Book Review

Next year (2024) will mark the 50th anniversary of the United Kingdom's Health and Safety at Work Act (HSAWAct). Many at the time viewed the statute as a major step forward in the protection of the health and lives of workers throughout Britain. The act sought to replace the thousands of rules and regulations that had emerged as the result of piecemeal efforts to protect workers over the last hundred years. Numerous regulations were irrelevant, incomprehensible, and weak. Worse yet, they didn’t protect workers from the myriad real dangers in British workplaces or provide effective sanctions and supervision of employers who flaunted the rules and who put profits before the health of employees.

The HSAWAct was the result of two years of deliberation by a committee established to review the fragmented and broken health and safety system. It was chaired by Lord Alfred Robens. The final report, published in 1972, pushed for a new approach to workplace health and safety protection, the product of which is at the center of a new book by Phil James and David Walters, Work and Health: 50 Years of Regulatory Failure. As James and Walters succinctly put it, the proposed reforms and the act that followed sought: “… to shift governance and regulation of work health and safety away from prescription and towards a more principled and process-based approach …. (i)t argued that detailed specification standards, developed ad hoc in response to the emergence of particular safety issues, had resulted in a patchy application across workplaces and a primary focus on factory-based physical hazards, with important other hazards (especially health ones) not covered.” (p. 5) These problems were addressed by the 1974 act, passed under a Labor government, and resulted in a “triangle” of reforms that stressed the employer's responsibility for evaluating and controlling risks; worker representation that facilitated input and monitoring; and government regulation and improved workplace inspection and enforcement. All of this was achieved through the oversight of a tripartite authority—the Health and Safety Commission—with representatives from employers, workers and unions, and government agencies. These broad arrangements have been in place for 50 years. As the authors stress, this whole system assumed an identity of interest between workers and employers in reducing injuries and health threats in the workplace.

The core argument in this densely packed and extremely informative analysis is that the basic assumptions of the Robens Report, and the act it gave birth to, are fundamentally flawed. With careful attention to history and the changing structure of work, James and Walters explain why these flaws are now crippling (and have already crippled) the effective protection of the health and safety of workers. But they go much further, providing the reader with a map and specific ideas about how to replace 50 years of regulatory failure with a system that truly provides for safer workplaces in the UK. They never lose sight of the fact that safer workplaces can only be achieved when safe work is considered (and enforced) as a basic human right.

Their argument builds on two critical insights: That dangerous workplaces pose serious challenges to broader public health problems and should be recognized as such, and that work and health must be viewed from a worker's perspective—one that now has to take into account the vast changes in the nature and structure of work in the UK. This last point is particularly important since the shift from a manufacturing to a service economy, which began long before the Robens Report, has fundamentally changed the political economy of work. The United Kingdom, like the United States, is no longer a country of factory workers and miners, foundry workers, and farmers. Work today, in stores and warehouses, offices and transport, is very different. The technologies, the exposure to exotic (and mostly toxic) chemicals and processes pose very different threats to worker health and safety. These structural changes have emerged along with the neo-liberal onslaught and domination of market ideologies, the decline in union membership, and a vast change in the demographics of the workplaces. The HSAWAct was never designed to deal with these changes and never has.

In nine stately chapters, the authors provide us with extensive information and carefully reasoned arguments. There is a lot of data here, graphs and tables a-plenty. They begin by showing how political, economic, technological, and demographic changes contribute to increased and significant work-related health problems. These include the increase in insecure employment (contract labor, casualization, temporary work of all forms) and the related shift to a—largely unorganized—service economy. Technological changes increase stress as they demand and allow more subcontracting labor, less definition of the working day, and a technological speed-up that increases stress with all its subsequent physical and mental health problems. This context, for James and Walters, exacerbates the failures of the system that Robens promoted. primarily its assumption of continuity of interest between workers and management in controlling risks in the workplace. In the wake of the neo-liberalism abroad and Thatcherism in the United Kingdom from the 1980s on it is clear that there really is not such common interest and the voice and control of workers remained largely ignored, replaced by a voluntary compliance model and the endless reliance on training workers to manage the risks they are exposed to rather than demanding such risks be removed from the work environment. They rightly recognize that while the structure of work has changed over the last 50 years, the essential imbalance in power between management and workers has not. And that this relationship is now even more unbalanced in a world of temporary and contingent work and declining trade union power. This has, of course, been compounded by weak government regulatory oversight of the workplace and the failure to acknowledge the fundamental right of workers to have a safe and healthful workplace. The chapter they provide on the absence of a meaningful voice for workers to protect their health and safety is especially worthy reading for an American audience.

Having examined the various failures and disappointments that constitute the 50 years of regulatory failure, the authors are determined (and successful) in developing a list of well-thought-out recommendations for how this system might be changed. They concede that these recommendations are unlikely to be acted on any time soon, given the current political climate. Broadly speaking, the change they envisage includes ensuring that all employers (in whatever form or context of work) have a duty and responsibility to their employees (casual, contingent, temporary, etc.) in all cases when potential harms might occur. Ultimately, they call for a radical enhancement of the collective rights of workers at all levels linked to a set of minimum employment rights that provide workers with “(a)ccess to fair and decent incomes, greater employment security, treatment based on respect and personal dignity, and work that reflects these principles.” (p. 133) This, of course, is right.

What the authors have given us here is a holistic view and critique of the UK's health and system as it was revised and established with the HSAWAct. They rightly place the problems with the initial Robens report in its assumptions about the commonality of interest employer, workers, and the state have in reducing injuries and health risk in the workplace. They show how structural changes in the economy and the rise of global neo-liberalism have altered the landscape and power of workers in the UK. Their recommendations and the analysis on which they are built are well worth further study. Although in places heavy going, readers with find an enormous amount of valuable information in this study, well-reasoned analysis, and a timely critique of a regulatory regime flawed from the start and certainly no longer adequate for the world in which we live. The story of this regulatory failure is a valuable contribution to the work on occupational health and safety in the United Kingdom. It will also help readers in the United States to compare and contrast with the many failures of the Occupational Safety and Health Act and the subsequent sorry history of a once valuable set of protections for the American worker.