Poland: Employment opportunities for people with chronic diseases

  • Observatory: EurWORK
  • Topic:
  • Labour market policies,
  • Darbo laikas,
  • Health and well-being at work,
  • Working conditions,
  • Published on: 14 Lapkritis 2014



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Disclaimer: This information is made available as a service to the public but has not been edited by the European Foundation for the Improvement of Living and Working Conditions. The content is the responsibility of the authors.

In public policy as well as national statistics, a definition of people with chronic diseases is not used, but in both areas, the category of people with disability is commonly used. Data shows that the activity rate and employment rate of people with disabilities are over three times lower than in the total population. Most of them are employed as workers in manufacturing and within the system of supported/sheltered employment. People with disabilities perceive their carrier opportunities as very limited. The main public policy aiming at improvement of their employment situation has its foundations in the Act of 27 April 1997 on vocational and social rehabilitation and employment of persons with disabilities.

Block 1: Concept, definitions, sources of information and methodological issues on chronic diseases and work from the national perspective

1.1. National definition of chronic disease

In the employment context in Poland, the legal definition of “disability” is used rather than the category of “chronic diseases”. Legally disabled people are people who, in accordance with the provisions of the Act of 27 April 1997 on vocational and social rehabilitation and employment of persons with disabilities, are aged 16 years or over and have the certificate of disability or inability to work. Three degrees of disability are specified: severe degree of disability or equivalent, moderate degree of disability or equivalent, minor degree of disability or equivalent.

The legal definition of disability refers to long-term diseases and health conditions or difficulties in performing basic activities. The legal definition of disability includes the following categories of chronic diseases or disorders: mental disorders; voice and speech disorders, hearing diseases; ocular diseases; locomotor disability; epilepsy; respiratory and circulatory system diseases; digestive system diseases; genitourinary system diseases; neurological diseases; pervasive developmental disorder; other disorders and diseases, including endocrinologic, metabolic, enzymatic disorders, zoonotic diseases, infectious diseases, disfigurements, hematopoietic system disorders.

The legal definition of disability is also used in the methodology of the Central Statistical Office (GUS).

1.2. Information on national sources of statistical information dealing with the issue of chronic diseases and their relation to employment and working conditions

The survey “Employment of disabled people in 2011”/ “Osoby niepełnosprawne na rynku pracy w 2011” (the Central Statistical Office/GUS). The survey was carried out in the second quarter of 2011 as a module of the Labour Force Survey (LFS) with the use of sample survey method. The observation covers all disabled persons (i.e. persons suffering from long-term health conditions and diseases, or with difficulties in performing basic activities), aged 15-64 years. The above mentioned health conditions and diseases did not have to be diagnosed and confirmed by a physician. The survey provides information on: type of health conditions suffered by the respondents, character of disability, impact of disability on the number of hours worked during a week, impact of disability on the type of performed work, the need of a disabled person to use special equipment or assistance in performing work.

The Yearbook of Labour Statistics 2012” and “The Yearbook of Labour Statistics 2010” (the Central Statistical Office/GUS). The data refers to the legal definition of disability. The Yearbooks include information on: economic activity by age, gender, place of residence and degree of disability, employment in public and private sector.

The National Census of Population and Housing (Narodowy Spis Powszechny) was conducted in the territory of the Republic of Poland in the period from 1 April to 30 June 2011. The census was carried out by the Central Statistical Office (GUS).  The census was taken with the use of so-called mixed method: administrative registers and information systems, statistical survey (complete and sampling). General information on disability has been included: the number and structure of people with disabilities by age, gender, place of residence, marital status, level of education, gender, income, livelihoods and economic activity. Interviewed people answered questions on disability on a voluntary basis.

Data on the number of employees with disabilities and employers who employed them is also collected by The State Fund for Rehabilitation of Disabled Persons (PFRON) in System Obsługi Dofinansowań i Refundacji .

Block 2: Prevalence, recent evolution and effects of the problem of chronic diseases among workers and companies

2.1. People affected by chronic diseases and employment

Generally speaking, information/data on chronic diseases are not collected in Poland. According to the LFS (a module survey “Employment of disabled people”), in the second quarter of 2011, the population of disabled people in Poland (determined according to the legal criterion) comprised 3,402 thousand, which constituted 10.7% of the total population aged 15 years and more. The disabled population consists mainly of the elderly; people aged 65 years and more constituted 33.7% of the total disabled population, while people aged 55-64 years – 32.3%. It may be observed that the share of disabled people visibly increases with age.

The data collected in the National Census of Population and Housing (Narodowy Spis Powszechny), conducted in 2011, indicates that there are nearly 4.7 million disabled people in Poland, which constitutes 12.2% of population in Poland, in relation to 14.3% in 2002 (according the previous census). Almost 46.1% of all disabled people are men as compared to 53.9% who are women. More than 3.1 million people have the certificate of disability. The figures might differ due to the underestimation of collected data. According to the census, the total number of legally disabled people has been decreasing since 2002 and the number of not certificated disabled people has been growing.

According to the LFS, among long-standing health conditions, the most often mentioned were problems or diseases connected with heart, blood pressure or circulatory system. Problems with back or neck (including rheumatism or arthritis) are in the second place. These health problems were observed among less than 5% of the respondents.

Table 1. Basic indicators for the total population and for disabled persons in 2011 (according to the legal criterion)

Specification

Population total

Disabled people

In %

Activity rate in %

56.0

17.2

Employment rate in %

50.7

14.8

Unemployment rate in %

9.5

13.7

Source: LFS  2011, GUS

According to the LFS, activity rate and employment rate of disabled people were over three times lower than the respective indicators for the total population aged 15 years and more, while unemployment rate was lower by almost a half. Employment rate among disabled men was 17.7%, while among disabled women - 11.9%. Among 504 thousand employed disabled people, 350 thousand were employed full-time. Over 70% of employed disabled people worked as employees, mainly in the private sector, whereas self-employed people comprised over 23%. The disabled employed in manufacturing (104 thousand) constituted the largest group; almost the same number of disabled persons were employed in agriculture, forestry and fishing (102 thousand).

Table 2. Economically active disabled persons in 4th quarter

 

2010

 

2011

2012

total

men

women

total

men

women

total

men

women

Total (in thousands)

 

579

 

344

 

235

 

571

 

332

 

240

 

588

 

388

 

250

 

in % of disabled person aged 16 and more

17.3

20.4

14.1

17.1

20.0

14.2

17.7

20.6

14.8

Source: The Yearbook of Labour Statistic 2012, GUS.

The number of economically active disabled people as well as the employment rate have not changed over few years. Among disabled men, about 20% are economically active, while among disabled women – about 14%.

Table 3. The number of employees with disability and employers who employed them  (as of  31 December)

 

2006

2007

2008

2009

2010

2011

2012

2013

Employees total (in thousands):

212,1

221,0

203,0

247,2

267,2

245,5

243,6

248,7

- In the Supported Employment Enterprises

174,1

178,8

163,8

188,7

198,2

173,8

163,1

166,4

- on the open labour market

38,0

42,2

39,2

58,4

68,7

71,6

80,5

82,3

Employers total:

7 949

9 135

9 281

13 596

16 086

17 481

18 740

19 253

- the Supported Employment Enterprises

2 251

2 185

2 146

2 087

2 003

1 807

1 437

1 388

- the open labour market

5 698

6 950

7 134

11 507

14 075

15 671

17 302

17 865

Source: The State Fund for Rehabilitation of Disabled Persons, 2014.

According to PFRON most of the people with disabilities are employed in the system of supported employment but in the recent years one can observe an important trend: the number of employees on the open labour market has been significantly growing.

Table 4. Registered unemployed disabled persons (as of 31st December)

2008

2009

2010

2011

2012

In thousands

In % total unemployed

73,1

94,5

100,3

104,7

111,5

5.2

Source: The Yearbook of Labour Statistic 2012, GUS.

The number of registered unemployed disabled persons has been systematically increasing since 2008. It can be closely related with the economic crisis.

The main difficulties to access or stay in the labour market are: insufficient education, transport and architectural barriers, prejudices of employers, lack of workplaces adjusted to the needs of people with disabilities (State Fund for Rehabilitation of Disabled Persons, 2010, “Job satisfaction among people with disabilities. Report”).

According to the LSF (a module survey “Employment of disabled people”), one can indicate that certain jobs are associated with certain chronic diseases or health problems:

  • Most problems with arms, hands, legs or feet were observed among agricultural, forestry and fishery workers, among craft and related trades workers;
  • Problems with back or neck most often were observed among agricultural, forestry and fishery workers, then among service and sales workers;
  • Cancer was mostly observed among professionals, craft and related trades workers;
  • Heart, blood pressure or circulatory problems were observed among agricultural, forestry and fishery workers, then – among craft and related trades workers.
  • Chest or breathing problems were observed mainly among professionals and elementary occupations;
  • Diabetes was mostly observed among craft and related trades workers as well as among elementary occupations;

However, the analysis of particular occupational groups indicates that:

  • Managers most often suffer from heart, blood pressure or circulatory problems;
  • Professionals have problems with back and neck (including arthritis or rheumatism);
  • Technicians, associate professionals and clerical support workers suffer from blood pressure or circulatory problems;
  • Service and sales workers, agricultural, forestry and fishery workers, craft and related trades workers, plant and machine operators and assemblers have problems with back or neck (including arthritis or rheumatism);
  • Elementary occupations workers suffer from problems with back or neck as well as heart, blood pressure or circulatory problems.

According to the LFS, health problems and diseases had an impact on limitation in the type of work that the respondents were able to perform. This was declared by over a half of the group of about 5.7 million persons aged 15-64 and suffering from various conditions (among the employed it was reported by 32%). Health problems or diseases, which most often caused these limitations include: progressive illnesses (including sclerosis multiplex, HIV, Alzheimer’s disease, Parkinson’s disease), epilepsy, learning difficulties, mental or nervous problems (including schizophrenia, phobias, anorexia, sleeplessness, chronic anxiety), cancers. People who attained a low level of education more often reported the necessity for limitation in type of work than better educated persons.

2.2. Working conditions of employed people affected by chronic diseases

According to the LSF (a module survey “Employment of disabled people”), one can indicate that 24% employed people with long-standing health problems indicate health problems or diseases as the reason for limitation in the weekly number of working hours.

Due to various diseases or health conditions, persons suffering from them may have limited possibility of getting to and from work. They may have problems with the access to buildings (high steps and lack of ramps for wheelchairs, lack of lifts) and the necessity to use special transport, special equipment (e.g. wheelchair), the help of other persons - about 27.5% respondents reported it. About 10.9% of people suffering from health problems or diseases declared that they would need or use special equipment or workplace adaptations.

25.2% of respondents declared they needed or used special working arrangements enabling work, e.g. sedentary work, possibility to perform work at home, the number of working hours and arrangement of working time (part-time work, flexible hours of work).

The “Job satisfaction among people with disabilities. Report” (“Zadowolenie osób niepełnosprawnych z pracy. Raport”), prepared by TNS OBOP for the State Fund for Rehabilitation of Disabled Persons (PFRON), provides some interesting information on working conditions of employed people with disabilities. In 2010, TNS OBOP carried out quantitative research (via Paper and Pencil Interviews, PAPI) among employed people with disabilities. The research analysed the following issues s: earnings satisfaction, communication with supervisor and co-workers, working conditions, career opportunities, quality of job, employment security. 

Best assessed by people with disabilities were working conditions and relations with co-workers and superiors, while salaries, employment security, carrier opportunities and professional development were assessed as very bad.

The relatively low level of education among people with disabilities is strongly associated with the positions occupied by them. Only 3% respondents were managers (primarily, middle and lower level). The same percentage of respondents were employed as specialists. 10% of respondents worked as white-collar workers, clerical or administrative staff. The largest group was skilled workers (55%), while unskilled workers comprised 11%. It may affect their carrier opportunities which were assessed as strongly limited. About 45% of respondents claimed there was no chance for a promotion at work for them, while 31% of respondents had no opportunity to develop their occupational skills.  25% of respondents had no opportunity to take part in occupational trainings or workshops. These aspects were particularly poorly rated by people with mental illness.

Some 45% of respondents were not afraid of losing their jobs (18% were afraid of it). It was declared mainly by people with hearing difficulties, while people suffering from epilepsy and circulatory system diseases as well as young employees were the largest groups who were afraid of losing their jobs.

Block 3: Policies and measures adopted by public and private agents to favour the employment situation and working conditions of people with chronic diseases

3.1. Description of main policy measures/initiatives developed by public authorities or social partners

The main policy measures developed by public authorities in Poland to improve the employment situation and working conditions of people with chronic diseases is the Act of 27 April 1997 on vocational and social rehabilitation and employment of persons with disabilities. In the Act, the basic rights of employees with disabilities and employers employing persons with disabilities are defined. Some other regulations are included in the Labour Code.

The employees with disabilities have the right to:

  • Additional break in a daily working time; people with disabilities have the right to additional work break (15 minutes), which is included in their working time and is intended for exercise or recreation;
  • Additional vacation leave; people with a significant or moderate degree of disability receive an additional vacation time (10 days per year). They have the right to take time off work for medical examinations and treatment, rehabilitation and purchase or repair of orthopedic equipment;
  • Time off work for rehabilitation or medic tests with the right to remuneration; they can take 21 days once a year;
  • Shorter working time: 7 hours daily and 35 weekly. The Act on Rehabilitation includes limitations as to the maximum working time: 8 hours a day, 40 hours a week. Employer and employee with disabilities have also ability to set their own working time arrangements;
  • Employers are obliged by the Labour Code to implement “reasonable adjustments” (“racjonalne usprawnienia”) for people with disabilities at the workplace. According to the Act on Rehabilitation, employers have to equip and adapt a workplace to the needs of a person with disabilities.

The employers employing persons with disabilities can get:

  • Subsidy for remuneration of employees with disabilities;
  • Refund of the cost of adapting the workplace;
  • Refund of the cost of the workplace equipment;
  • Refund of the cost of training;
  • Refund of the cost of employing a person who assists the employee with disabilities.

All the subsidies and refunds are paid by the State Fund for Rehabilitation of Disabled Persons (Państwowy Fundusz Rehabilitacji Osób Niepełnosprawnych – PFRON). PFRON is a special fund whose funds are allocated to occupational and social rehabilitation of persons with disabilities and employment of persons with disabilities. It operates under the Act on vocational and social rehabilitation and the employment of persons with disabilities.

There are also special forms of enterprises employing people with disabilities. If one employer has more than 50% of workforce composed of persons with disabilities, it can get the status of the Supported Employment Enterprise (Zakład Pracy Chronionej). Such enterprise does not have to pay some taxes and fees but is obliged to run a special fund from which the costs of vocational, social and medical rehabilitation of employees with disabilities are paid.

Local authorities (gminas and poviats) and non-governmental organizations (associations and foundations) can establish a Vocational Rehabilitation Facility (Zakład Aktywności Zawodowej). Such facilities are subsidised by PFRON and allowed not to pay some taxes and fees. They have to employ more than 70% of all workforce people with disabilities. Facilities are obliged to run special fund from which the costs of purchase of special equipments, repairs of flats, training are paid.

There are no comprehensive studies or evaluations concerning the forms of support described above. It can be stated that about 70% of all working people with disabilities are employed in Supported Employment Enterprises but in the recent years, a decrease in the numbers of such enterprises and employees can be observed. At the end of 2013, there were only 1.388 enterprises which employed about 166.400 people. Vocational Rehabilitation Facilities are far less important. At the end of 2013, there were only 67 facilities which employed about 2.300 people.

3.2. Examples of enterprises and/or collective agreements implementing initiatives or establishing clauses to support people with chronic diseases

It is hard to identify initiatives or clauses to support people with chronic diseases implemented by enterprises or collective agreements. No institution collects such data. Most of the cases which can be found and described are examples of non-governmental organizations’ or PFRON’s activities. Some of them promote occupational activity of people with chronic diseases, like the Contest “Simply Active” (the contest was created in 2013 and was addressed to non-governmental organizations supporting people with Inflammatory Autoimmune Diseases) or new measures to support employment of people with disability. One can find examples of campaigns promoting good practises in employing of people with disabilities but it is not possible to fully describe a single case study. The "Promoting Healthy Work for People with Chronic Illness" campaign took place in Poland in 2012. The campaign was led by the National Centre for Workplace Health Promotion. On the centre's website one can find information on chronic diseases and their impact on work as well as the list of scientific articles related to this issue.

Commentary

It must be emphasised that it is quite difficult to provide more detailed information on the situation of people with chronic diseases in the labour market in Poland. Firstly, most of the collected data concerns the situation of a wider category, namely, people with disabilities, both in public policy and national statistics. Secondly, the available data does not give a full picture of the situation of people with chronic diseases, especially if they are not certified as disabled people. 

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