Maintaining a Population of Healthy Workers

Stafford Beer's cybernetic model of the Toronto healthcare system from 1986 presents some very interesting ideas for thinking about occupational health. 

Not least is what's in the middle. Normally we think of a health system as a means of treating sick people, so the population of sick people forms the focus of the system. By putting a population of healthy people in the middle, then the question becomes one of "how do you create a system to keep people healthy?". So it's not a huge step to think "How do you create a system to keep people healthy in work?"

On the left hand side, the distinction between "unrecognised ill" and "recognised ill" is important in organisations, because "ill" can be an indication of "bad for the organisation" rather than with immediate symptoms of ill-health individually. Also the "iatrogenic" loop - healer-induced sickness - contributing to the "known ill" rings true for many occupational health services - it is the "failure demand" of the system, where services which are meant to help, actually make things worse. 

Also at the bottom is the distinction between known needs and unknown needs, and the way in which known needs and expectations must be balanced and mediated by political concerns. 

On the right hand side there is the information environment and the personal self-management around health. This isn't much different in occupational health. Here, government and media coalesce with self-monitoring, education and social services to deal with known risks and unknown risks.

So if we put a "Population of healthy workers" in the middle of this, where do occupational health providers sit in the equation? Where does the DWP and government sit? Where does the NHS proper fit? What about self-help and lifestyle issues? Where do the cocaine habits of stock market traders sit? And crucially, what in the system is iatrogenic and pathological?

The mapping can work. As occupational health globalises, there are important things to think about here.