Common characteristics of external OSH services in the EU The similarities of external prevention services in 15 EU Member States are given with regard to the obligation to use external prevention services, the type of organisation, the remuneration, the expertise and multidisciplinarity and the quality control. The information is based on a comprative study on the organisation of external protective and preventive services conducted by Prevent with the support of Mensura External Service for Prevention and Protection at Work
The 1989 Framework Directive on the implementation of measures aimed at promoting improvements in occupational health and safety for workers requires results from Member States, yet it allows each country to freely defi ne the capabilities and aptitudes necessary for reaching these objectives. To comply with European requirements, each country
had therefore to conduct a somewhat comprehensive review of its prevention system. Similarities can be seen today, however differences continue to exist between the systems in the different countries.
The information collected in the study does indeed show that while the Framework Directive has contributed to bringing all national policies in line, full harmonisation has not yet been achieved. Special features continue to exist and are a result of different situations, legacies and mentalities in certain countries.
The obligation to use external prevention services
The Framework Directive obliges all enterprises from all Member States to initially use the internal service and then to use external expertise (people or services) when the internal expertise is insuffi cient for organising protection and prevention work. The intention of the legislator was to allow enterprises that had an internal service to retain it, and for those that did not, to be able to call on quality external services.
This principle on the hierarchy of protection and prevention services set out in Article 7, though included by virtually all countries, and most recently the Netherlands, has resulted in diverse adaptations.
It should be remembered that Denmark obliges enterprises belonging to certain sectors of activity to join an external service equivalent to 0.6 hours per worker/year.
In contrast to this, Spanish enterprises considered as “at risk” have to set up an internal service responsible for two disciplines from among occupational medicine, occupational safety, occupational hygiene, ergonomics and psychology. As regards Portugal, this approach is taken a bit further with at risk enterprises setting up an internal service, which by virtue of its nature, knows the enterprise’s special features and risks better than an external service. For Portuguese enterprises falling under “at risk” sectors, only those with prevention indicators below their sector average can be exempted from this obligation and can refer to an external service provided their indicators remain below the average.
In Austria, all enterprises with more than 50 workers must call on a prevention service, whether internal, external or inter-enterprise.
Another approach is taken in the United Kingdom where use of prevention services is left to the discretion of employers who are only obliged to be responsible for the health of workers in so far as this is possible.
The type of organisation for external services
The most widely spread organisation among the 15 European countries studied is the private organisation. However, in the majority of countries, this type of organisation is not exclusive and there is generally a diversifi ed market for external services.
Insurance organisations can therefore also act as an external service, as is the case in Germany and Austria where the AUVA makes its nine prevention centres available free of charge to employers. Similarly in France, the CRAMs, just like the ANACT and the OPPBTP, have the authority to accredit people and other bodies as prevention services. In Spain also, the mutuas have been able to play the role of external service with their member enterprises since 1995.
Another type of organisation for external services relates to their specialisation according to a sector or a geographic area, as is the case in Denmark and Finland as well as in France where the OPPBTP is the professional organisation for prevention in the building industry and public works.
Remuneration for external services
In all of the European countries, the costs of protection and prevention services are borne by enterprises and employers, however some systems have mechanisms for reducing the costs.
In Finland, social security may therefore contribute to covering up to a maximum of 50% of the costs; in Italy, some employer organisations offer their members competitively priced prevention services; in Austria, the AUVA is indirectly financed by enterprises via their insurance premium and provides its prevention services free of charge to employers.
Spain has a similar situation where the mutuas offer their services as external services without additional costs for their member enterprises.
Expertise and multidisciplinarity within the external services
Communication 62 of the European Commission recognises that one of the problems relating to the organisation of external services is the lack of qualifi ed personnel, both inside and outside enterprises. The Framework Directive does not in fact specify the aptitudes or capabilities for these services, as this task is left to the Member States.
The legislation in some countries does not specify the expertise that prevention services must have. This is notably the case in Ireland, Italy, Sweden and the United Kingdom where legislation introduces a tautology by clarifying the term “competent people”.
While the multidisciplinary nature is not clearly specifi ed, it can nonetheless be logically determined from the content of the Directive and is specifi ed in numerous pieces of national legislation.
In Belgium, the legislator has made it compulsory to create a single service bringing together the different disciplines into one multidisciplinary structure. In Denmark, the external services must have at least fi ve specialists who cover five different fields, while in Spain, the external services have to include at least one expert for each of the following disciplines: occupational medicine, occupational safety, occupational hygiene, ergonomics and applied psychology. As regards the prevention services in the The Netherlands, there must be at least one specialist in each of the following four fi elds: occupational medicine, occupational safety, occupational hygiene and work organisation.
Elsewhere, the principle of multidisciplinarity is reduced to a dualism between the occupational doctor and the safety experts. It is clear that in some countries these two functions, although set up to work together, do not always carry out their activities on a multidisciplinary basis. In Portugal for example, health work and safety work can be separated and exempted by distinct services.
While the profiles of occupational doctors and safety experts are the profiles that are most frequently compulsory in external services, it should be remembered that these two terms refer to specialists with different training and skill requirements according to the countries concerned.
In Germany, the training of these two specialists is stipulated in legislation, however there are no specifications as to the method of acquiring the expertise. They can therefore be trained at universities, institutes, associations etc. In Spain and Portugal also, legislation specifies the expertise required of occupational doctors and safety engineers, however one of the aims of the Portuguese ISHST is to organise and accredit the courses given to these two specialists. It is also interesting to mention the case of Finland, where in order to update the training of its specialists, they are required to follow a training course at least once every three years.
Quality management of the external services
Quality control of external prevention services is also a point highlighted by Communication 62 of the European Commission. The Commission recognises that certification of service providers is a way of guaranteeing a high level of quality, however it goes on to emphasize that this certifi cation only allows for analysis of the structures. It cannot serve as a basis for any evaluation of the quality of procedures and results.
In order to guarantee the quality of external services, certification should ideally also take place with an evaluation of the procedures and results of the service concerned. According to our study, eight out of 15 countries have a certification or accreditation system that is valid for varying lengths of time. This is the case in Belgium, Denmark, Spain, Finland, Greece, the Netherlands, Portugal and France where the three bodies the ANACT, OPPBTP and CRAMs have the authority to accredit other people and bodies.
In countries where there is no accreditation or certification, it is the inspection that verifies the appropriate level of qualification of staff, as is the case in Austria. The situation in Germany is unique as there is no compulsory certification, however there is voluntary certifi cation for prevention services.
Evaluation of the work of external services is not very widespread in the countries studied here. Some countries entrust this evaluation to the Ministry concerned, as in Germany and Austria, however in Denmark it is the external body Danish Accreditation that annually verifi es that the work required is correctly carried out by the external services. In Sweden, Finland, Italy and Portugal, the work of prevention services is not evaluated. This applies even if the external services have to provide a report on their activities, as is the case in Portugal and other countries. This area is indeed the subject of controversy as for example in Portugal. In Spain and Ireland, employers themselves are required to take part in evaluating the work of external services.
The result is that competition between prevention services is becoming increasingly tough in the different European countries. If the quality of their work is not guaranteed, there is a real danger that enterprises will not use services offering the best expertise and qualifications, instead they will opt for cheaper services to the detriment of the quality of
services provided to them.
|