In the UK, the government is increasingly focusing on occupational health (OH). Employers do not currently have a legal duty to provide medical care for their employees and, in fact, only about 50% of workers in the UK have access to OH services, principally those employed in large enterprises. OH services in any event do not provide clinical care which is made available free of charge through the National Health Service (NHS). General practitioners (GPs) are responsible for primary care under the NHS system. The NHS does not provide OH services, other than for its own employees and for a few employers who pay them for it. Most OH services are provided by commercial organisations for which employers must pay. OH has come to develop its own unique significance, especially in the prevention of occupational diseases. One of the reasons why occupational physicians are well utilized in the UK, even though it is not legally required to appoint them, is that employers are legally obliged to protect workers against work-related diseases and injuries, and they are useful as a risk hedge for employers. Also, health and wellbeing promotion leads to less sickness absence and greater productivity. As OH is not stipulated in the legal system, it has been developed as a business. The bulk of OH provision is the responsibility of nurses, technicians, physiotherapists, occupational therapists and counsellors, with services being led by a few physicians. OH nurses are respected by both labour and management and collaborate with related professions such as occupational psychologists and physiotherapists. Increasingly, OH services are multi-disciplinary. Universities and private commercial organizations are actively providing training. Certification for occupational physicians and nurses is provided by the Faculty of Occupational Medicine (FOM) of the Royal College of Physicians and the Nursing and Midwifery Council (NMC). It is also noteworthy that nurses and some other professionals are given the authority to write fit notes, which are equivalent to medical certificates in Japan, thus alleviating the burden on GPs.
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