Organizational models for OHS
Organizational models for OHS
Occupational health services for all workers, irrespective of age, sex, nationality, type of employment, size or location of workplace, has been a long-term objective of the World Health Organization. Few countries, if any, have fulfilled this suggestion completely. The development of occupational health services differs from country to country. Some countries have hardly any occupational health services at all; others provide highly developed services.
The occupational health services (OHS) are organized in various ways in different countries. An important issue is that the OHS must be free and independent. They are a health service which must be a support to both the employer and the employee. The OHS must be neutral and not take side with any of these two parts of the working life. So how can this be accomplished best?
Two main types of occupational health services exist; one called “internal occupational health services” in which personnel are employed by individual companies, and another called “external occupational health services”. in which personnel work in a unit serving several companies.
a) Internal OHS
Internal OHS - An occupational health services can be organized inside a factory, as an internal OHS. ©University of Bergen
In internal occupational health services, the occupational health personnel are located on the company premises, and the personnel are employed by the company. This is a solution often chosen by large companies who can afford to employ their own personnel. This model of OHS makes it possible for OHS personnel to be close to the workers and their problems, and gives great opportunities for understanding the work processes as well as the company culture. However, the closeness to the company might make it difficult for OHS personnel to ask for changes; as for improvement of the work environment. It is important for such OHS units to keep their integrity.
b) External OHS
External OHS - An occupational health service can be external, serving many companies. ©University of Bergen
Personnel in the external model are most often based in units outside the companies. There are different ways to organize such units. An external occupational health services can be owned by a number of companies who co-operate. These types of OHS can also be established as separate companies, owned by an outside owner, a hospital or a stock-company. It can also be owned by the health personnel themselves, those who are working in the OHS. An external type of OHS serves many companies, and is a good solution for smaller companies who cannot employ their own OHS staff. The external OHS unis often describe themselves as particular independent, as they do not depend on the company they serve – directly. However, such units have to find customers. The customers are the companies. Discussions on the price of the service and how to attract clients are common among personnel in the external occupational health services, and competition between the units can be high in some countries. External OHS units can sometimes be large, giving opportunities for a good scientific environment, but can also be organized as a chain of smaller units where the personnel work much alone.
In some countries, the OHS is paid by the companies themselves, with no public support. In other countries, the OHS can be partly paid by public sources. Some countries integrated the OHS in other activities such as community health units, while other countries have OHS as separate units, with no specific association with other parts of the health system. It is difficult to say what the best solution is. What seems to be important is that the countries have a legislation which requires OHS to be in place, one way or the other. Without any legislation, establishment of OHS is hard to achieve. The legislation can for instance ask for OHS to be established within certain industries or activities where the risk of work related diseases and injuries is high.
The OHS must be paid by someone. ©Colourbox
© University of Bergen/Author: B.E. Moen