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Previous comments: C.155 and C.187, C.161 and C.115
Repetition Article 5(g) and (h). Adaptation of work and vocational rehabilitation. The Committee notes that the Government has not provided a specific response to the comments previously raised by the Committee under this Article. The Committee therefore reiterates its request that the Government indicate the measures taken or envisaged, in law and in practice, to ensure that occupational health services promote the adaptation of work to the worker, in accordance with Article 5(g); and contribute to measures of vocational rehabilitation, outside of the measures taken regarding handicapped persons, in accordance with Article 5(h).Application in practice. The Committee notes the information provided by the Government indicating that public health protection authorities continuously carry out supervision of occupational preventive health care and that occupational health care services have improved and the relevant trend remains positive. The Government indicates that according to supervisory findings in 2009, full occupational preventive health-care services were provided for 65 per cent of employers, while a total lack of occupational preventive health care was only recorded for 2 per cent of employers, compared to 2.5 per cent in 2008. The Committee notes the information that improvements in occupational health care services have also been supported by the creation of numerous private health care facilities providing occupational health care within an extent corresponding to the Convention. The Committee asks the Government to continue to provide information on the application of the Convention in practice.
Repetition Article 10 of the Convention. Professional independence. The Committee notes the response provided by the Government which indicates that providers of occupational health care are independent from employers and that currently the care provided is almost entirely based on a contractual relationship between the employer and the occupational health-care provider. The Committee notes the comments by the Czech-Moravian Confederation of Trade Unions (CMKOS), included in the Government’s report, which state that there are health-care institutions which still use their own employees (doctors) for occupational health purposes and their independence is thus compromised. The Committee notes the Government’s response thereto, which indicates that the comments by CMKOS were discussed at the tripartite Working Group for the Cooperation with the ILO of the Council of Economic and Social Agreement on 18 October 2010, and it was agreed that a special sitting of the Working Group (with the expert participation from the side of the Government, as well as of the social partners) will be dedicated, in the near future, to the issue of occupational health services, as well as the White Lead (Painting) Convention, 1921 (No. 13). The Committee asks the Government to continue to provide information on the measures taken or envisaged to ensure that the personnel providing occupational health services enjoy full professional independence from employers, workers, and their representatives, where they exist, in relation to the functions listed in Article 5, with reference to the comments by CMKOS; and to provide further information on the outcome of the abovementioned tripartite working group. Article 11. Qualifications required for personnel providing occupational health services. The Committee notes the response provided by the Government, which indicates that, in addition to occupational health-care specialists, occupational health-care services are also provided by general practitioners. The Government indicates that the Institute of Healthcare Post-Graduate Education organizes training for general practitioners targeted at occupational health-care issues through courses covering 150 hours of lectures. The course is concluded by examinations and tests, after the passing of which the graduate receives a certificate. CMKOS admits that although new legislation has introduced specific provisions for education of medical doctors and nurses specializing in occupational health, these services are, in practice, usually carried out by general practitioners, and that the reform of the national health legislation has not been realized yet. The Committee notes the response above by the Government to the comments by CMKOS. The Committee asks the Government to continue to provide information on the qualifications required for the personnel providing occupational health services, with reference to the comments by CMKOS; and to indicate whether general practitioners, who undertake a role in occupational health care, do not do so until they are certified in such duties.
Further to its observation, the Committee notes the information provided in the Government’s latest report, including references to the availability of legislation online, and recent amendments to legislation concerning the application of the Convention, including the repeal, and replacing of Act No. 65/1965 Coll., Labour Code, by Act No. 262/2006 Coll., Labour Code, which came into effect on 1 January 2007; the amending of Act No. 258/2005 Coll., on public health protection, by Act No. 392/2005 Coll.; the repeal, and replacing of Government Regulation No. 178/2001 Coll., by the Government Regulation No. 361/2007 Coll., stipulating conditions of occupational health protection; and the adoption of a new Government Regulation No. 31/2010 Coll., on specialized education branches and professional specifications for health workers with special qualifications and Decree No. 185/2009 Coll., on specialization areas in the education of physicians, dentists, and pharmacists, and on the study areas of certified courses. The Committee further notes the information provided on the measures taken to ensure occupational health services fulfil their functions according to the requirements under Article 5 of the Convention. The Committee asks the Government to continue to provide information on relevant measures undertaken with regard to the Convention.
Article 5(g) and (h). Adaptation of work and vocational rehabilitation. The Committee notes that the Government has not provided a specific response to the comments previously raised by the Committee under this Article. The Committee therefore reiterates its request that the Government indicate the measures taken or envisaged, in law and in practice, to ensure that occupational health services promote the adaptation of work to the worker, in accordance with Article 5(g); and contribute to measures of vocational rehabilitation, outside of the measures taken regarding handicapped persons, in accordance with Article 5(h).
Part VI of the report form. Application of the Convention in practice. The Committee notes the information provided by the Government indicating that public health protection authorities continuously carry out supervision of occupational preventive health-care and that occupational health-care services have improved and the relevant trend remains positive. The Government indicates that according to supervisory findings in 2009, full occupational preventive health care services were provided for 65 per cent of employers, while a total lack of occupational preventive health-care was only recorded for 2 per cent of employers, compared to 2.5 per cent in 2008. The Committee notes the information that improvements in occupational health-care services have also been supported by the creation of numerous private health-care facilities providing occupational health-care within an extent corresponding to the Convention. The Committee asks the Government to continue to provide information on the application of the Convention in practice.
Article 10 of the Convention. Professional independence. The Committee notes the response provided by the Government which indicates that providers of occupational health care are independent from employers and that currently the care provided is almost entirely based on a contractual relationship between the employer and the occupational health-care provider. The Committee notes the comments by the Czech-Moravian Confederation of Trade Unions (CMKOS), included in the Government’s report, which state that there are health-care institutions which still use their own employees (doctors) for occupational health purposes and their independence is thus compromised. The Committee notes the Government’s response thereto, which indicates that the comments by CMKOS were discussed at the tripartite Working Group for the Cooperation with the ILO of the Council of Economic and Social Agreement on 18 October 2010, and it was agreed that a special sitting of the Working Group (with the expert participation from the side of the Government, as well as of the social partners) will be dedicated, in the near future, to the issue of occupational health services, as well as the White Lead (Painting) Convention, 1921 (No. 13). The Committee asks the Government to continue to provide information on the measures taken or envisaged to ensure that the personnel providing occupational health services enjoy full professional independence from employers, workers, and their representatives, where they exist, in relation to the functions listed in Article 5, with reference to the comments by CMKOS; and to provide further information on the outcome of the abovementioned tripartite working group.
Article 11. Qualifications required for personnel providing occupational health services. The Committee notes the response provided by the Government, which indicates that, in addition to occupational health-care specialists, occupational health-care services are also provided by general practitioners. The Government indicates that the Institute of Health Care Post-Graduate Education organizes training for general practitioners targeted at occupational health-care issues through courses covering 150 hours of lectures. The course is concluded by examinations and tests, after the passing of which the graduate receives a certificate. CMKOS admits that although new legislation has introduced specific provisions for education of medical doctors and nurses specializing in occupational health, these services are, in practice, usually carried out by general practitioners, and that the reform of the national health legislation has not been realized yet. The Committee notes the response above by the Government to the comments by CMKOS. The Committee asks the Government to continue to provide information on the qualifications required for the personnel providing occupational health services, with reference to the comments by CMKOS; and to indicate whether general practitioners, who undertake a role in occupational health care, do not do so until they are certified in such duties.
The Committee is raising other points in a request addressed directly to the Government.
1. Further to its observation, the Committee notes the information in the Government’s report, including information in response to questions raised in its previous comments, including regarding Article 5, paragraph (k). It also notes the information concerning the adoption of several pieces of new legislation relevant in this context, including Act No. 258/2000, on public health and Decree No. 424/2004 stipulating activities of health-services employees and other specialized employees. The Committee requests the Government to provide a copy of this legislation and additional information on the following issues.
2. Article 5, paragraph (g) and (h). Adaptation of work and vocational rehabilitation. The Committee notes the Government’s reference in this context to section 80 of Act No. 435/2004 providing for measures to ensure the insertion of handicapped persons. The Committee notes that provisions in Article 5, paragraph (h), of the Convention applies to all workers, not only handicapped persons and that the report is silent on provisions that provide for the adaptation of work and vocational rehabilitation for all workers. The Committee requests the Government to provide information in this regard.
3. Part III of the report form. The Committee notes that the report is silent on the special provisions adopted under section 138 of the Labour Code regulating specialized state supervision of occupational safety and health and on whether the former regulations are still in force. The Committee therefore renews its requests to the Government to provide a copy of these regulations and to state whether the former regulations are still in force.
1. The Committee notes the detailed information supplied by the Government in its report and information on the adoption of several new pieces of legislation including Act No. 155/2000 to amend the Labour Code, Act No. 95/2004 on terms of acquisition and recognition of professional qualifications, as well as Act No. 96/2004 on terms of acquisition and recognition of non-medical occupations and Decree No. 424/2004 stipulating activities of the health-services employees, and introducing a new specialization - nurse for occupational health care. The Committee also notes the observations of the Czech-Moravian Confederation of Trade Unions (CMKOS), included in the Government’s report.
2. Article 5 of the Convention. Occupational health services. The Committee notes that, according to the CMKOS, no measures have been taken to address the problems related to the general shortage of occupational health physicians, and that, as a result, occupational health physicians do not take part in the development of programmes for the improvement of work practices, the testing and evaluation of health aspects of new equipment. The CMKOS also indicates the requirement in Act No. 155/2000 that employers should refer workers to medical establishments for the provision of occupational health services, including vaccinations and preventive medical examinations required by their function cannot be fulfilled by most employers. Noting that the Government does not provide any further information on this issue, the Committee requests the Government to indicate measures taken or envisaged to ensure that the occupational health services in the country are able to fulfil their functions according to this Article.
3. Article 10. Professional independence. The Committee notes that the CMKOS considers that the provisions requiring that occupational health services should be professionally independent are not fully applied in practice. In their view, the fact that the medical centres at enterprises employ their own physicians to perform occupational care compromises the independence of the occupational health services. Noting that the Government does not provide any further information on this issue, the Committee requests the Government to indicate measures taken or envisaged to ensure the professional independence of occupational health physicians.
4. Article 11. Qualifications required for personnel providing occupational health services. The Committee notes the Government’s reference to new legislation in this area, including Acts Nos. 95/2004 and 96/2004, concerning qualification requirements for occupational health physicians and nurses respectively. The Committee also notes the statement by CMKOS that this new legislation is not adequately applied in practice, as occupational health services, when performed, are often performed by general practitioners. The Committee requests the Government to indicate measures taken or envisaged to ensure a full application in practice of this Article of the Convention.
5. The Committee is raising certain other points in a request addressed directly to the Government.
The Committee notes the information supplied by the Government in its last report to the effect that section 133 of the Labour Code has been amended in order to set out employers’ obligations in the area of health and safety. The Committee recalls that in its first report on this Convention, received in 1994, the Government stated that there had been a fundamental transformation of the whole health system. It also indicated that Act No. 550/1991 abolished the Instruction of the Ministry of Health concerning the organization of enterprise health services. It further stated that new legislation was under preparation. The Committee therefore renews its request to the Government to provide as soon as possible copies of the laws or regulations in force which give effect to the provisions of the Convention.
The Committee notes the information concerning Articles 10 and 12 of the Convention. It draws the Government’s attention to the following points.
Article 5, paragraphs (d), (g), (h) and (k). The Committee notes that, according to the Government, Act No. 20/1966 on People’s Health Care covers occupational health services. This Act describes briefly the role of occupational health services. The Committee also notes that apart from the medical centres of a few big companies, there is a general shortage of physicians specializing in occupational health services. Furthermore, these services are currently provided by general practitioners, who perform only preventive medical examinations. They participate only to a minor extent, if at all, in the development of programmes for the improvement of working practices, testing and evaluation of the health aspects of new equipment. The Committee notes that, according to the Government, the same applies to the provisions of the Convention on the adaptation of work to the worker, vocational rehabilitation measures, and analysis of occupational accidents and diseases. The Committee asks the Government to keep the Office informed of any improvements in this area and to report on any measures taken to ensure that occupational health services carry out the following functions: participation in the development of programmes for the improvement of working practices as well as testing and evaluation of the health aspects of new equipment; promotion of the adaptation of work to the workers; contribution to measures of vocational rehabilitation; participation in analysis of occupational accidents and occupational diseases.
The Government indicates in its report that the obligation to ensure occupational health services is based on the provisions of the People’s Health Care Act, No. 20/1966, and that work is in progress on a new health-care Act in which the subject of occupational health services will be covered in full conformity with EC legislation and Convention No. 161. The Committee asks the Government to keep the Office informed of progress made in this regard and to provide a copy of the new Act once it is adopted.
Part III of the report form. The Committee notes that section 138 of the Labour Code provides for specialized state supervision of occupational safety and health which shall be regulated by special provisions. It asks the Government to provide a copy of these regulations and to state whether the former regulations are still in force.
The Committee notes with regret that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:
1. The Committee requests the Government to provide additional information on the following points.
Article 5(d), (g), (h) and (k) of the Convention. Please specify to what extent the following functions are guaranteed by occupational health services: participation in the development of programmes for the improvement of working practices as well as testing and evaluation of health aspects of new equipment; promotion of the adaptation of work to the workers; contribution to measures of vocational rehabilitation; participation in analysis of occupational accidents and occupational diseases.
Article 10. Please indicate the provisions made to guarantee the professional independence of the personnel in all new institutions from employers, workers and their representatives.
Article 12. The Committee notes that, according to the Government’s report, the financial and economic conditions relating to the health benefits granted by occupational medical services are not completely covered by legislation. It requests the Government to indicate whether the surveillance of workers’ health in relation to their work is free of charge for them in all health services, whether it involves any loss of earnings for them, and what provisions govern the financial conditions of the surveillance of workers’ health.
2. The Committee notes that, according to the Government, the system of national health institutions is undergoing a period of fundamental transformation, and changes and amendments must be made to the national legislation governing the activity of occupational health services. The Committee requests the Government to indicate any progress made in this regard by specifying in particular the regulatory texts adopted which remain in force.
The Committee notes that the Government's report contains no reply to its previous comments. It must therefore repeat its previous direct request, which read as follows:
Article 12. The Committee notes that, according to the Government's report, the financial and economic conditions relating to the health benefits granted by occupational medical services are not completely covered by legislation. It requests the Government to indicate whether the surveillance of workers' health in relation to their work is free of charge for them in all health services, whether it involves any loss of earnings for them, and what provisions govern the financial conditions of the surveillance of workers' health.
The Committee notes with interest the information provided by the Government in its first report.
The Committee notes with interest the information provided by the Government in its first report. It also notes from the information provided by the Government concerning the application of ratified Conventions generally that the new health insurance system came into force on 1 January 1992 and that new legislation concerning occupational health services is in the final stage of preparation and should come into force in April of this year. The Government is requested to transmit copies of this legislation to the Office as soon as it is adopted.