Sixth National Public Health Conference 2011

Strengthening the Public Health System Enhancing Equity & Efficiency

Equity & Efficiency in Private Occupational Health Settings Dr. Abed bin Onn

Content
Introduction Financial and human costs of failures Legal compliance Inequality in provision of Occupational Health Services (OHS)

International Labour Organization (ILO)

Occupational Safety and Health Convention 2006: Prevention of occupational injuries, diseases and deaths Provision of appropriate measures for the protection of all workers, in particular, workers in high-risk sectors, and vulnerable workers such as those in the informal economy and migrant and young workers. Take measures to protect the safety and health of workers of both genders, including the protection of their reproductive health.

International Labour Organization (ILO)

Decent Work: Work is a source of personal dignity, family stability, peace in the community, democracies that deliver for people, and economic growth that expands opportunities for productive jobs and enterprise development.

International Labour Organization (ILO)

Decent Work: Reflects priorities on the social, economic and political agenda of countries and the international system. Productive employment and Decent Work are key elements to achieving a fair globalization, reducing poverty and achieving equitable, inclusive, and sustainable development.

International Labour Organization (ILO)

Decent Works 4 strategic objectives: Creating jobs Guaranteeing rights at work Extending social protection Promoting social dialogue

World Health Organization (WHO)

Occupational Health Services Convention 1985: Occupational health services for all workers, including those in the public sector and the members of production co-operatives, in all branches of economic activity and all undertakings. such protective measures should also be made for self-employed persons

World Health Organization (WHO)

Conduct workplace environmental and personal exposure monitoring Medical surveillance Sanitary facilities Education and training for workers on hazards Training in the proper use and maintenance of personal protective equipment Job Safety Analysis and modification of work Analysis of occupational health performance data

World Health Organization (WHO)

Global Plan of Action on Workers' Health (20082017)
Strengthen the governance and leadership function of national health systems to respond to the specific health needs of working populations Establish basic levels of health protection at all workplaces to decrease inequalities in workers health between and within countries and strengthen the promotion of health at work.

World Health Organization (WHO)

Ensure access of all workers to preventive health services and link occupational health to primary health care. Improve the knowledge base for action on protecting and promoting the health of workers and establish linkages between health and work. Stimulate incorporation of actions on workers health into other policies, such as sustainable development, poverty reduction, trade liberalization, environmental protection and employment.

Financial cost of Occupational Safety and Health (OSH) failures

In 2009, SOCSOs total payout was RM 1.408 billion!

Human cost of Occupational Safety and Health failures - Accidents

Accidents reported to SOCSO in 2009:

Total accidents: 55,188 Commuting accidents 20,810 Industrial accidents 34,378 No. accidents/10,000 employees 104 No. comm. acc./10,000 employees 39 No. of ind. acc./10,00 employees 65

Human cost of Occupational Safety and Health failures Occupational Diseases & Poisonings
Chemical agents 75 Physical agents 401 Biological agents 5 Respiratory system 54 Skin disorders 37 Musculoskeletal diseases 161 Cancer 19 Others - 197

Department of Occupational Safety and Health (DOSH)

Occupational Safety and Health Act 1994
To secure the safety, health and welfare of persons at work against risks to safety or health arising out of the activities of persons at work. To protect person at a place of work other than persons at work against risks to safety or health arising out of the activities of persons at work

Department of Occupational Safety and Health (DOSH)

Occupational Safety and Health Act 1994
To promote an occupational environment for persons at work which is adapted to their physiological and psychological needs To provide the means whereby the associated occupational safety and health legislations may be progressively replaced by a system of regulations and industry codes of practice operating in combination with the provisions of this Act designed to maintain or improve the standards of safety and health.

Guidelines on Occupational Health Services (OHS) 2005

Objectives: To assist employers and Occupational Health practitioners in the implementation of appropriate levels of OHS in their respective organizations To guide employers and OH practitioners on how to form an OHS To encourage all stakeholders to form an OHS

Guidelines on Occupational Health Services (OHS) 2005

Provision of OHS by In-house resources External resources Combination of above
Dependent on: Nature of operations, hazards & risks Number of workers potentially at risk Duration of operations

Guidelines on Occupational Health Services (OHS) 2005

Example:
No. of workers 50 - 1000 Occupational Health Nurse Part-time Occupational Health Nurse Full-time X Occupational Occupational Health Doctor Health Doctor Part-time X Full-time

1000

Inequality in provision of OHS

Non-universal coverage: Foreign workers Self-employed Domestic helpers Informal sector Temporary/Contract workers Civil servants

Inequality in provision of OHS

Small and medium enterprises: Ignorance Costs Lack of OHS service providers Lack of enforcement

Inequality in provision of OHS

Failure of self-regulation Maintenance of low cost of production maintaining competitiveness in global market Dearth of private OHS providers

Inequality in provision of OHS

Multi-national Companies: Compliance with national regulations Compliance with corporate policies

Promotion of Efficiency in Provision of OHS

Department of Occupational Safety and Healths role: Legislative Enforcement Ministry of Health's role: Provision of OHS Link with primary health care

Promotion of Efficiency in Provision of OHS

National Institute of Occupational Safety and Healths (NIOSH) role: Education and training Research and development Occupational Health Practitioners NGOs role: Education and training Advocacy role

Promotion of Efficiency in Provision of OHS

Universities role: Education Research and development Trade Unions role: Education and training Research and development Advocacy role

Conclusions
Provision of OHS in an equitable and efficient manner is vital to protect the human capital In line with ILO, WHO and national aspirations All stakeholders have to take a more active role in securing the health and safety of people at work

Thank you for your attention. Any questions or comments?