Innovation in occupational health management Riitta Sauni Ministry of Social Affairs and Health Finland

Population of Finland, age and gender 1950, 1970, 2003 and 2030 (predicted)

Aims and measures nationally to extend careers Significant decrease of disability pensions Efficient and comprehensive collaboration in health care system to maintain work ability Tools for the workplaces to improve well-being at work Prolonging of careers also in the beginning of work careers Increasing know-how and training at work To improve abilities needed for work life already at school

New legislation in Finland 2011: In order to get 60% compensation instead of 50% from the preventive work of occupational health care, the workplace should have a management strategy to maintain and promote workability. 2012: To prevent unnecessary long sickness absence periods, the employer must inform OHS if a worker’s absence has continued 1 month. To get compensation after 90 days, the worker must send a certificate from the OHS physician, who should evaluate the working capasity and negotiate with the employer about adjustments at work which could help the worker to return to work.

New legislation in Finland (cont.) Partial sickness absence: 72 days -> 120 days Enables partial sickness absence also if a person has two or jobs at the same time. Updated Government Decree on the principles of good practices in occupational health practices, the content of occupational health care and the educational qualifications required of professionals and experts.

Expected effective retirement age, all new retirees on an earnings-related pension

Vocational rehabilitation New work disability pensions

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Occupational health care system in Finland Occupational health services (OHS) means the activities of occupational health care (OHC) professionals and experts that the employer has a duty to arrange by law and which are used to promote the prevention of work-related illnesses and accidents, the healthiness and safety of the work and working environment, the functioning of he workplace community and the health, working capacity and functional capacity of employees. In Finland OHS is seen as a part of the primary health care system, but also as a part of the workplace health and safety system. It is the duty of an employer to arrange occupational health care, but entrepreneurs and other self- employed can arrange OHS on voluntary basis.

Special features of the Finnish OHS  Tripartite Advisory board on Occupational Health Care (based on law)  Tripartite negotiations in state level  planning and follow-up of OHS  Legislation since 1978  Curative services as part of the OHS  Since 1990 the concept of Maintenance of Work Ability as part of OHS  Finnish Institute of Occupational Health with five Regional Institutes

Tasks of occupational health care (Occupational Health Care Act 1383/2001) The purpose of the Act is to promote the following through cooperation between the employer, the employee and the occupational health care provider: 1) the prevention of work-related illnesses and accidents; 2) the healthiness and safety of the work and the working environment; 3) the health, working capacity and functional capacity of employees at the different stages of their working careers; and 4) the functioning of the workplace community.

Coverage of OH services in Finland and the OHS providers

Trends in OHS in the past 10 years The coverage remains high among salaried employees, but is still low among self-employed and private enterpreneurs for whom OHS is voluntary. The services has shifted to private OHS clinics, also the number of public- service companies are increasing. The size of OHS units is still small in terms of the number of clients, although the propotion of bigger units is increasing. The number of qualified personnel is developing favorably especially in the private OHS clinics and public-service companies, although there is still a demand for physicians especially in the municipal health centers. The importance of prevention of work disability is increasing as well as co-operation with the health care system as a whole.

Factors causing work disability Patric Loisel, Ontario University Current health Workplace-related factors -The climate at work -The stability of employment -Return to work-practices Health care system-related factors -Practices in sickeness absence -Co-operation of different stakeholders Economical factors -Compensation from work and from absence of work

Monitoring and promoting the ability of employees to cope at work and referring for rehabilitation (Decree 708/2013 8§)

What we have achieved The idea of maintenance of workability is accepted The effective retirement age has risen (61,2 yrs in 2014) New disability pensions have decreased by 26% ( ) Sickness absences have decreased by 12% ( )