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9 Working Within the Law
in Industry
There are all kinds of external agendas and pressures that determine the scope and
boundaries of our practice the most obvious being legislation. While occupational
therapists are not expected to have an in-depth understanding of the law and the legal
system, it is important that the practitioner is familiar with the most relevant legislation
that governs their particular specialty, and practices within the law. The employment
sector has additional legislation which will be of relevance to the occupational thera-
pist working in vocational rehabilitation (VR). Policies that the practitioner will need
to be familiar with may usefully be grouped under health and safety and disability
rights . This chapter provides an overview of the pertinent legislation and regulations
in these two areas, as well as the bodies responsible for producing and enforcing
the various regulations and laws. This chapter will also touch briefly on some other
relevant Acts.
Health and safety legislation, which is primarily designed to safeguard and protect
workers in the UK, is a particularly wide field, therefore this discussion is limited to
looking at the legislation which is applicable to all workplaces, irrespective of the
type of work that is undertaken. It is important to be aware that this chapter is by no
means exhaustive, and that within industries where there is a higher risk of health
and safety problems, such as agriculture and construction, additional regulations will
apply. Policy is regularly updated, so occupational therapists involved in VR are
advised to take steps to stay abreast of these changes.
THE HEALTH AND SAFETY AT WORK ACT
The Health and Safety at Work etc. Act (1974) forms the basis for the system of
regulating health and safety at work in the UK. For this reason, the occupational
therapist who practises in the workplace needs a sound understanding of this piece
of legislation, since it has implications for the return to work process. The Act itself
sets out basic principles of occupational safety, designed to protect all workers, re-
gardless of the industry in which they work. In doing so, it imposes statutory duties
on companies, managers and their employees. Before its introduction, only certain
groups of workers, in certain types of industry, had any sort of protection under the
existing laws. The main purpose, therefore, was to produce a thorough system of law
to raise the health and safety standards for workers across the board. This law also
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214 OCCUPATIONAL THERAPY AND VOCATIONAL REHABILITATION
covers members of the public who are not at work, but may be affected in some way
by the actions of the workers, such as customers and passers-by (Foot and Hook,
2005). Importantly, the Act also allows for older laws and outdated safety regulations
to be overhauled and updated, producing new codes of practice which are applicable
within the modern, ever-changing, working world.
THE HEALTH AND SAFETY COMMISSION AND THE HEALTH
AND SAFETY EXECUTIVE
The Health and Safety Commission (HSC) is a government body which came into
being as a result of the Health and Safety at Work Act (1974). It has statutory re-
sponsibilities for regulating health and safety in the UK, and its main function is to
safeguard the health, safety and welfare of people at work and the public. This is done
by proposing new laws and standards, carrying out research, and providing advice
and information (Health and Safety Executive, 2002a). The HSC, together with an
employer organisation called the Confederation of British Industry and the Trades
Union Congress, is responsible for national health and safety policy (Howard, 2000).
The Health and Safety Executive (HSE) is a separate organisation which advises
and assists the Commission, as well as having its own specific responsibilities. The
HSE recommends standards and provides guidance to the HSC, particularly where
new problems are encountered, or where potential hazards are inherent within a
particular type of industry, for example, within the nuclear power industry. The HSE
is responsible for enforcing the requirements of the Health and Safety at Work Act,
as well as a number of other Acts and statutory instruments which are relevant to
the working environment. The guidance, approved codes of practice, and regulations
which are produced by the HSE can be accessed from the extensive publication
library contained on their website: http://www.hse.gov.uk (accessed 06/05/07). Local
authorities complement the work of the HSE by enforcing the Act in specific sectors.
They appoint inspectors, usually known as environmental health officers, who are
responsible for distribution, office and retail, and leisure and catering services (Health
and Safety Executive, 2002a).
EMPLOYERS RESPONSIBILITIES UNDER THE HEALTH
AND SAFETY AT WORK ACT
Employers are bound by seemingly vast volumes of legislation and regulations which,
as we have just learned, are enforced by the HSE. Essentially, this reflects the fact
that they have a duty of care to ensure the health, safety and welfare of their em-
ployees. They also have to ensure the workplace is safe, and safely organised, and
that any equipment has been correctly maintained. They must ensure that there are
safe ways for people to get into and out of buildings. They must provide training
and information about health and safety and make sure that accidents don t happen
because of incorrect handling, storage or transportation within the workplace. They
must also make adequate welfare provisions for their staff. They may appoint a health
and safety officer to ensure that they are fulfilling their responsibilities.
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WORKING WITHIN THE LAW IN INDUSTRY 215
However, employees must also take responsibility for their own health and safety
and that of their colleagues. They must not act in a way that may cause health and safety
problems for others, and this may include failing to act. They must not recklessly
interfere with, or misuse, any machinery or equipment and must co-operate with
employers about health and safety initiatives.
OTHER HEALTH AND SAFETY REGULATIONS
A directive from the European Union in 1992 resulted in the introduction of six further
sets of regulations.
The Management of Health and Safety at Work Regulations 1992
The Health and Safety (Display Screen Equipment) Regulations 1992
The Manual Handling Operations Regulations 1992
The Workplace (Health, Safety and Welfare) Regulations 1992
The Provision and Use of Work Equipment Regulations 1992
The Personal Protective Equipment at Work Regulations 1992.
(Foot and Hook, 2005)
These regulations extended the existing health and safety law, and also placed addi-
tional requirements on employers. Since their introduction, several amendments to
these regulations have become necessary. The following paragraphs do not, there-
fore, present a full synopsis of the regulations or amendments, but just highlight those
aspects of the regulations which may have a particular relevance for occupational
therapists in their work.
The management of Health and Safety at Work Regulations 1999
These regulations updated those introduced in 1992, to make more explicit what
employers are required to do to manage health and safety. The employer s main re-
quirement is to carry out a risk assessment (you may remember that we discussed the
risk assessment process in an earlier chapter). Additionally, employers are required
to make arrangements to implement the health and safety measures identified during
the risk assessment and appoint a competent person(s) to help implement these ar-
rangements. They must also provide information and training to employees on health
and safety (Health and Safety Executive, 2003a). The competent person identified
here may well be an occupational therapist with the necessary skills and expertise.
This role is regularly fulfilled by occupational therapists in other countries.
The Health and Safety (Display Screen Equipment) Regulations 1992
This legislation was most recently amended by the Health and Safety (Miscellaneous
Amendments) Regulations 2002. Under the Health and Safety (Display Screen Equip-
ment) Regulations (1992) employers are required to undertake an analysis of all the
workstations used by their staff to assess and identify any health and safety risks to
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216 OCCUPATIONAL THERAPY AND VOCATIONAL REHABILITATION
the computer user. They must ensure that workstations meet at least the minimum
requirements. They are also required to plan, or provide for, short frequent breaks
or changes in activity within the work routine. These should preferably involve per-
forming other tasks away from the keyboard. Where a routine audit carried out by
an employer identifies problems, particularly musculoskeletal ones, an occupational
therapist may be called upon to undertake a comprehensive workstation assessment
to address these issues.
The Manual Handling Operations Regulations 1992
Also amended by the Health and Safety (Miscellaneous Amendments) Regulations
2002, the Manual Handling Operations Regulations 1992 aim to reduce the levels
of injury and ill-health associated with manual handling of loads at work. You may
recall that we examined some of the details of these regulations in an earlier chapter.
The effects of the legislation will vary across workplaces, depending on the nature
of the work being undertaken (Foot and Hook, 2005). When trying to determine
the potential risk involved in each manual handling activity, the employer must take
into account factors such as: the physical suitability of the employee, the clothing
worn, the knowledge and training which has been received, findings from previous
risk assessments and the level of risk involved in the activity. The HSE (2006a) has
produced a short guide that contains helpful details about good practice in manual
handling. This is available on-line at: http://www.hse.gov.uk/pubns/indg143.pdf
(accessed 20/04/07).
The Workplace (Health, Safety and Welfare) Regulations 1992
These regulations were also updated in 2002. They provide clear information about
what facilities the employer is expected to provide for employees, including a good,
clean working environment with adequate space, temperature control, ventilation
and lighting. Where a job requires the person to sit, the seating should be suitable
for the work being done, and for the person using it. It should provide adequate
back support and a foot rest should be supplied where needed. Under the amend-
ments, employers are also required to ensure that the design of equipment, such as
workstations, and facilities such as passageways, stairs, rest areas and washrooms,
which are used by disabled people at work are organised to meet the specific needs
of those workers. An on-line HSE guide (2006b) on this subject is available at:
http://www.hse.gov.uk/pubns/indg244.pdf (accessed 21/04/07).
The Reporting of Injuries, Diseases and Dangerous Occurences
Regulations 1995
These regulations require the employer to report work-related accidents, diseases and
dangerous occurrences to the HSE or local authority. For example, if a person who
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WORKING WITHIN THE LAW IN INDUSTRY 217
is on the employer s premises, whether an employee or a member of the public, is
killed or taken to hospital, it must be reported. This action must also be taken when
an employee is absent for more than three days following a violent incident or injury
at work, or an employee is diagnosed with a reportable work-related disease. The
relevant authority must also be notified in the case of a near miss (Chambers et al.,
2001).
Other relevant employment legislation
The Chartered Institute of Personnel and Development (2006a) suggests that the
main legal tools for employers facilitating absence management are the Employ-
ment Act 2002 and the Employment Act 2002 (Dispute Resolution) Regulations
2004. The former relates mainly to statutory leave arrangements and the latter to
grievance and disciplinary procedures. Further information on these, and other em-
ployment matters, can be obtained from the Department for Trade and Industry,
which has responsibility for employment legislation of this nature (http://www.dti.
gov.uk/employment/index.html, accessed 03/05/07). A useful on-line resource, which
brings together a wide range of public service information and services, and provides
straight-forward advice for employees about work employment rights and responsi-
bilities can be found at: http://www.direct.gov.uk (accessed 03/05/07).
THE DISABILITY DISCRIMINATION ACT
The Disability Discrimination Act (DDA) was passed in 1995 to address the discrim-
ination that is faced by many disabled people. In 2004 it was estimated that around
700,000 children and 10 million adults in Britain were considered to be disabled and
were therefore covered by the terms of the Act. At the time, about one in five was
a person of working age. More recently, the number of working age adults has risen
by half a million, to 5.7 million people, reflecting a general trend in the population to
report milder health conditions and disabilities (Department for Work and Pensions,
2006b). By far the greatest majority of this group will have acquired their disability at
some point during their life, since just a small percentage (17 per cent) of those who
are disabled will have been born with their particular condition (Disability Rights
Commission, 2006).
Different parts of the DDA legislation have taken effect at different times, and,
in common with other legislation, there have been a number of amendments to the
original Act. For example, in 2004, four kinds of discrimination were identified:
direct discrimination, failure to make reasonable adjustments, disability-related dis-
crimination and victimisation. The following year, The Disability Discrimination Act
2005 introduced a disability equality duty into the Act. This duty came into effect
in December 2006, and is aimed at overcoming systemic discrimination. It requires
public authorities to promote equality of opportunity for disabled people in the way
they conduct their business. The scope of the DDA was also extended to include
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218 OCCUPATIONAL THERAPY AND VOCATIONAL REHABILITATION
people with HIV infection, cancer or multiple sclerosis, and the requirement that a
mental illness must be clinically well-recognised was removed.
As far as public understanding of the DDA goes, it has been suggested that
employers, particularly those in smaller companies, tend to have a narrower per-
ception of what constitutes a disability than that stated in the DDA. Disability is
often understood in terms of visible, physical impairments. There remains a need
for general education, to raise awareness about the nature and breadth of disability
(Roberts et al., 2004), and occupational therapists may be well-placed to provide this
education.
A person is disabled under the terms of the DDA if:
they have a mental or physical impairment
AND
the impairment has an adverse effect on the person s ability to carry out their
normal day-to-day activities in at least one of the following areas: mobility; manual
dexterity; physical co-ordination; continence; ability to lift, carry or move everyday
objects; speech, hearing or eyesight; memory or ability to concentrate, learn or
understand; understand the risk of physical danger
AND
the adverse effect is substantial and long term, in that it has lasted for 12 months,
or is likely to last for more than 12 months.
When determining if someone is disabled under the terms of the Act, any treatment
or correction (such as a prosthesis) should not be taken into account (except glasses
and contact lenses). If the impairment is no longer substantially affecting the person s
ability to carry out their normal day-to-day activities, but it has done so in the past
and is likely to do so in the future, it still counts as a disability under the DDA.
Furthermore, if the person has a progressive condition which will substantially affect
their abilities in the future, it is covered by the DDA from the moment it has some effect
on normal everyday activities. Some conditions, namely cancer, HIV infection and
multiple sclerosis, are automatically covered, as are people who have been certified
as blind or partially sighted by a consultant ophthalmologist.
Section 2 of the Act is concerned with employment. It requires employers to make
reasonable adjustments for a disabled person put at a substantial disadvantage by
a provision, criterion or practice, or physical feature of the premises. What counts
as reasonable depends on a number of factors, such as the size and resources of
the organisation, how practical it is, how disruptive, the costs involved, and how
effective the adjustment might be in overcoming the disadvantage (Disability Rights
Commission, 2004).
Some suggested reasonable adjustments in the amended DDA (2004) include:
alterations to premises
re-allocating certain duties to others
altering working hours
allowing time off for rehabilitation, treatment and assessments
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WORKING WITHIN THE LAW IN INDUSTRY 219
providing additional training and modifying equipment (Howard and Cox, 2000)
mentoring, providing supervision or a reader/interpreter
modifying instructions or manuals.
However, as is witnessed from this list, the majority of accommodations that
are described in the literature concern physical rather than psychiatric disabili-
ties (MacDonald-Wilson et al., 2002). Barriers to providing accommodations for
this group are identified as: resources, issues around disclosure, the attitudes of
co-workers, and communication difficulties. Providing accommodations for people
with a mental illness is often inexpensive, but they do require observation, flexibility
and good management (Pollet, 1995). Further American studies have suggested the
following accommodations at work for people who have a mental health problem:
training of supervisors
modifications of the non-physical work environment (Fabian et al., 1993)
emotional support
flexibility
supervision
wages and benefits
addressing co-workers attitudes.
(Parrish, 1991)
In addition, it is suggested that guidance and information about psychiatric disabilities
needs to be provided to employers, especially in the area of interpersonal relationships
(Marshall, 1995). Further up-to-date information about the DDA can be found on
the Department for Work and Pensions website http://www.dwp.gov.uk (accessed
19/07/07).
THE DISABILITY RIGHTS COMMISSION ACT
The Disability Rights Commission Act (1999) led to the establishment of the Dis-
ability Rights Commission in 2000. The Commission s statutory duties include:
working to eliminate discrimination against disabled people
promoting equal opportunities for disabled people
encouraging good practice in the treatment of disabled people
advising the government on the working of disability legislation, such as the Dis-
ability Discrimination Act 2005
enforcing the law in the public interest (it is therefore able to provide support for
certain individual cases, as well as conducting formal investigations).
The Disability Rights Commission has produced a comprehensive Code of Prac-
tice on Employment and Occupation (2004). This code contributes to the Commis-
sion s mission to eliminate discrimination against disabled people. It gives practical
guidance on how to prevent discrimination against disabled people in employment,
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220 OCCUPATIONAL THERAPY AND VOCATIONAL REHABILITATION
or when they are seeking employment. It describes the duties of employers and
others, and is intended to assist employers to prevent workplace disputes. It also
helps to explain what the law means for disabled people and what they can do if
they feel that they have been discriminated against. The Code can be accessed on-
line at: http://www.drc.org.uk/library/publications/employment/code of practice -
employment.aspx (accessed 28/04/07).
OTHER RELEVANT LEGISLATION
There is other relevant legislation which protects the rights of people as individuals,
irrespective of whether they have a disability or not. Let us consider, very briefly, how
these might apply to the occupational therapist in VR.
The Data Protection Act
The Data Protection Act (1998) governs the use of personal information by businesses
and organisations. Some information, such as a physical or mental health condition,
is classified as sensitive information and is subject to tighter controls under the terms
of the Act. Such information may only be used when there is an essential need to use
it or where the individual has given their explicit consent. Therefore, you must ensure
that you, as a health professional, ensure the confidentiality of the personal details
which your client shares with you. You may not divulge this information to another
person, particularly the client s employer, without their consent. It is important to
discuss with the client what they are prepared to let their employer know about their
health condition or disability.
Employees may be fearful of revealing this type of information if they feel that
it may jeopardise their job. Since the unscrupulous employer may indeed use this
information for other purposes, their concerns may well have validity. On the other
hand, however, the employer cannot be expected to make reasonable adjustments,
under the terms of the DDA, if the employee refuses to make known that they have
a disability. On this point, it is worth noting that it is not impossible to encounter a
situation where the employer has been informed, by an occupational health physician,
that they need to make adjustments for an employee who is protected by the DDA, but
they have not been told what accommodations are needed. This seems, to me, to be
a rather untenable situation for both parties. There is far less risk of potential conflict
between the two positions where a basic level of trust underpins the relationship
between the client and their employer. This is what you should be aiming to achieve,
wherever possible. For further information, the Data Protection Act can be found on-
line at: http://www.opsi.gov.uk/ACTS/acts1998/19980029.htm (accessed 01/05/07).
Additional laws which are of relevance are The Human Rights Act (1998), which
includes working rights, and The Employment Equality (Age) Regulations (2006)
which makes it unlawful to discriminate on the grounds of age, unless there is a
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WORKING WITHIN THE LAW IN INDUSTRY 221
justifiable reason for doing so. The regulations cover recruitment, terms and condi-
tions, promotions, transfers, dismissals and training.
IMPLICATIONS OF LEGISLATION FOR THE OCCUPATIONAL
THERAPIST IN VOCATIONAL REHABILITATION
As stated at the outset, this is not a comprehensive outline or list of the laws affecting
VR, nor could it possibly be so. Laws must be interpreted, and so as each new case
is brought before the courts it adds a further dimension to how that law is intended to
be applied and understood.
Having read through the laws and regulations which have been outlined above you
will no doubt have recognised the need to strike a delicate balance. This balance must
be, on the one hand, between the rights of any individual not to be discriminated
against and to have every opportunity to participate in meaningful work. On the
other, it concerns the duties placed on an employer to ensure that they adhere to
robust working practices, for the health and safety of all employees as well as any
members of the public who might be affected by their actions. Finding this middle
ground perspective in VR is important, because it would be unreasonable to expect
an employer to contravene health and safety regulations, in order to comply with
disability discrimination law, or vice versa.
Many occupational therapists may currently be unfamiliar with health and safety
legislation, since it is seldom a core element of existing undergraduate programmes
(Ross, 2006). However, you will see from the brief discussions above that there
is an increasingly visible role for knowledgeable occupational therapists to assist
employers to meet their obligations in this area.
OTHER ORGANISATIONS IN WORK, HEALTH
AND DISABILITY
There are a significant number of other organisations which play a direct, or an
indirect, role in aspects of workplace health and safety, or in disability and work
matters, and it may be helpful for the occupational therapist who wants to gain
an understanding of the wider picture, to familiarise themselves with just a few of
them.
The Commission for Equality and Human Rights
This Commission is still in the planning stages, and is expected to be created in the
autumn of 2007. It will include the Disability Rights Commission, which we read
about earlier, as well as two other existing equality commissions.
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222 OCCUPATIONAL THERAPY AND VOCATIONAL REHABILITATION
The Office for Disability Issues
This new office was brought into being in 2005 and its purpose is to co-ordinate
disability policy across government departments and drive forward the recommen-
dations which were outlined in Improving the Life Chances for Disabled People
(Department of Work and Pensions, et al., 2005). For further information about their
current priorities visit: http://www.officefordisability.gov.uk/ (accessed 11/05/07).
The Industrial Injuries Advisory Council
The Industrial Injury Disability Benefit Scheme is a state benefit which provides
weekly compensation for people injured at work in industrial accidents and with cer-
tain prescribed diseases. Matters concerning the administration of the benefit scheme
are dealt with by the Industrial Injuries Advisory Council (IIAC). It is a statutory body
which was established in 1948. The IIAC s role is to provide independent advice to the
Secretary of State for the Department for Work and Pensions, as well as to advise on
the prescription of diseases. It monitors and reviews new scientific evidence about cer-
tain diseases which may have an occupational link, and then decides whether the list of
prescribed diseases, for which benefit may be paid, should be expanded or amended.
For interested readers, the full list of diseases covered by the Industrial Injury Dis-
ability Benefit may be found at: http://www.iiac.org.uk/prescribed diseases/index.asp
(accessed 28/04/07).
Advisory, Conciliation and Arbitration Service
The Advisory, Conciliation and Arbitration Service (ACAS) is a publicly funded or-
ganisation that was founded in 1975. ACAS provides independent, voluntary and con-
fidential services to organisations which are intended to improve working life through
creating better employment relations. They provide a range of training and work with
employers and employees to resolve problems, such as disputes and disagreements at
work. They will assist in the management of conflict, directed towards reaching an ac-
ceptable solution without involving, for example, an employment tribunal. They have
produced recent guidance on age discrimination in the workplace (Advisory, Concilia-
tion and Arbitration Service, 2006), and tackle discrimination and promoting equality
(Advisory, Conciliation and Arbitration Service, 2005), which is concerned with any
form of discrimination, including sex, race, disability, sexual orientation and religion.
Further information about ACAS can be found at: http://www.acas.co.uk (accessed
19/07/07).
Trades Union Congress
The Trades Union Congress campaigns for a fair deal at work, as well as for social
justice in the UK and abroad. It has 66 affiliated unions and represents about seven
million working people. It advises people about their rights at work as well as being
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WORKING WITHIN THE LAW IN INDUSTRY 223
a major contributor to the national policy debate on the need for better access to
occupational health services and the protection of workers health and safety while at
work. More information can be found at: http://www.tuc.org.uk (accessed 05/05/07).
Professional Organisations in Occupational Safety and Health
Professional Organisations in Occupational Safety and Health (POOSH) is an or-
ganisation which exists to promote the continuous improvement of the practice of
occupational safety and health. It focuses in particular on education, communication
and the encouragement of co-operation between all persons and agencies involved
in the provision of a healthy and safe working environment. For the occupational
therapist, the website www.poosh.org is a good resource for finding out about differ-
ent professional groups and bodies within occupational health and safety in the UK.
Organisations currently represented on POOSH include:
Association of Occupational Health Nurse Practitioners (UK)
British Occupational Hygiene Society
Chartered Institute of Environmental Health
Ergonomics Society
Faculty of Occupational Medicine
International Institute of Risk and Safety Management
Institute of Risk Management
Institution of Occupational Safety and Health
Royal Environmental Health Institute of Scotland
Royal Society for the Promotion of Health
Royal Society of Chemistry
Safety and Reliability Society
Society of Occupational Health Nursing
Society of Occupational Medicine.
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