Occupational health Strategy & Planning: Dr. Ramnik Parekh
Dr. Ramnik Parekh,
MBBS, DIM, DIH (London),
FIAOH (Hon), FCGP (Hon)
UnitedHealth Parekh TPA P. Ltd.
Matrix Medicare P. Ltd.
Business Excellence (BE) is about developing and
strengthening the management systems and processes
of an organization to improve performance and create
value for stakeholders.
• BE is much more than having a quality system in place.
BE is about achieving excellence in everything that an
organization does (including
leadership, strategy, customer focus, information
management, people and processes) and most
importantly achieving superior business results.
“If you want to run a company that is sustainable beyond your life time, then
yes, you should go ahead and adopt business excellence”.
Kenny Yap, CEO, Qian Hu Corporation Lt,
The first SME to win the Singapore Quality Award in 2004
“Person, group or organisation that has a direct
or indirect stake or interest in the organisation
because it can either affect the organisation or
be affected by it. Examples of external
stakeholders are owners
(shareholders, customers, suppliers, partners, g
overnment agencies and representatives of the
community or society.
Examples of internal stakeholders are its people
or groups of people.”
-European Foundation for Quality Management
organisations share a
common set of beliefs.
These beliefs captured
a shared set of
organisations held to
be true & committed
themselves to be
guided by. This set of
eight beliefs were
common to all of the
members and partners
Management by fact
Focus on results and
Focus on the future
Human Resource Planning
Employee Learning and Development
Employee Well-Being and Satisfaction
Employee Performance and Recognition
In order to excel, the organisation should
develop and tap the full potential of its
employees at the individual, team based and
Fairness and equality among employees must
be practised and people at every level should
be involved and empowered to make changes.
Employees should be cared for, rewarded and
recognised so that they are motivated to
perform to their best ability and stay
committed to the organisation.
If an organization is seeking to improve their health and
safety performance, there is evidence to support
adoption of a healthy workplace strategy which
integrates efforts focused on:
• physical work environment (traditional health and safety);
• personal health resources (enabling healthy worker
• organizational culture (creating a positive work
environment that enables employee engagement and
the integration of health and safety behaviours).
A healthy workplace is one that enables physical, mental and social
well-being of employees by engaging employees in a meaningful way
to create healthy, supportive working conditions. The working
conditions addressed by a healthy workplace fall under three key
1. conditions of the physical work environment;
2. conditions that support and enable positive personal health practices;
3. conditions that foster a supportive organizational culture.
The three elements of a healthy workplace intersect one another. All three
elements need to be addressed to achieve a truly healthy workplace
Health is the Greatest Wealth: The key to future economic prosperity and
business excellence ...
– The European Network Enterprise Health , 2008
Organisations are today confronted with a wide range of challenges:
The contribution of employees to the value added factor has never
been more important.
As their workforces grow older, many companies may well face
problems replacing their essential skills and experience.
Health plays a crucial role in facing up to the new challenges. One of
the key mainstays of economic and social development
Not only the basis for personal well-being but also the foundation for
productivity, innovation and social cohesion.
Health not only governed by personal patterns of behaviour and
people's resources, but it also embraces living and working conditions.
To have optimal performance, an organization needs to make a conscious effort to
create the culture and work environment that will best enable employees to work
safely, while creating high quality outputs in efficient timelines.
When employees feel respected, valued and satisfied in their jobs and the physical
work environment is safe, they are likely to be more committed and productive in
Creating healthy work environments & making health a top business priority
increased employee satisfaction, motivation and productivity, and
in-turn decrease employee turn-over, absenteeism and insurance costs.
Positive conditions to attract and retain the best and the brightest talent.
Conditions to ensure a foothold in a competitive market place.
• In 2007, Dofasco (a steel plant taken over by AcelorMittal) : By
supporting worker healthy lifestyle practices, there was opportunity to
reduce lost time injury by 46%.
• MDS Nordian reduced sick day usage to 4 days per year, compared to 7.4
days on average.
• Delta Hotels decreased employee turnover to 19-22% compared to 40-
60% in their sector.
• Irving Paper decreased short-term disability costs by over 50% in 5 yeas,
with a savings of over $80,000.
• Prudential Insurance showed a 46% decrease in benefit expenses.
• Coors Brewing Company showed an 18% drop in absenteeism.
• At one company: an obesity management campaign, decreased 7 out of 10
health risks, reduced health care expenditures by $184,582 and saw
productivity improvements of $127,173.
Johnson + Johnson (3.8 : 1)
Union Pacific Railroad (4 : 1)
Citibank (4.56 : 1)
Pepsi-cola, Motorola, Dupont (1.9-6.1 : 1)
Companies with HIGH employee engagement saw:
13.2% improvement in net income growth
19.2% improvement in operating income
27.8% improvement in Earnings per Share
Companies with LOW employee engagement saw:
3.8% decline in net income
32.7% decline in net income growth
11.2% decline in EPS
(Source: ISR. 664,000 employees world wide, one-year study, 2006)
Most economic gains have been from advances in technology
As pace of technology has slowed, more focus on human capital
Human capital now one of few remaining differentiation's for competitive
• Rising costs of healthcare
• More people living longer
• And maybe staying in work
• We have become obese
• More epidemics
• Increasing average age of workforce
• Fewer full-time employees
• Post baby-boom deficit of skilled
• Continuing shift of healthcare
costs from state to private sector
The world has been changing
Modifiable risk factors such as smoking, lack of exercise, alcohol
use, poor nutrition, obesity and hypertension increase an
employer’s healthcare expenditures by 25% and are currently
estimated to account for 2.1% GDP.
It is estimated that in India productive years of life lost to
cardiovascular disease alone will almost double between 2000
Around 17% of males and 15% of females above the age of
15years have a Body Mass Index of above 25.
Reducing just one health risk increases an employee’s on the job
productivity by 9% and cuts absenteeism by 2%.
Major Non Communicable Diseases (NCDs) like Cardiovascular
Diseases, Diabetes, Cancer and Chronic Respiratory Diseases
contribute to 53% of all projected deaths and 44% of Disability
Adjusted Life Years in India.
Over 2005 – 2015 while deaths from infectious diseases, maternal
and perinatal conditions and nutritional deficiencies are expected to
decrease by 15%, deaths from NCDs are expected to increase by
18% and most significantly deaths from diabetes are expected to
increase by 35%.
India by 2015 is projected to lose US$237 billion in national income
on account of deaths due to CVDs, stroke and diabetes.
Organizations invest an average of US$ 290 in labor costs to generate
US$ 1,000 in revenue. By helping employees work longer and have
more productive lives, organizations can protect this asset in the face of
growing labor shortages globally.
Workers with chronic disease are cause as much as 400% more
Productivity losses than the cost of treating chronic disease.
Examples:disability, unplanned absences reduced workplace
effectiveness, increased accidents and negative impacts on work
quality or customer service.
Depression, as well as fatigue and sleeping problems – conditions or
risks that are often co-morbid with chronic diseases – have the largest
impact on productivity. As with healthcare costs, more risk factors
multiply the losses in productivity.
Change Agent for Safety, Health & Environment
To inculcate best practices in the field of occupational health and
safety, an innovative idea was introduced in 2003 by RIL medical
team i.e“CASHe” (Change Agent for Safety, Health &
This innovative project with a proactive preventive approach
comprising team work of Medical, Safety, Environment and
technical department has established a landmark in the field of
Through CASHe program, Reliance experience proves that
occupational health pays for itself and does not require additional
investments for controlling workplace hazards
A model and initiative for development of OHS at manufacturing
sites of Reliance
Started with pilot project at seven RIL sites, now extending to 12
sites, Oil & Gas business & offices also.
As per our HSE policy, we at Reliance believe that
• Safety of a person overrides all production targets.
• All injuries, occupational illness as well as safety &
environment incidents are preventable.
• Reliance shall strive to be a leader in the field of
management of Occupational health, safety & environment.
To achieve these objectives we have to focus on
prevention because prevention is not only better but
cheaper than cure.
• To bring about a positive change and continual improvement in
occupational health practices so as to prevent morbidity and
mortality due to Occupational hazards, resulting in hazard free
environment for our employees and contract workers from the
grass roots to the highest level.
• To achieve fruitful project execution, the CASHe team in
consultation with project coordinator developed a strategy which
• A road map like detail action plan,
• Weekly review meetings,
• Awareness and attitude change towards OHSE through shop
floor & intranet portal trainings,
• CASHe booklets distribution,
• Monthly progress reviews,
• Medical surveillance and periodic workplace monitoring.
Result in terms of
Safety & Health
• A Resounding Success: from 2003 to till date nearly 1300
projects are completed
• A significant improvement across the sites in Awareness
and attitude towards compliance with OHSE
• Attitude of workers towards work practices,
• Use of PPEs and
• Importance of Housekeeping.
• Benefits of CASHe are outstanding. There were many
valuable projects which helped for workplace improvement
• CASHe program also helped significantly in construction &
designing of new projects.
For last 10 years intersite competition of CASHe was held at
various RIL sites and awards were distributed under various
Best CASHe Trophy -
• Major sites
• Polyester sites, E & P
Best Site Trophy
• Major site
• Polyester site, E & P
• Best Innovative Project
• Best Ergonomic Project
• Best Inspired Project (copied from any other plant /
site, credit should be given to the source)
PLUS National and International Recognition
In reality CASHe initiatives are not any cost expensive
instead these are the cost beneficiary.
In first implementation of CASHe program in 2003-04
earning 4,00,000 US $ against investment of 20,000
US $ and this is continuous gain till date.
Hindustan Unilever Limited’s
Vitality Index Concept
Our Assets – Our Brands and Our People
Both Assets Need to Embody Vitality
They raised questions:
Is there a surrogate for Personal Vitality?
Can we measure something as holistic as Health with
Are there a few important factors to enable us to make a
Reasonable Assessment of Health?
Answer: “VITALITY INDEX”
a Surrogate for Personal Vitality
A Composite of 4 carefully chosen Critical Health Determinants
Tested and validated with a small sample within the
• Periodical medical evaluation
– <35 years: once in three years
– 36-45 years once in two years
– > 45 once every year or if in the red zone
– Clinical evaluations, biochemical tests
– Specific investigations like Mammography, Pap smear (>35
– PSA testing (>50 years)
– CT angiography – preventive angioplasties
• Nutritional Menu and counseling
• Prevention of substance abuse e.g. smoking
• Intranet based monitoring and health education.
The question is no longer whether companies
should invest in comprehensive workplace
health promotion, but how best to design,
implement and evaluate these programs for
optimal results. Interventions don’t need to be
large to make a difference.
“People want to stay with organizations that have a
demonstrated ability – and an ongoing process – to
retain good people. The moment individual
contributors who have the respect of their peers walk
out the door, others are more inclined to follow.”
Towers Perrin Global Workforce Study – Canada 2005
Step One: Gain „Demonstrable‟commitment
• To ensure there is buy-in from senior leadership, unions,
and other key stakeholders.
Step Two: Form a committee – „Shared Leadership‟
• To plan and implement a healthy workplace strategy.
Step Three: Do a needs assessment
• To determine key organizational issues, as well as the
needs and wants of employees and management.
Step Four: Analyze the results
• To prioritize issues identified by the needs assessment and
Step Five: Develop a workplace health plan
• To have a 3 to 5 year healthy workplace strategy, and to
identify a clear vision of the intended outcome.
Step Six: Develop program action plans
• To choose evidence-based activities and assign
responsibilities/actions that logically align with the
Step Seven: Review and evaluate
• To recognize success and identify opportunities for
Dr. T. Rajgopal, Hindustan Unilever Ltd.
Dr. R. Rajesh, Reliance Industries Ltd.
Prof. Dr. Dr. h.c. Mult. Rita Süssmuth, President of the
European Network Enterprise for Health
“Achieving Business Excellence –Health, Well-Being
and Performance” –Publisher Bertelsmann Stiftung, BKK Bundesverband
“Healthy Workplaces: Journey to Excellence”- Health and
Safety, Ontario, Canada, 2011
“Implementing Business Excellence – A guidebook for
SMEs”-Dr. Robin Mann,Musli Mohammad, Ma Theresa A. Agustin for
Asian Productivity Organisation
European Foundation for Quality Management
“Business Excellence Framework” – Singapore Quality
William Hesketh LEVER
“If we leave the human factor out of our
business calculations, we shall fail every