Labour and social protection policies and primary health care


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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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Labour and social protection policies and primary health care

  1. 1. WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague) Labour and social protection policies and primary health care Igor FEDOTOV, M.D., Ph.D, Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK, Geneva, Switerland
  2. 2. Major Challenges for Occupational Health Services
  3. 3. Major Challenges for Occupational Health Services  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 How can labour and social protection policies meet these challenges?
  4. 4. Investment in occupational healthWorker Health:- added value for productivity and sustainable development- indicator of success of social and economic policies- critical economic factor at enterprise and nationallyPolicies should aim at:- risk management, disease prevention & health promotion- reduction of social costs through preventionPolicies be based on:principles of equity, affordability and accessibility
  5. 5. ILO Occupational Health Services Convention 161 Primary taskEntrusted with essentially preventive functions and responsiblefor advising employers and workers on requirements forestablishing and maintaining a safe and healthy workenvironment and adaptation of work to the capabilities ofworkers- Requires the establishment of comprehensive national policy on OH Services- Determines functions, organization and conditions of operation
  6. 6. Labour policies – national labour codesSolid OSH legislationEmployer liability in case of work-related accidents and diseasesEnforcement of law – labour inspectionTripartite cooperation (collective agreements)National safety and health tripartite bodyMain goalsReduction of risks, prevention of occupational injuries and diseases, health promotion, medicalrehabilitation, and return to work
  7. 7. Labour policies strengthening legal OSH frameworksOccupational 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 profileNational 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 economyNational programme:to be endorsed and launched by the highest national authorities
  8. 8. Social security policies – national social security codesSocial security legislationHealth insurance (general) to cover medical care of any mobid condition andsickness benefitEmployment injury insurance to cover medical, sickness, disability andsurvivors benefits in case of occupational accidents and diseasesMain goalSocial protection of victims of work related injuries and diseases and socialrehabilitation
  9. 9. Social polcies strengthening social protectionMinimum Standards of Social Security C. 102Part VI. Employment Injury Benefit – to preserve minimum contingencies to be covered due to accidentor disease resulting from employmentEmployment Injury Benefits C. 121National legislation on employment injury benefit shall protect all employeesIt 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 2010Medical Care and Sickness Benefit C.130Part II. Medical care: requires to secure to the persons protected the provision of medical care ofcurative and preventive nature in case of contingencies, including incapacity to work resulting fromsicknessPart III. Sickness benefit: requires to secure to the persons protected the provision of sickness benefit incase of contingencies, including incapacity to work resulting from sickness
  10. 10. Synergies of Labour and Social PoliciesTo 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, enterpriseand individualThe 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
  11. 11. 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”
  12. 12. 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
  13. 13. Recommendations1. 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 Services2. Promote: ratification and application of the ILO Conventions 161 and 187
  14. 14. Recommendations3Link the development of OH Services with the establishment of comprehensive national OSH action programs and countries’ profiles.Build up wide partnerships to strengthen ILO and4. WHO actions to influence decision-making and provision of resources at national and international levels
  15. 15. 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 Thank You! ILO Programme SAFEWORK Geneva, Switzerland More from: