory panel and his lead was soon followed by the Medical officers for Slough and Eton. HAving the Health service on board was to prove of great value. The Medical Director visited staff at local hospitals and was encouraged by the interest sown and helpful advice he was given. All agree to co-operate.

The project consisted of a central poly-clinic, two sub clinics located close to the factories, Medical departments in bigger firms and a mobile dressing station, in addition there was a residential Rehab centre and one ambulance. It was found possible to equip the following departments, Reception, Casualty, Resuscitation, X-ray, Ohysio, chiropody and records.

The larger firms in the area who had their own medical departments and employed their own nursing staff now all worked under the professional direction of the Medical Director who visited them and the sub clinics regularly.

The success of mobile units in the army suggested the same principles could be used to the advantage for firms at a distance from the clinics, many of whom had no adequate facilities for the treatment of injuries or medical examination. The Directors at Horlicks who already had their own medical department paid £4,250 for the first mobile unit. This was a very generous offer and helped support local firms. This unit proved to be of the greatest value, not only from the medical aspect in that it brought facilities for efficient and prompt treatment to the factory door, but as the average time of work for a dressing was now under five minutes, management and workers were given a practical demo of saving man hours.

mobile unit copy                    mobile interior copy

Farnham park, the former home of Viscount Kemsley, had been acquired as the residential rehab centre for the service. It w as within reasonable distance of the local hospitals, and it was estimated with a little alteration it could provide accommodation for 60 in patients and 30 out patients with the required living in staff.

This period of hectic endeavour was not without incident, the central clinic was vandalised when youths broke in and did wanton damage to the furniture and equipment. Worse was to follow. With great difficulty linen had been obtained to the value of £1,000. Early one morning, as workers arrived they found a driver of a van having some difficulty getting his van through the gates. Under the impression he had been delivering goods, they assisted him only to find on entering the house that the linen store had been broken into.

It was appreciated that while suitable accommodation and a certain amount of equipment was required, the success of the service would to a large extent depend on attracting staff with the required personality and ability. This presented a very real problem in that there was no security of tenure, neither was the service in a position to offer salaries which in any way could be regarded as a financial inducement. These handicaps in the end proved to be of advantage, in that a nucleus of staff was formed of men and women who were prepared to take a risk, who were not concerned with pensions or long term security, but who were united in their determination to make the venture a success. Great credit is due to these pioneers in all grades, who in the early days were prepared to turn their hand to any task which would further the interests of the service.

On 1st May, 1947, The Central Clinic and the sub clinic were opened, and responsibility for the professional administration of the medical departments in larger firms was taken over by the service.

Previous Blogs

Upcoming Blogs

  • Development of the Slough OH service
  • The Casualty Service
  • The Rehab Services
  • Occupational hygiene services
  • Social Services
  • The records
  • The Future as it was in 1963

If you would like to know more about Corporate health please do note hesitate to contact us. The blog was recreated from extracts of ‘Venture into industry’ ‘The Slough Industrial Health Service 1947-1963’ Author A.Austin Eagger.

www.corporatehealth.co.uk

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: