Academic journal article Nordic Journal of Working Life Studies

Understanding the Challenges Facing Occupational Health Services in the Swedish Public Sector

Academic journal article Nordic Journal of Working Life Studies

Understanding the Challenges Facing Occupational Health Services in the Swedish Public Sector

Article excerpt

Introduction

The overall aim of Occupational Health and Safety Management (OHSM) is to establish an effective prevention of work-related ill-health and to achieve beneficial working conditions. The question is whether or not Occupational Health Service (OHS) providers contribute to these goals in the public sector. This article will explore processes and contextual conditions for the use of OHS providers in the Swedish public sector.

According to Swedish legislation and regulation, the employer shall cooperate with employees in their preventive OHSM in order to create healthy and safe workplaces (Swedish Work Environment Authority, 2014a). OHSM in the strategy's mandatory form, EU's framework Directive (89/391(EEC; from 1989), specifies how employers should manage the work environment and the primary objective is for employers to protect employees from risks at work (Frick, 2014). To work preventive and systematically with the work environment is a continuous process with recurring activities, and in order to achieve this, it needs to be an everyday aspect of work. The Plan-Do-CheckAct model is basic in preventive OHSM, and to achieve continuous improvement, it is important to identify and address all types of risks at work and to have an effective monitoring process to reduce accidents, injuries, and ill-health. In support of this process when competence within the employer's own organization is insufficient, legislation states that the employer shall employ external resources such as an OHS provider (Swedish Work Environment Authority, 2001). The Work Environment Act defines the role of an OHS provider as working specifically to prevent and eliminate health hazards in the workplace and providing the skills necessary to identify and explain connections between the working environment, organization, productivity, and health and safety (Swedish Work Environment Authority, 2014b). An OHS provider is not part of the public health, but operates as an independent company in an open market or is incorporated into the organization (Gunnarsson et al., 2011). Compared to the Nordic countries, the Swedish OHS providers are among the least regulated with no monitoring or evaluation of the system of OHS providers (Hämäläinen et al., 2001). In the discussion of the role and tasks of the OHS provider, it is important to consider the differences of OHS systems between countries (Westerholm et al., 2000). The role given to OHS provider by law and regulation differs between countries, which makes comparison difficult. It would be very complex and give little insight in how to make best use of OHS within each given context.

Similar requirements for the provision of the preventive services are defined in many national laws (Fedotov, 2005). The Nordic countries have considerable different solutions; in Finland, it has been obligatory for employers to arrange preventive OHS since 1979 (Kankaanpää, 2008, 2013). In Norway, the enforcement of the Law on the Working Environment became stricter and an accreditation system for OHS providers was introduced in 2010. Now, an OHS provider has to be authorized by the Norwegian Labour Inspection Authority (Vinberg et al., 2015, 2017). The accreditation system has improved the quality of the OHS providers' in Norway, for example, increased professional competence and multidisciplinary working (Lie & Bjørnstad, 2015). A new OHS system has also been introduced in Denmark in 2005. Thereafter, the Danish Working Environment Authority screen enterprises at a kind of informal inspection and then defining which problems require advice from an OHS provider (Danish Government, 2011; Arbejdstilsynet, 2013).

Deficiencies in OHSM in municipalities and county councils in Sweden have been identified (Frick, 2013b; Dellve et al., 2004). In the public sector, most work is service work, largely done by women (Kamp et al., 2013a; Swedish Agency for Public Management, 2015) and bearing in mind the high rates of absenteeism due to illness and longterm sick leave in the public sector (Vingård et al. …

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