In occupational sickness and health

Phil Revell examines how to combat the high illness-related absence rates of teachers.

ABOUT 6,000 teachers phoned a teacher helpline in the past year, mostly to complain of stress and overwork. And the first official survey of teacher illness has revealed the loss of 2.5 million teacher-days a year. No wonder, then, that the Government is about to issue new advice on how to manage staff sickness in education.

Six out of 10 teachers took sick leave last year for an average of 10 days - a higher average than for most businesses, according to CBI figures which suggest a national average of less than eight days.

Figures like these have led teacher employer organisations to propose stricter procedures in distinguishing genuine sickness from "suspect absence" in order to reduce absenteeism. Education Secretary David Blunkett, meanwhile, has set a target of a 20 per cent reduction in teacher-absence next year.

Now the Department for Education and Employment is to issue guidance on how to achieve this. The advice is expected to include suggestions for education managers on the use they can make of their local authority's occupational health service to reduce sickness-related absence and improve the health of their workforce.

But an occupational health service on its own will not be enough, warns the Institute of Personnel Development's Diana Sinclair. "High absence levels need to be tackled on all fronts." She advocated a well-managed return-to-work procedure where staff were interviewed about the causes of their absence and records kept to indicate trends.

Such a policy might have identified the kind of problems faced by science teacher John Gill. He was head of science at The Royal Manor School in Dorset who became disabled through years of exposure to carbon monoxide gas leaking from a defective boiler.

Managers misinterpreted his poison-induced lethargy and, far from investigating school-based causes of his illness, instituted competence proceedings in an attempt to have him dismissed. Dorset did not admit liability in the subsequent court case, arguing that the boiler fault was a "one-in-a-million chance" that could not have been detected by maintenance. But their insurers did pay out pound;500,000.

Proper investigation of patterns of illness could prevent similar tragedies. Zelda Thomas, senior occupational health nurse with Wolverhampton LEA, identified stress as the most frequent cause of a referral, but other cases were caused by ergonomic problems in the school, possibly leading to repetitive strain injury.

Occupational health practitioners can also advise on the best strategy for a phased return to work and offer advice on how schools can meet their obligations under disability legislation.

But one of the problems with such services is that they are usually centrally-based, which can make them diffiult for teachers to access. The result is that schools may often be paying for a service that they underuse.

Denis D'Auria is well aware of the problems faced by employees whose work ties them to a particular location. D'Auria is the director of occupational health at St Bartholomew's amp; London NHS Trust. "There's a similar problem in ambulances," he says. "Staff can't just walk off the job when they like."

Occupational health is preventative, he argues, but adds: "There's an in-built tension in some services between managers - who see the role of the service as forcing down absence rates - and medical staff, whose responsibility is to the patient.

"I would hate to think that any of my colleagues were into policing absence," D'Auria says. "But managers frequently see it in precisely those terms."

D'Auria is concerned about teachers' overuse of their most important professional tool: their voice. Voice clinics have identified up to one-third of all enquiries as coming from teachers, and Midlands teacher Patricia Clowry won a claim for industrial injury in 1995 after developing nodules on her vocal chords.

"Someone should finance some work into this as a matter of urgency and teachers should be given training in how to recognise throat problems and in how to use their voices," says D'Auria.

But the major occupational health problem in teaching is the non-stop working day. "It's a resource issue," says D'Auria. "Just as doctors and nurses won't allow a patient to be compromised, teachers too often give all their free time to school. They are putting their health on the line."

He argues that a genuine occupational health strategy for education would address that culture. "You don't find teachers in the United States or on the Continent giving up their lunch hours to supervise children or staying after school to run clubs," he says.

It will be interesting to see which side of the occupational health equation the new DFEE advice opts for. Will it be the preventative, employee-centred approach Denis D'Auria would advocate? Or will the emphasis be on the policing of absence, with the real issues faced by teachers remaining unaddressed?

In the past, ministers have consistently supported initiatives which have crammed even more into an already crowded working day. Are they now about to attempt to rid schools of a culture which sees teachers' time as an elastic commodity?

The most common causes of absence in non-manual occupations:

1 Minor illnesses (colds and flu)

2 Stress

3 Recurring medical problems: asthma, angina, allergies.

4 Back pain

5 Other muscular-skeleto injuries

6 Acute medical conditions: stroke, cancer.

7 Home family responsibilities

8 Absence for reasons not seen as genuine

Source: Institute of Personnel Development Tel: 0208 263 3240

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