Few risk and health professionals were surprised that Dr. Angela Donkin, senior advisor at the Institute of Health Equity, UCL, used her keynote session Getting the UK Working Again to highlight a link between improving health and wellbeing and increasing employee engagement. But the link between poverty and ill health constituted less familiar territory for delegates at the Corporate Adviser Group Risk Forum in London last month.
Poor employee mental and physical health resulting from poverty is reducing productivity, she argued. Worryingly, in London over half of people live in households with incomes below a ‘living wage’ – the amount deemed sufficient to pay for needs relating to nutrition, physical activity, housing, psycho-social interactions, transport, medical care and hygiene. What’s more, the proportion of Britons affected in this way is increasing, particularly amongst certain ethnic minority groups. So engaging with employers on issues such as low pay and zero-hours contracts should form part of the corporate adviser’s human capital management consultancy remit, she argued.
Donkin said: “Access to facilities like counselling, CBT and onsite occupational health departments can be very important for helping people in work situations who are stressed, but does not necessarily address some of the root causes. To improve the health of workers you need to be advocates of the living wage, which includes enough to save for retirement, as opposed to the minimum wage. Otherwise it’s bad for employee health.”
But during the ensuing Q&A session many advisers made it clear that discussing management consultancy issues with employers in addition to employee benefits was considered a step too far in most situations. The audience was asked how many of them would have the confidence to discuss the living wage with employers on the grounds that it affected long-term productivity, and not a single person raised their hand.
Mercer senior associate Bonny Payne said that although she wouldn’t be prepared to raise the subject of the living wage she would be prepared to discuss employment issues that would affect health, but a number of attendees stressed that it was far from a given that all employers would pay much attention even to this, given the other burdens being placed on their shoulders at present.Group Risk Forum delegates
Group Risk Development spokesperson Katharine Moxham said: “Apart from for pensions, there is no mandatory requirement for employers to introduce these measures. The rest is down to their sense of social justice and paternalism, and recent years have seen a real move away from paternalism to meeting shareholders’ needs.”
Ellipse chief executive John Ritchie said: “In a free market economy isn’t the whole concept of health equity just wishful thinking? If we can get rid of zero-hour contracts and bring up the minimum wage it will get rid of half the inequality, so it’s all political.”
Friends Life director of group protection David Williams agreed that a healthy and engaged workforce was valuable but emphasised the need to be able to demonstrate the business case to clients who would be looking for a return on their investment.
Ritchie echoed this view during his presentation – Getting out of Outcome and into Process, saying: “Speaking as someone who started a business for a big global capital shareholder, they are only really interested in the return on the capital they put in. So if an adviser came to me and convinced me about health, wellbeing, absence management and productivity, and I could actually see how the costs impacted on any return then I would be very interested. I think any employer would be. The rest of it is political.”
But Aviva head of group risk Steve Bridger, in his session headed Welfare Reform and Group Risk, suggested that the issue was not so much a lack of information about return on investment being available but a lack of effective communication of the existing evidence.
He said: “We are starting to get evidence, and the Grid claims survey is starting to tell us what a great job we do, so you should be putting the message across to customers about how we can help people get back to work and stay there. We do all these things every day already, so why can’t we make the case more compelling?
“If you go to a company and ask if they want to insure against a potential catastrophe, anyone with any sense of risk would always say yes. But it’s about translating that into something that the general layman at director level will understand and want to do. We need to get into their consciousness that the costs they are already paying on absence are probably more than the insurance costs, so we need to get back into a more consultative era as opposed to just doing broking and squeezing rates.”
Bridger continued: “Whether you are a high or low earner you get some support, and what can be more noble than helping people back to work? But we don’t say enough about it. We have a spokesperson for our industry but we need to do more than that. This is about all of us talking about this and getting it more widely understood and achieving broader media coverage than just via the trade press.”
In the subsequent panel debate What Next for Group Risk? Moxham pointed out that one way in which intermediaries could really help in this respect was by coming forward with real-life case studies that could be used to put some of the key messages forward in a more engaging way to employers and to the media.
But she was pleased with the degree of cooperation Grid members had shown to date, saying: “People are beginning to pull together as an industry and we are getting there slowly. I forget sometimes providers are competitors but we do work together very well.”
But many present clearly felt there was considerable scope for improvement in the way that intermediaries and insurers work together. Trust was considered a major issue here.
Panellist Jon Ford, group insurance sales director at Canada Life, said “If you look at the full life cycle of a policy there are a number of occasions where the intermediary doesn’t need to be involved, so show more trust and let us do this work.”
Ritchie echoed this view, saying: “We need an outbreak of trust between us. You intermediaries need to check out the systems of your insurers and then you need to trust them. Let it go.”
Both providers were referring primarily to their abilities to make life easier for advisers at the smaller end of the SME market, where they are gearing up to do battle. But Punter Southall Health & Protection Consulting director, service proposition & marketing Cheryl Brennan, felt more standardisation between insurers was needed in this area, particularly given several providers’ call to intermediaries to target the SME opportunity presented by the roll-out of auto-enrolment.
She said: “We now have a number of different providers with different ways of wanting to transact. We are struggling to make money from the smaller size of client where you are saying the opportunity is, and only way we can succeed is if providers work together to make it easier for us by differing less.”
But Ritchie also made it clear that there were ways that intermediaries could make life easier for insurers.
He said: “I’d point out that at quote time pre-contract we don’t get paid for any of the work and we think very carefully in our business about whether we want to become a free price checker for advisers charging fees for market reviews. Some of you will know that we sometimes unvolunteer ourselves from their service. It’s got to be economic.”
Provider/intermediary relationships also figured prominently in the final panel debate The Future of Employer Protection, and once again trust was considered a major issue.
Speaking from the panel, MetLife employee benefits director Tom Gaynor said: “I think a lot of insurers would happily try and promote things a lot more but there is an understandable reluctance from advisers to keep us away from employees. So why not use us to help you get the message across and build the value of the benefits?
But fellow panellist John Dean, director of Punter Southall Health & Protection Consulting, pointed out that some advisers might not have the confidence to let insurers give a presentation because they might undermine them by doing it better than them.