Risk assessment at work during the coronavirus pandemic and while ‘living with’ COVID-19: What can England learn from Sweden?

by Peter Andersson, University of Gothenburg and Tonia Novitz, University of Bristol Law School

The crisis which arose in March 2020 regarding the coronavirus pandemic immediately centred on risk. Predictions had to be made swiftly regarding how the virus would spread, whom it might affect and what measures could be taken to prevent exposure, including in the workplace. As part of a broader Swedish Research Council project (2018 – 2022), we have conducted a comparative study of English and Swedish responses to the pandemic, focussing on their treatment of risk.

It was apparent that the two countries took very different approaches to COVID-19. For example, ‘lockdowns’ like those implemented in the UK were not imposed in Sweden, although Swedes were requested to work at home as much as possible.

We recognise that risk assessment plays two key roles. One is pre-emptive, namely to prevent harms rather than only compensating for such harms after the fact. The second role is defensive, protecting an employer from liability by demonstrating that due care was taken. We have found that the Swedish approach is more pre-emptive, while in the UK risk assessment is used more defensively in criminal and civil litigation.

The pre-emptive role of risk assessment, or the scope of any ability to prevent harms, is inherently limited by who is identified as the legitimate subject of risk assessment: ‘employees’, ‘workers’ or ‘independent contractors’? This has been the subject of a judicial review action brought by the Independent Workers’ Union of Great Britain (IWGB) against the Secretary of State for Law and Pensions. A significant outcome of the judgment delivered by Chamberlain J, which sought to implement the European Union (EU) Framework Directive on Health and Safety and the Personal Protection Equipment (PPE) Directive, was the extension of entitlement to PPE to so-called ‘limb(b) workers’ (as designated under UK statute) as opposed to merely ‘employees’. Moreover, the judgment recognised the right of ‘workers’ to refuse to work where there is serious or imminent danger under section 44 of the Employment Rights Act (ERA) 1996 without detriment. However, only those workers deemed ‘employees’ could claim protection from dismissal under section 100 of the ERA.

By way of contrast, Swedish work environment law has long recognised that a broader range of persons qualify for health and safety protections as ‘employees’ or ‘equivalent to employees’. A specific project was created extending protections to self-employed platform workers. After legal challenges in which employers successfully argued that they did not have ‘employer responsibility’, the Swedish Work Environment Authority abandoned this scheme, but a proposed EU Platform Work Directive (if adopted) may enable its reinstatement. In this sense, EU law has a significant effect on the coverage of risk assessment, which raises important issues regarding protection of those at work in the UK post-Brexit.

There is also a vital difference between England and Sweden in terms of the statutory funding and powers of relevant supervisory bodies. While both countries have comparable statutory agencies engaged in promoting assessment of risk by employers and its amelioration, the UK Health and Safety Executive (HSE) and the Swedish Work Environment Authority (SWEA), there were notable disparities between their capacities in the context of the pandemic. Both actively advocated that employers undertake additional risk assessment during the pandemic. However, funding of the HSE had declined dramatically in the years preceding the pandemic (from £331 million in 2009/10 to £226 million in 2019/20), such that a temporary injection of £14 million in May 2020 could not readily revive its supervisory functions, nor did the HSE intervene with detailed advice as regards what risk assessment in English workplaces should entail. Instead, it appeared that the HSE had ‘gone missing’. It was the English Government that issued sometimes questionable guidance on what was ‘COVID-secure’, with prominent advice from what was ‘Public Health England’ (since October 2021 replaced by two bodies, the UK Health Security Agency (UKHSA) and the Office for Health Improvement and Disparities, which places health-related issues more directly under UK Government control). Risks identified in such guidance tended to be solely physical and not psycho-social, despite forms of stress created by combined teleworking and home schooling, especially for women. It remains probable that in England, few civil and criminal cases will be brought, given that employers did follow the bare bones of this guidance. In this sense, risk assessment in England has served its defensive function for employers, but the rates of deaths and long-COVID now being reported suggest that the workforce did not go unharmed.

Finally, there is a significant difference between England and Sweden regarding the extent of collective worker representation promoted in OSH. In publications issued by the HSE during the pandemic, recommending that employers ‘talk to’ their workers, statutory requirements to inform and consult workers were glossed over. By way of contrast, the SWEA received more complaints and carried out more inspections, prompted by the active statutory role which trade union representatives play. There are wider ranging entitlements in Sweden to call for a stoppage of work until OSH issues are addressed and these were deployed in the context of the COVID-19 pandemic on 328 occasions.

In February 2022, most COVID-19-related public health restrictions ended in England and Sweden, despite criticism from scientists and medical professionals, giving further cause to reflect on different responses to management of risk assessment and their effects. While coronavirus variants spread globally and other issues concerning viral contagion remain, we consider there remain compelling arguments for legal, policy and institutional reform that deserve continued attention.

See further:

Should treatments for covid-19 be denied to people who have refused to be vaccinated?

 

by John Coggon, Professor, Law School, University of Bristol

Since the early stages of the covid-19 pandemic, urgent attention has been given to expediting the approval and provision of treatments that are shown to prevent or limit the harms that people experience when they contract covid-19. Such treatments have both reduced the burden of disease and lessened rates of mortality. As with any treatments within a healthcare system, these come against considerations of rationing and prioritisation. Any treatment is a finite resource, and in some instances there may be insufficient supply to provide it to all people who might benefit clinically. How, in such instances, may the NHS best, and most fairly, allocate a limited resource?1

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Minority report(ing) on vaccinations: Who are the priorities and the dilemma of protection

By Ben Kassten, Vice Chancellor’s Fellow, Law School.

By Daniel Paquet

Against a backdrop of disproportionate morbidity and mortality from COVID-19, the need to prioritise and protect ethnic and religious minorities as part of the UK’s new vaccine programme has been the focus of recent media, public health and government attention. My question iswhois considered a ‘priority’ andhow can public health bodies engage productively and sensitively with ethnic and religious minorities.  (more…)

The PPE scandal shines a light on the worrying future of UK procurement law

By Professor Albert Sanchez-Graells (University of Bristol Law School).

The National Audit Office’s Report on its ‘Investigation into government procurement during the COVID-19 pandemic’ found that the relaxation of the standard procurement rules to allow for extremely urgent acquisitions, mainly of PPE, resulted in alarmingly widespread levels of procedural impropriety in the award of up to £18bn in public contracts. Most notably, the NAO report revealed the existence of a ‘VIP procurement channel’ for those with political connections, which resulted in much higher chances of obtaining very lucrative contracts than for those retained under the ‘normal’ pool of potential suppliers. This adds to (and partly explains) earlier reports of very large PPE contracts awarded to companies with no proven track record in the PPE market. (more…)

Healthcare procurement and commissioning during Covid-19: reflections and (early) lessons – some thoughts after a very interesting webinar

By Prof Albert Sanchez-Graells, Professor of Economic Law and Member of the Centre for Health, Law, and Society (University of Bristol Law School)

On 30 September, the Centre for Health, Law, and Society had the honour of hosting an excellent panel of speakers for a webinar on ‘Healthcare procurement and commissioning during Covid-19: reflections and (early) lessons’. The speakers provided short presentations on a host of very complementary issues surrounding the reaction of NHS procurement and commissioning to the COVID-19 challenges. The ensuing discussion brought to light a number of general themes that are, by and large, aligned with the worries that others and I had expressed at the outset of the pandemic*, and a number of challenges that will shape the readjustment or reregulation of NHS procurement and commissioning in the medium and long term.

This blogpost initially provides some brief notes on the most salient points made by the speakers in their presentations, which do not aim to be exhaustive. It then goes on to offer my own reflections and views on what lessons can be extracted from the procurement and commissioning reaction to the first wave of Covid-19, which do not necessarily represent those of the panel of speakers. (more…)

A perfect storm: Patients, psychiatrists and the pandemic

By Prof Judy Laing, Professor of Mental Health Law, Rights and Policy (University of Bristol Law School)

Mental Health Awareness week is an important time to reflect on how the Covid-19 pandemic is generating a global crisis in mental health. Earlier this month, the United Nations published a policy brief warning that:  ‘Although the Covid crisis is, in the first instance, a physical health crisis, is has the seeds of a major mental health crisis as well.

Stringent lockdown measures have increased social isolation, and for many, this is creating huge psychological distress. That is further impacted by the fear of infection, death and losing relatives and close friends to the virus. The state of the economy is creating additional anxiety and stress for those who have lost or are at risk of losing their income and livelihoods. Professor David Gunnell (a colleague at the University of Bristol who researches on suicide and self-harm) has highlighted with others in The Lancet  that the pandemic will ‘leave many people vulnerable to mental health problems and suicidal behaviour, and increased risks of suicide’. Taking action now to prevent the risk of suicide is therefore imperative. And the United Nations policy brief also urges national governments to take positive action to ensure widespread availability of mental health support, as well as building mental health services for the future to promote recovery from the pandemic. (more…)

The Commission Roadmap on Covid-19: is the EU Finding the Route or Continuing to Lose the Way?

By Prof Keith Syrett, Professor of Health Law and Policy (University of Bristol Law School)

Credit: European Union, Coronavirus Global Response, 2020

The European Union has been widely criticised for its response to the outbreak of pandemic coronavirus (COVID-19) in early 2020. Still distracted by Brexit and, more recently by the Turkish migrant crisis, EU leaders were caught off guard by the rapid spread of the virus, initially into Italy. Member states took actions into their own hands, imposing border controls, banning exports of protective equipment and, later, banning mass gatherings, closing schools, and instituting lockdowns, while the EU appeared to be a largely impotent bystander.

Perhaps the EU’s muted initial response was unsurprising, given that previous public health threats of a similar type, such as SARS, MERS and Ebola, had had little impact within the Union. However, more than a decade previously, concerns had been raised about lack of preparedness for a pandemic outbreak in Europe.[1] Notwithstanding the EU’s subsequent establishment of a firm legal basis for a response to pandemics, it now seems that the lessons presented previously had not fully been learned. (more…)

Beyond the Pandemic: More Integrated EU-wide Public Debt Instruments?

By Prof Albert Sanchez Graells, Professor of Economic Law (University of Bristol Law School)

Beyond its terrible death toll and massive public health implications, the COVID-19 pandemic and the lockdown measures put in place to try to contain or mitigate it are bound to have severe and long-lasting economic effects. The European Union (EU) and its economic and financial governance now face very significant challenges, possibly exceeding those of the 2008 crisis. The way in which these challenges are addressed will not only determine the path and speed of European (economic) recovery, but perhaps also pave the way for further changes beyond the pandemic. Here I reflect on some implications of the COVID-19 response for EU-wide public debt instruments. (more…)