Systems are deeply embedded in the way an organisation manages health and safety (H&S). Over the last century there are recognizable shifts in the approaches taken toward H&S systems. Four Health and Safety System Approaches are identified and covered showing how the perspective taken by each of H&S and related accident analysis differ. These Health and Safety System Approaches are not substitutable options, rather they can be viewed as progressively adding to ways in which H&S is improved by organisations, in a sense reflecting a progression in the level of maturity of organisational H&S. The multi-level perspectives reflected in Health & Safety System Approaches can be similarly reflected in the law of tort and in Commissions of Inquiry into H&S failures.