Report

Nye’s lost legacy

Think tank: Fabian Society

Author(s): Sasjkia Otto

September 15, 2025

This report from UK think tank the Fabian Society considers how a National Occupational Health Service could work with others in keeping people well at work.

Since Labour was last in power, the number of working-age people reporting a disabling condition has increased by 4.3 million. And over 300,000 people leave work with health problems each year. Healthy and inclusive work can help reduce the numbers leaving employment – and make it more feasible for others to return. But many are excluded from work because they cannot access the conditions or support they need. People also reported 1.7m cases of work-related illness in 2023-24. This represents a 44 per cent increase since 2010-11 – driven in large part by a 93 per cent increase in work-related mental illness.

These challenges can only be addressed if employers, workers and the state urgently step up to play their part, argues senior researcher Sasjkia Otto. Against the backdrop of Sir Charlie Mayfield’s independent investigation into healthy and inclusive work, she sets out an ambitious vision for a universal and integrated occupational health system, matched by rights and responsibilities. In other words: a National Occupational Health Service.

This report considers the health of the UK workforce, the limitations of the current occupational health system, and how a National Occupational Health Service could enlist employers, workers and the state in as key partners in keeping people well in work.