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The management of health and safety is an issue that is relevant and crucial to all organisations across all industries, to include traditional industries, commercial, information technology (IT), the National Health Services (NHS), care homes, schools, higher educational institutions, travel and leisure, etc. Health and safety is specifically significant and crucial for the construction industry. In the United Kingdom, the construction industry is the largest of all industries. It accounts for about 8% of gross domestic product, employs about 10% of the national workforce and generates an annual turnover of up to £250 billion. The UK construction industry has a global reputation for the quality of its work but yet it remains one of the most dangerous industries in the nation.. Research on this thesis is based on a general overview of health and safety in the construction industry, highlighting on a strategic approach to dealing with three major issues with regards to health and safety in the construction industry. First, the thesis tries to deal with the problem of how to improve organisational health and safety (OHS) through the monitoring of the process of procurement in construction projects. For instance, there is a strong belief in the construction industry that any organisational culture of any bidder chosen for a particular project will have an influence on the entire project. Hence, there is a need for the contractor to properly scrutinize bidders with regards to how they handle OHS and how this reflects on their organisational culture. In addition to the proper scrutiny of a client's OHS record, there is also an issue of financial and legal status of a client with regards to indemnity or any insurance considerations in the case of construction accidents. That is, can a client be held accountable for an accident? What type of accidents that will happen during work on the project that the client will be accountable for? Secondly, the thesis will address the issue of cost-effectiveness in construction projects and how OHS is dealt with simultaneously. For instance, in the process of choosing a bidder, sometimes contractors may tend to ignore health and safety issues and decide to choose a client that will result in cost savings, or choosing the highest bidder irrespective of OHS concerns. Hence, there is a risk management concern to be dealt with in such cases. Third, the thesis considers what type of strategic decisions and the responsibilities of both the contractor as well as the client in terms of dealing with OHS with regards to construction projects. In so doing, the research considers various literatures along with previous and practical cases of construction projects and the type of strategic decisions taken by both contractors as well clients with regards to OHS. A quantitative/qualitative research approach is employed in conducting this research alongside an inductive research paradigm. Data collection includes various sources, such as library, internet, (such as web searches with various keywords and databases as Emerald Insight, SPSS, Elsevier, Mintel, etc.). Materials to be used include textbooks, journal articles (print and online), peer review journals from databases, online publications, websites, media articles, PDF documents, and more. Henceforth, this research will discuss and try to identify a gap within health and safety in the construction industry, reviewing procurement monitoring, cost effectiveness and strategy.