Health Checks May Become More Expensive in The Future

The Ministry of Social Affairs is planning to change the regulation concerning health checks. The intent contains positive amendments for the employers as well as amendments that will significantly increase expenses for the employers.

It is positive that the decisions of health checks will become digital and the format of the decisions will become clearer. In the future, the decisions of health checks will be sent to employers through the work life information system. This means that there will be no sending or preserving of paper documents. It is also positive that the different doctors will be able to e-consult with each other and attempts will be made to solve the problem related to availability of the service.

At the same time, the intent contains several amendment proposals that entrepreneurs are not in favour of.

Extending the content of occupational health services will significantly increase the expenses of employers

Today, we are facing a problem that the employers and occupational health doctors are not cooperating sufficiently and the health checks are not based on the risks of the work environment. To solve the problem, the Ministry wishes to extend the content of services related to health checks in the way that in addition to health checks employers would be obliged to order from the occupational health doctors analysis of the company as a whole, visiting the work environment and consultations.

The Chamber of Commerce emphasised to the Ministry that contributing to the health of the employee is definitely important and due to that it is important that the occupational health checks would be of high quality and substance. However, the Chamber did not support the solution offered for that moment as it makes the service much more expensive for the employers while the problem could be solved with other measures.

Focus should be on making supervision more efficient and health check decisions more thorough

As generally the cause of the problem is the fact that the employer risk analyses do not reflect the actual situation in the working environment and the health check decisions do not help improving the working environment in practice, the focus should be on making the risk analyses more accurate to reflect the actual situation and that the decisions of the health checks would be clearer and more thorough than today. More thorough decisions allow employers to better understand how the working environment could be improved. The Chamber made a proposal to the Ministry to focus first on making the supervision more efficient and health check decisions clearer and more thorough.

Concerning plan to update the list of occupational illnesses with illnesses caused by psycho-social risk factors

Such amendment would essentially mean that in the future, if an occupational health specialist diagnoses an illness that may be caused, for example, by unequal treatment, monotonous work, bullying etc and it is revealed that the employer did not take any measures to alleviate the risks, the employee will be able to request compensation of damages from the employer. The Chamber drew the attention of the Ministry to the fact that in practice it is very difficult to find causal relation between psycho-social risk factors and occupational illness. Mental health problems related to work and personal life might be connected and very often they cannot be separated. Therefore, it is important that there would be specific measures. In the contrary case there would be many disputes.

Additional measures should be taken in order to improve availability of the occupational health doctor

In order to improve availability of service across Estonia, the Ministry is offering a solution to allow occupational health doctors to provide their service in the rooms of other doctors where they normally do not work. There would be no obligation to go there or other doctors to allow them to go there.

This amendment certainly has a certain positive effect, but it is not enough. The Chamber proposed to consider if the areas where the occupational health service is not reasonably available and the working environment risk factors are “easier”, health checks could be conducted by family physicians, who would consult with the provider of occupational health service provider. If it is revealed that an employee still needs a more thorough check-up, they can be sent to the occupational health doctor.

In certain cases, the right to conduct health checks could be extended to family physicians

In addition to the above, the Chamber made a proposal to give the employers the option to send their employees to health checks, in certain cases, at the family physician’s of the employee during regular visits. Such option could be given to the employers when the employee is an office worker and the risks of the workplace are lower and foreseeable or when it is necessary to pass the first check-up before commencing work (e.g. in case of night workers or workers in contact with chemicals). Whether the check-up conducted by the family physician is enough or there is a need for more thorough service, should be revealed by the risk analysis.

The option to pass health checks at the family physician’s is reasonable not only from the point of view of employers but also employees. Family physicians are more available compared to the occupational health doctors and there is probably a long-term confidential relationship between the family physician and employee, due to which it could be presumed that family physicians know the health of the employee better.

Read more on the intent of the Ministry here.