Tripartite talks launched on improving health at work

In November 2001, the Swedish government launched tripartite talks with the social partners on the issue of 'increased health in working life', against a background of increasing levels of sickness absence. The talks will seek to put into effect an 11-point programme drawn up by the government.

In the state budget bill for 2002, the Swedish government has set out a strategy for 'increased health in working life' ('en ökad hälsa i arbetslivet') in the form of an 11-point programme, first presented in May 2001. The aim of this programme is to give more workers possibilities to remain in or return to work after sick leave. Tripartite talks between the government and the social partners, which started on 13 November 2001, are a central part of the programme. These talks should create consensus and lead to the proposal of measures for prevention and rehabilitation, according to the programme. The government hopes that the tripartite talks will lead to a 'powerful' action plan that can be accepted by 'everybody'.

The parties invited to the first meeting in November were, on the trade union side, representatives of the Swedish Trade Union Confederation (Landsorganisationen, LO), the Swedish Confederation of Salaried Employees (Tjänstemännens Centralorganisation, TCO) and the Swedish Confederation of Professional Associations (Sveriges Akademikers Centralorganisation, SACO). The employers' representatives are the Confederation of Swedish Enterprise (Svenskt Näringsliv) representing the private sector, the Swedish Agency for Government Employers (Arbetsgivarverket), the Swedish Association of Local Authorities (Kommunförbundet) and the Federation of County Councils (Landstingsförbundet). The Employers' Alliance (Arbetsgivaralliansen), which negotiates on behalf of not-for-profit associations such as sports clubs and adult education organisations, and the Federation of Private Enterprises (Företagarnas Riksorganisation), which represents 60,000 small enterprises, will also take part in the talks, though without a negotiating role.

Two ministers, Ingela Thalén (social insurance) and Mona Sahlin (employment) represent the government in the discussions. Kenth Pettersson, general director of the Swedish Work Environment Authority (Arbetsmiljöverket) will lead and coordinate the talks. The government wants to see an action plan, capable of dealing with the high level of sickness absence, by May 2002.

The background to the tripartite talks and the forthcoming action plan is that there has been an immense increase in long-term sickness absence during recent years (SE0008160N). According to figures for May 2000, more than 100,000 Swedish workers - 65,000 women and 36,000 men - were on sickness absence of more than 12 months, and about one-third of these were absent for more than two years. In 1998, the state paid about SEK 20 billion in sickness insurance benefits, a figure which is predicted to increase to SEK 50 billion in 2002.

The state budget also sets aside SEK 10 million in both 2001 and 2002 for the training of regional safety representatives. Local trade unions already have responsibility for training safety representatives at the workplace.

The 11-point programme

The new 11-point programme at the centre of the tripartite talks sets out a range 'measures for better work conditions and increased health in working life', It should be understood more as part of dynamic process than an 'set package', according to the government. The programme was first presented in a report by a working group of the Ministry of Industry, Employment and Communication (Näringsdepartementet) in May 2001 (Ds 2001:28). The programme's 11 points aimed at producing a better work environment and increasing employers' responsibility are as follows.

1. National goals for increased health in working life. It is of utmost importance, says the government, that the social partners cooperate in formulating these goals.
2. Tripartite talks between the government and the social partners. A principal aim of these talks is to reach consensus on measures that may be proposed (see above).
3. Economic incentives for employers to prevent ill-health at the workplace. The government will try to find economic methods to make employers more willing to meet their responsibilities for working conditions and to integrate preventive and rehabilitation measures in their business activities. A condition for such an effort, however, is that there should be a consensus between the social partners on this matter.
4. Further development of the working environment in workplaces. For example, SEK 10 million will be invested in both 2001 and 2002 for the development of new methods in occupational health services.
5. Health accounts. Special measures will be introduced in the public sector, based on 'accounts' drawn up by public employers on the health of their employees. The possibility of introducing similar health accounts in the private sector will be investigated.
6. Attempts to decrease ill health in the public sector. The government will invest about SEK 150 million for 'experimental activities' in large public sector workplaces in order to counteract extended sickness absence.
7. Renewal of rehabilitation. There is a need for renewal of the administration of periods of sickness absence that risk becoming extended. There is also a need to make individual rehabilitation measures (SE0011161F) more effective. SEK 70 million will be invested in this area in 2002.
8. Adjustments to the current legislation. These are needed in order to raise the quality of rehabilitation work. The government will propose amendments to the sickness insurance legislation in due course.
9. Revision of the formal aspects of the sickness certification process.
10. Improvement of statistics and research in the area of ill-health.
11. Better access to treatment in the public health and medical service. A national action plan for development of the public health and medical service contains SEK 9 billion earmarked for primary care, geriatric care and psychiatric care in the period 2001-4. County councils will, in 2002-4, be assigned SEK 3.75 billion in order to increase access to various treatments provided by the service.

Commentary

A 'powerful action plan' is what the government wishes to obtain from the social partners as a result of the tripartite talks on increased health in working life. The costs to society of sickness absence, as well as the frequency of occupational diseases, have increased at frightening speed in the last few years. It is evident that measures of all kinds have to be implemented. One proposal that has been publicly discussed is a special 'work environment fee' for employers. This fee could be returned to the employer as a kind of bonus for 'successful' improvements in the work environment. There is currently a similar system in operation in Denmark. When the government talks of 'economic incentives for employers to prevent ill health' this method of placing more responsibility on employers may be one measure that will be proposed to parliament in 2002. However, an evaluation of the Danish experience will be carried out before Sweden considers copying the arrangement.

No reservations about the tripartite talks have yet been expressed by any of the social partners invited to attend by the government. All parties no doubt understand the seriousness of the human and economic problems raised by the increasingly bad health of the Swedish population, and many cases of sickness absence result from deficiencies in the work environment. (Annika Berg, Arbetslivsinstitutet)