Role and contribution of corporate health service providers

A project by the National Institute of Occupational Health and the Norwegian Labour Inspection Authority examined the role and impact of occupational health service providers in Norwegian enterprises. Companies claimed to prioritise work environment surveys and occupational health monitoring more than the corporate health services believed they did. Both parties believed that corporate health services contributed to dialogue much more than indicated by inspections.

About the survey

It is essential that businesses receive the occupational health services they want and need. In 2008–2009, the National Institute of Occupational Health (STAMI) and the Norwegian Labour Inspection Authority (Arbeidstilsynet) carried out a project that looked at the role and contribution of occupational health services in Norwegian enterprises. The aim of the project was to learn more about the services offered to companies by corporate providers and the extent to which companies and their corporate health service had appropriate cooperation and dialogue.

A project group was established with participants from both companies and corporate health services. The Norwegian Labour Inspection Authority conducted inspections at 72 selected enterprises in seven regions to see how they used their occupational health services. A checklist was drafted to ensure the same issues were examined at all inspected enterprises. The conditions were assessed and recorded in an audit database.

For the survey, a questionnaire was designed that focused on the priorities of the working environment as well as the cooperation between companies and corporate health services. The questionnaire was sent to both parties so that the situation was recorded from their respective viewpoints. Thus it became possible to gain knowledge about how they worked and to what extent they had a good dialogue.

STAMI sent out questionnaires to the 72 companies and their corporate health services, and gathered up the responses for further evaluation and statistical analysis. Three businesses and eight corporate health services did not respond. This gave a response rate of 95% and 88%, respectively. Data were also obtained from the Norwegian Labour Inspection Authority database for 70 of the businesses. The aim was to look at cases where both companies and their occupational health service provider had responded. A total of 59 such pairs were found and these were chosen to be used as a selection for all statistical runs and analysis.

Key findings

Questionnaire responses

Companies consistently reported that they prioritise work environment surveys and the monitoring of occupational health to a greater extent than the corporate health services’ experience of this. However, the picture is reversed when asking who carries out monitoring of the working environment and provides information services. Corporate health services claim that they provide appropriate services to a greater extent than companies perceive and report. This is seen especially for consulting services for planning and changing jobs. While 73% of the corporate health services believed that they provide these services, only 35% of businesses reported that they do this.

At the same time, the businesses were generally very positive about their company health services and 80% agreed that they were enthusiastic, cooperative and helpful. The companies also stated that they received the services they needed and that their employees were happy.

Inspection findings

The inspections by the Norwegian Labour Inspection Authority produced a more negative picture of the companies’ use of corporate health services. In particular, it concluded that the businesses are using the mandatory counselling services to an insufficient extent. Weakest, at 54%, was the requirement that the company health services assisted with in-house rehabilitation work. The assistance of corporate health services in reducing absenteeism was also considered inadequate.

In general, the corporate health services and companies believed that the former contributed more to a greater extent to public health education on reducing work absence than indicated by the inspection findings. At the same time, the data from the inspections showed that companies with an Agreement on a More Inclusive Working Life (IA Agreement) use their corporate health services to a significantly greater extent than non-IA participating companies, and that they are more active in tackling absenteeism.

Commentary

Audit data confirm the importance of extensive audits by the Norwegian Labour Inspection Authority into how companies make use of their corporate health services in complying with working environment regulations. As the data show that only 33% of businesses have been checking that their corporate health services have sufficient competence to implement the regulations’ requirements, the government’s decision to introduce a certification scheme for corporate health service providers in Norway seems appropriate.

Reference

Bjornstad, O., Lie, A., Sletmo, K. and Steinar Høiback, S. (2010), Bedriftshelsetjenestenes rolle og innsats i virksomhetene [Corporate health services’ role and efforts in enterprises], STAMI report 6, National Institute of Occupational Health, Oslo.

Bjørn Tore Langeland, National Institute of Occupational Health