WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague) Igor FEDOTOV, M.D., Ph.D, Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK, Geneva, Switerland Labour and social protection policies and primary health care
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Labour and social protection policies and primary health care
Presentation by dr. Igor FEDOTOV, Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK,Geneva, at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012
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WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague)
Igor FEDOTOV, M.D., Ph.D,
Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK, Geneva, Switerland
Labour and social protection policies and primary health care
Major Challenges for Occupational Health Services
How can labour and social protection policies
meet these challenges?
Fragmentation of work, no more one job for life
Increasing number of work-related accidents
and diseases, many are not registered
Growth of the informal economy
High numbers of vulnerable workers (migrants, HIV/AIDS,
disabled) and ageing workforce
Impact of crisis: downsizing OSH, income inequalities
Escalating health costs
Disruptions of social security schemes
Lack of OSH personnel and inadequate resources
Major Challenges for Occupational Health Services
Investment in occupational health
Worker Health: - added value for productivity and sustainable development - indicator of success of social and economic policies - critical economic factor at enterprise and nationally
Policies should aim at: - risk management, disease prevention & health promotion - reduction of social costs through prevention
Policies be based on: principles of equity, affordability and accessibility
ILO Occupational Health Services Convention 161
Primary task
Entrusted with essentially preventive functions and responsible for advising employers and workers on requirements for establishing and maintaining a safe and healthy work environment and adaptation of work to the capabilities of workers
- Requires the establishment of comprehensive national policy on OH Services
- Determines functions, organization and conditions of operation
Labour policies – national labour codes
Solid OSH legislation Employer liability in case of work-related accidents and diseases Enforcement of law – labour inspection Tripartite cooperation (collective agreements) National safety and health tripartite body
Main goals Reduction of risks, prevention of occupational injuries and diseases, health promotion, medical rehabilitation, and return to work
Labour policies strengthening legal OSH frameworks
Occupational Safety and Health C. 155 requires: - to formulate and implement a coherent national policy (Art.4) - policy shall include the respective functions and responsibilities for OSH of public authorities,
employers, workers … (Art. 6) - the necessary coordination between various authorities and bodies (Art.15)
Promotional Framework for OSH C. 187 requires: - development of national OSH policy, system, programme and profile
National system includes: - occupational health services - collaboration with insurance or social security schemes to cover work injuries and diseases - support mechanisms for progressive improvement of OSH conditions in SMEs and in the informal
economy
National programme: to be endorsed and launched by the highest national authorities
Social security policies – national social security codes
Social security legislation Health insurance (general) to cover medical care of any mobid condition and sickness benefit Employment injury insurance to cover medical, sickness, disability and survivors benefits in case of occupational accidents and diseases
Main goal Social protection of victims of work related injuries and diseases and social rehabilitation
Social polcies strengthening social protection
Minimum Standards of Social Security C. 102 Part VI. Employment Injury Benefit – to preserve minimum contingencies to be covered due to accident or disease resulting from employment
Employment Injury Benefits C. 121 National legislation on employment injury benefit shall protect all employees It includes Schedule I. List of occupational diseases - ILO adopted Rec. 194, 2002, that requires a national list of occupational diseases for the purposes of
prevention, recording, notification and compensation to be established by the competent authority - national list to be reviewed in line with the most up-to-date list of ILO - ILO revised the list of occupational diseases in 2010
Medical Care and Sickness Benefit C.130 Part II. Medical care: requires to secure to the persons protected the provision of medical care of curative and preventive nature in case of contingencies, including incapacity to work resulting from sickness Part III. Sickness benefit: requires to secure to the persons protected the provision of sickness benefit in case of contingencies, including incapacity to work resulting from sickness
Synergies of Labour and Social Policies
To be effective, the policies should aim at: - keeping labour and social protection high on technical and political
agendas - establishing OH Services and social security institutions - developing overall infrastructure for OH practice - promoting creation of safety culture at the level of society, enterprise and individual
The policies should address risks: - in humans (biological) – to prevent ill-health, loss of working capacity,
temporary or permanent disability - in society (economic) – to prevent loss of income due to occupational
injuries and diseases
UN Initiative on Social Protection Floor
• ILO and WHO the lead agencies
• WHO – basic health protection and medical care services development
• ILO – basic income protection (disability, maternity, pension, unemployment)
• Standard setting item for International Labour Conference, 2012 “Recommendation on the social protection floor”
Conclusions
Labour and social protection policies are in the core of the ILO Decent Work Agenda
Effective labour and social policies are critical for good governance and sustainable development
Countries need to recognize a critical importance of developing OH Services to cover all workers
To create synergies: labour, health and social policies should be comprehensive, consistent and complimentary
Develop:
a. Mechanisms for multi-channel provision of OH services, especially through PHC system, and indicators for measuring progress
b. Cooperation between labour and health sectors on OH Services and their expansion into the informal economy
c. Training tools and good practice guides to assist countries in stepwise development of OH Services
Promote: ratification and application of the ILO
Conventions 161 and 187
Recommendations
1.
2.
Link the development of OH Services with the establishment of comprehensive national OSH action programs and countries’ profiles
Build up wide partnerships to strengthen ILO and WHO actions to influence decision-making and provision of resources at national and international levels
3
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Recommendations
4.
Igor FEDOTOV, M.D., Ph.D Coordinator, Occupational and Environmental Health ILO Programme SAFEWORK Geneva, Switzerland
WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague)