The Comparison of Health Systems in Great Britain and the Caribbean - Essay Example

Before one moves or opens a company dealing directly with public health and safety from one country to another, it’s important to understand the similarities and differences between the common practices of each country involved. Without this knowledge, it would be difficult to obtain the proper permits and licenses necessary to operate the business as the impact to the surrounding community can present a variety of health and safety concerns. Most countries require some sort of attention be given to these concerns prior to granting approval to operate any type of business activity within their borders. The way in which they do this varies, however, from one country to the next. While the Caribbean islands handle this administration through a prescriptive approach, the UK uses something called goal-setting strategies to ensure basic human health and safety standards are met. This particular method of enforcing compliance is quite different from prescriptive strategies in many ways, which will be enumerated through various examples throughout this document. Companies that operate in more than one country may find it beneficial to meet the most restrictive of the requirements set forth by both countries, but can only do so once those requirements are delineated and compared. By understanding the current conditions and prescriptive strategies used in the Caribbean as well as the conditions and strategies used in the UK, one can compare the similarities and differences between the two systems and adjust each for maximum goal-setting strategy development prior to company relocation. In discussing prescriptive strategies versus goal-setting strategies, it is important to understand the difference between the two. Although legislation can be created in any country that governs the use of goal-setting strategies as well, the use of the term prescriptive strategies as it is used in this document will refer to all health and safety management strategies that are specifically outlined in legislative form. In other words, these strategies are required by mandate as a means of meeting basic minimum compliance levels, and tend to spell out the exact requirements, methods, practices and means of reporting or record keeping in the areas of health and safety management for employees and companies operating within a specific governmental sphere. These minimum requirements can be applied to any kind of health or safety issue including environmental concerns at large, employee health plans or allowable workforce demographics. Goal-setting strategies, on the other hand, will refer to those strategies developed through objective decision-making obtained through step-by-step analysis of various situations, practices, job duties, equipment use and environmental dangers presented as well as close consideration of those minimum requirements set forth by the prescriptive laws. Goal-setting strategies tend to be more amorphous, lending themselves more to individual interpretation and implementation and a necessarily more active role taken by all individuals throughout the development and implementation process. They are also more adaptable to needed change for region-specific customization and therefore can more adequately implement best practices. By enforcing the use of goal-setting strategies, the government of the UK is attempting to increase the level of health and safety throughout their countries. Health and occupational safety legislation as it exists in the Caribbean leaves much room for improvement both in the quantity of issues covered as well as in the methods by which companies must show their compliance. A look at the current legislation in Trinidad and Tobago reveals only two pieces of legislation added to the books in recent years (Trinidad and Tobago, 2005). Although the Occupational Safety and Health Act of 2004 sets forth provisions for general duties of employees to employers, employers to employees and companies to the surrounding environment, the only reaction required of the company is that it follows the guidelines set forth. There is no interaction between the company and the legislation and no real responsibility on the part of the company to define its own best practices given the specific environment and conditions involved in daily operation and production. Practices concerning such specific issues as defining pregnancy among female workers, their associated required notifications and employment status within the company are expressly defined, but little attention is given to exactly what constitutes safe employment for pregnant workers within the specific industry or environment (Trinidad and Tobago, 2005). Risk assessment does appear deep within the document, primarily in the formation of a safety and health committee comprised of members of the company (employer and employees) when there are more than 100 workers employed. These committees’ chief function is to respond to perceived threats to safety or health within the workplace rather than to identify them prior to implementation. Risk assessments required to be completed by employers are not specific as to demographics of the workforce or smaller companies. As in the health and safety committees, risk assessments are only required when the company employs more than 25 people and self-employed people are not mentioned. Santa Lucia is another Caribbean country that is reported to have fairly modern health and safety laws, but are only now reaching a beginning level of participation. “In most of the countries, however, the existing legislation is largely outdated. The statutes do not apply to all workplaces and penalties do not provide effective deterrent to OSH violators. Also, the existing legislation does not have provisions for current industrial practices, workplace technologies, physical, chemical and biological hazards” (Jiwa, 2002). In addition, many of the countries of the Caribbean place OSH responsibilities in the hands of a variety of departments, making it difficult for any concerted reform or enforcement. The United Kingdom, on the other hand, has at least 38 new pieces of legislation adopted in the past decade that deal specifically with occupational health and safety (United Kingdom, 2005). The disparity in the number of pieces of legislation involved immediately indicates a much more vital, involved and organized governing body in the UK than what is present in the Caribbean. As in the Caribbean, these laws change slightly from one province to another. However, in the UK, they are all are based on the same goal-setting strategies rather than the specifically worded prescriptive strategies of the Caribbean. The United Kingdom’s Management of Health and Safety at Work Regulations of 1999, for example, begins with risk assessment, principles of assessment and many other proactive measures before beginning to enumerate specific duties deep into the document. This is a precise reversal of the order seen in the most modern Caribbean documents. Risk management under the UK document extends to include assessment of risks to self-employed people, includes assessment of risks to young people if they are to be employed and is applicable for companies of as few as five workers (Management of Health and Safety at Work Regulations, 1999). In addition, law in the UK requires companies to ensure employees are provided with appropriate health surveillance to guard against any risks identified through these assessments and that appropriate materials and protective gear are provided to meet every risk identified. Some of these provisions are also made in the Caribbean laws, however, they are deeply buried within the document and do not cover such detailed areas as the specific risks to young people or smaller companies. Finally, to ensure compliance among the various organizations and the current legislation, companies in the UK are asked to employ at least one individual who is deemed to be competent in the areas of risk assessment and management (Management of Health and Safety at Work Regulations, 1999). Within this portion of the document, the specific duties and functions of this position are clearly spelled out to ensure all relevant material and information is amply provided to the assessor. Unlike the legislation provided in the Caribbean, risk assessment specifically as it relates to pregnant women and younger workers is clearly spelled out and required. The Caribbean legislation indicates various policies protecting pregnant women, but did not include specific assessment regarding what was considered hazardous for pregnant women. With the inclusion of such details, the UK has the built in requirement that employers reassess health and safety factors as often as changes in equipment, workforce demographics or other matters arise, resulting in a much higher rate of revision and adaptation to workplace-specific risks. The position of these provisions at the very beginning of the document further illustrates the importance placed on these requirements and demonstrates the interaction between legislation and company policy in the form of the on-staff expert in assessment and management. Similarly, legislation protecting the greater public health and environment is noticeably lax in the Caribbean as compared to the legislation currently in effect in the UK. In the Bahamas, for example, legislation to create the country’s Department of Environmental Planning and Protection was only introduced in 2005. This draft document defines the ability of the newly created department to develop and implement plans regarding land use; conservation of surface waters, wetlands and mangroves; oversight of groundwater maintenance; and the creation of an entire siting system to be used in the future (Environmental Planning and Protection Act, 2005). The Trinidad and Tobago government created a unified Environmental Management Authority as early as 1995. This organization has since been working to establish working relationships with other state agencies, draft new legislation, draft environmental codes and establish a means of enforcing those codes, but have just begun enacting these new policies (McIntosh, n.d.). Jamaica is further ahead than most of the other countries in the Caribbean in terms of environmental controls. This is evident in the development of specific legislation such as the Natural Resources Conservation Authority Air Quality Regulations of 2002. However, even this most modern of laws is based on a prescriptive approach, indicating what companies can and cannot do, but not offering incentives, programs or other strategies to assist in developing new ways of protecting the greater environment (Minister of Land and Environment, 2002). Even in these more environmentally conscious countries where legislation is present, regardless of how new, most of them are facing additional problems of having the responsibilities for enforcement split between too many departments, sandwiched into already overburdened departments, and/or lack of funding for the necessary manpower and equipment. Environmental controls in the UK are much more stringent as well as sternly enforced. To ensure companies operating upon their soil take an active interest in protecting the natural resources and public health of the surrounding community, legislation in this area, too, is based on the step-by-step process of the goal-setting system. “The starting point and main principle of the HSW Act is that it is those who create risk from work activity who are responsible for the protection of workers and the public from any consequences” (Health and Safety Executive, 2002). Although some of the regulations included in the act are specific and read much like the prescriptive laws seen in the Jamaican document, the UK document mandates employers must take up the challenge of assessing risks and taking appropriate action if they wish to operate in these countries. For example, instead of requiring a company to meet a specific maximum percentage of ground level concentration of a pollutant emitted from the facility, the UK law requires the company to conduct its own risk assessment of the emission of said pollutant and take steps to correct the pollution situation “up to the point where the taking of any further steps would be grossly disproportionate to any residual risk” (Health and Safety Executive, 2002). In the way that the act is written, it is incumbent upon the company in question to do everything “so far as is reasonably practicable,” but this somewhat ambiguous statement is imbued with the strict interpretation that the least possible damage to the environment and public health should be allowed. This interpretation is further backed up with the proper funding and concentrated manpower available to enforce these laws. In the three countries of England, Scotland and Wales, there are more than 400 local authorities whose prime responsibility is the enforcement of health and safety regulations in more than one million locations (Health and Safety Executive, 2002). More than simply regulating a select few types of businesses who have blatant effects on the surrounding environment, the regulations in the UK cover every industry conducted within its borders including offices, hotels and residential care as well as the more obvious petrol filling stations and, of particular note, leisure industries. Another strong difference between health and safety practices in the UK as opposed to the Caribbean exists in the relationship labor unions share with their associated governments. Because of the violent association between labor unions and reform in recent (last 100 years) history, there is still a strong rift in the partnership between unions and government in many of the Caribbean countries. Even as recently as 2005, an agreement between trade unions and the First Caribbean International Bank was a rare enough occurrence to warrant media coverage. “Speaking at the historic event, Director of the ILO’s Programme for the Promotion of Management Labour Cooperation, Dr. Andre-Vincent Henry cautioned both parties not to expect that decades of suspicion and low levels of trust will suddenly disappear as a result of the signing” (Bennett, 2005). This lack of cooperation between the labor organizations, the corporations and the governments paradoxically reduces the effectiveness of any legislation passed on behalf of occupational health and safety. Although progress has been made to bring new legislation to the table, most Caribbean countries don’t have the funding or organization required to make the changes stick. The adversarial nature of the union/corporation relationship in most Caribbean countries prevents them from working in concert to solve the common issues regarding the health and safety of both employees and the general public. Rather than being able to consider ways in which both employees and corporations can win, these relationships are typically characterized by a “If I win, you lose” perspective. The benefits to be gained by establishing cooperation between unions and organizations have been recently reported on in a Caribbean study conducted on UK union relationships. In this study, it was shown that unions can have a significant impact on health and safety statistics within the workplace when such cooperation is possible. One of the reasons given for this is that the unions can then concentrate on making sure their safety representatives are well-trained (National Union of Government and Federated Workers). This removes some of the burden from the company’s shoulders while also reassuring employees that health and safety regulations are going to be applied as recommended by law. This concentrated attention further enables specialists to keep up with changing legislation, new awareness of health concerns and updated techniques that might further reduce risk of injury. “The survey also found that over 80 percent of safety representatives had received training in health and safety in the last two years, compared to 44 percent of managers” (National Union of Government and Federated Workers). The proactive approach ensures safety inspectors and laws are constantly revised for best possible practice. Because they are frequently working in close association with the workers on the floor, union representatives have been shown to be aware of risks and health concerns long before management realizes a problem exists. This same close association can also assist in finding a solution to the problem in a much shorter duration of time than it might otherwise require should management alone attempt to tackle the problem. Finally, the comfort level among employees being able to speak to an individual regarding concerns without risking irritating their employer fosters an increased interest on the part of those same employees to maintain a safe and efficient working environment (National Union of Government and Federated Workers). By having the personal presence in the workplace with a comfort level at both the worker and the employer levels, a stream of communication is created that works together for the benefit of the organization as a whole. By forcing the companies themselves to conduct risk assessments and implement changes to reduce those risks in combination with strong enforcement of the policies that require such assessments take place and the cooperative presence of the trade unions, the UK has shown a much lower injury rate and a healthier workforce than proportionate statistics demonstrate in the Caribbean. In “The Union Effect” (2004), it is cited that unionized workplaces show a 24 percent reduction in workplace injury than those places without union representation. A cited Canadian study showed nearly 80 percent of unionized workplaces show high compliance with health and safety regulations while less than 60 percent of non-unionized companies held similar compliance. Statistics indicate injuries are the leading cause of premature death in the Caribbean even though it is anticipated that the available numbers are inaccurate because many injuries remain unreported in many of these countries (Ezenkwele, Holder, 2001). This is something attributed primarily to poor risk management within the workplace. By comparison, the leading cause of premature death in the UK is attributed to coronary heart disease (British Heart Foundation, 2005). With all these major differences in labor unions, goal setting versus prescriptive laws, environmental regulations and much more, it’s difficult to know where to begin to prepare the company for a move to the UK from the Caribbean. We must begin by reviewing the specific laws of the UK dealing with air pollutants released from our surfing goods manufacturing as well as current equipment and materials used within our Caribbean plant. For this, it may be beneficial to request some additional information from the UK labor unions as we prepare to conduct our own in-house risk assessment. Prior to moving, the company should conduct a highly detailed assessment of health and safety risks taking into account the closed air spaces of the UK and our specific site location. Once the hazards are identified and evaluated according to a structured hierarchy of greatest hazard to least, a plan should be developed to address these issues and minimize each risk to the greatest affordable degree (Lee, n.d.). Particular attention should be given to the risks associated with special needs employees, female workers and younger workers. By doing this, we will become somewhat more familiar with the difference in regulations between the two governments and will be taking the first steps toward cooperation with the existing labor unions in the UK. References Bennett, D. (6 July, 2005) Historic Signing Between First Caribbean Bank and Regional Trade Unions. Caribbean Net News. Retrieved 20 December, 2005 from < http://www.caribbeannetnews.com/2005/07/06/signing.shtml> British Heart Foundation. (2005). 2005 Coronary Coronary Heart Disease Statistics. Department of Public Health. Oxford: University of Oxford. Retrieved 20 December, 2005 from < http://www.bhf.org.uk/professionals/uploaded/factsheet2005finalaw.pdf>. Environmental Planning and Protection Act. (2005). The Government of the Bahamas. Retrieved 20 December, 2005 from < http://www.best.bs/Webdocs/Draft_Enabling_Legislation_A_Bill%20_final_doc.pdf> Ezenkwele, U.A. and Holder, Y. (2001) Applicability of CDC Guidelines Toward the Development of an Injury Surveillance System in the Caribbean. Injury Prevention. Retrieved 19 December, 2005 from < http://ip.bmjjournals.com/cgi/content/full/7/3/245>. Jiwa, S. (2002). Situation Analysis. Worker’s Health and Safety in the Caribbean. West Indies. Retrieved 20 December, 2005 from < http://www.cehi.org.lc/wh/SituationAnalysis.htm> Health and Safety Executive. (2002). The Health and Safety System in Great Britain. Norwich: Crown publishing, pp. 14-17. Retrieved 20 December, 2005 from < http://www.hse.gov.uk/pubns/ohsingb.pdf> Lee, A. (n.d.). Practical Risk Management. Norwich Union Risk Services. Aviva plc. Retrieved 17 December, 2005 from < http://academia-research.com/files/message/41931_irm_nw_group_nu_health_safety.pdf> Management of Health and Safety at Work, The. (1999). Statutory Instrument 1999, No. 3242. Norwich: Crown publishing. Retrieved Dec. 20, 2005 from < http://www.strathclydepolicefederation.org.uk/news_&_information/health_&_safety/uk_si_1999_3242.pdf> McIntosh, D. (n.d.). Establishment of the Environmental Management Authority in Trinidad and Tobago. Environmental Management Authority. West Indies. Retrieved 20 December, 2005 from < http://www.sidsnet.org/successtories/29.html> Minister of Land and Environment. (June 2002). The Natural Resources Conservation Authority Act. Jamaica. Retrieved 20 December, 2005 from < http://www.nrca.org/regulations/AirQuality_RegulationsJune2002.pdf> National Union of Government and Federated Workers. (2 August, 2004). The Union Effect. TUC Online. Retrieved 17 December, 2005 from < http://nugfw.org.tt/health_safety/the_union_effect.htm> Trinidad and Tobago. (2005). International Digest of Health Information. World Health Organization. Retrieved 20 December, 2005 from < http://www3.who.int/idhl-rils/frame.cfm?language=english> United Kingdom. (2005). International Digest of Health Information. World Health Organization. Retrieved 20 December, 2005 from < http://www3.who.int/idhl-rils/frame.cfm?language=english> Read More