AsDr David Kelly’s employer, should the MoD have done more to help him deal withthe stress he was experiencing, and what measures could OH have taken tohelp? By Nic Paton Amid the clamour surrounding the conclusions of the Hutton In- quiry intothe death of Government scientist Dr David Kelly, the criticisms of histreatment by his employer, the Ministry of Defence (MoD), have garneredrelatively little publicity. Yet there are lessons for occupational health in how the MoD handled Kellyin the run-up to his death. Management attitudes towards OH best practice insupporting a stressed employee, how to manage a whistleblower and dealing withan employee who may not naturally ask for help or assistance are all issuesthat were relevant to the inquiry. In his summary, Lord Hutton was clear that the MoD did fail Kelly. Once thedecision to give his name to the press had been taken, “the MoD was atfault and is to be criticised for not informing Dr Kelly”, he said. “It must have been a great shock and very upsetting for him to havebeen told in a brief telephone call from his line manager, Dr Wells, on theevening of 9 July, that the press office of his own department had confirmedhis name to the press, and [this] must have given rise to a feeling that he hadbeen badly let down by his employer,” he concluded. “I further consider that the MoD was at fault in not having set up aprocedure whereby Dr Kelly would be informed immediately his name had beenconfirmed to the press and in permitting a period of one-and-a-half hours toelapse between the confirmation of his name to the press and information beinggiven to Dr Kelly that his name had been confirmed to the press,” headded. In mitigation, Hutton argued that the issuing of Kelly’s name to the presswas simply one factor placing him under stress, that MoD officials did try tohelp him, particularly over his appearances before the Commons’ foreign affairscommittee, and that Kelly was not an easy man to help or to give advice. Most of the issues arising out of the care of Kelly boil down to poormanagement, argued Greta Thornbory, consulting editor of Occupational Healthand a former senior occupational health adviser with the Cabinet Office. “Occupational health can be instrumental in advising managers and beinginvolved with managers in the development of policy. But it is all about beingproactive and preventative. Once an event such as Dr Kelly’s death hashappened, it is too late,” she said. How Kelly was treated was also, of course, an HR issue. As Hutton madeclear, the right level of support was not given and managers did not react inthe right way. It is also evident that whatever protocols were in place fordealing with such an eventuality, they were either inadequate, not followedthrough or not communicated properly. “Even if there was support there, even if there was something in placelike an employee assistance programme, the employees may not have known it wasthere or might not have wanted to use it,” added Thornbory. By all accounts, Kelly was an intensely private, self-sufficient man. Whenan employee is going through a traumatic or stressful incident, however muchhelp there may be on tap, there still has to be an element of willingness onthe part of the employee to accept help. Stress consultant Carole Spiers said: “The OH professional can giveencouragement to seek support but only once the person has made contact. But italso is a case of OH having a higher profile, so that managers and employeesknow to whom they can turn.” Even though Kelly was a whistleblower who had unauthorised meetings withjournalists and so was also under a disciplinary cloud, the MoD still had aduty of care. As such, his managers needed to handle the situation carefullyand – even if there were no outward signs that he was not coping – withconsideration for his mental state. No doubt the MoD will learn lessons, but Thornbory said that too often thetalk is still about how much initiatives are going to cost, rather than what isthe cost going to be if we don’t do it. “It is about management and HR.Too many employers gamble on the fact their employees will be all right,”she said. Key questions for OH– Had there been a risk assessment of the workplace and employeeroles in relation to the mental health risks?– Was the employee known to OH, and if so, had their progressbeen monitored/followed-up? – What were the relevant sources of support (employeeassistance line, health information, intranet, etc)?– Were these easily accessible, how were they marketed, and howfrequently?– What was the level of backing of well-being issues from keystakeholders?– Was there a pressure management policy in place, was itseffectiveness reviewed regularly, was there any pressure management educationin place for employees and managers?– Was private healthcare insurance in place for easy and quickreferrals?– What workplace adjustments had been made to support theemployee?– What sort of relationship was there between OH, HR and linemanagers to ensure effective case management?– Did line managers and colleagues feel confident they couldrecognise signs/symptoms of stress, did they know of sources of supportavailable to them?– Were managers’ interpersonal skills assessed as part of theirappraisals? 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