The different occupational health services in France
In France, occupational medical service is necessarily organised by the employers, both materially and financially, within occupational health services. There are two kind of services : inter-company occupational health service (called in French service interentreprise), the service is common to several companies or an integrated occupational health service, which is set up by an employer in his own company, who wants his own internal service, (called in French service autonome). Occupational medical service is an independent private organization, under the responsibility of the ministry in charge of Labour.
Inter-company occupational health services services ( called in French services interentreprises)
Integrated occupational health services (called in French services autonomes)
The missions of occupational health services
Occupational risk prevention in France, under the responsibility of the ministry in charge of Labour is a dual system : State authorities on one side, and Social Security on the other (occupational accidents and diseases sector).
The inter-company health services are common to several enterprises.
- They provide medical surveillance for 90 percent of employees, whose exclusive purpose is occupational health-care.
- They are not-for-profit organizations.
Doctors are on salary in these services.
Each company has to pay contributions to this service for its employees, to have medical surveillance and working conditions monitoring for them. It is not necessary if the company has still its own integrated occupational health department.
Governance in these inter-company services
It is a joint governance in these services
- a president representing the employers,
- a treasurer representing the employees.
A control committee is presided by an employee representative
The multidisciplinary team provide the missions of the occupational health service
According to the French Labour Code ( article L 4622-8 ), the members of this team are :
- occupational health physician ( who manages the team),
- occupational health nurse,
- stakeholders in prevention of occupational risks,
- ergonomist, etc
A project service is compulsory in an inter-company service : it is carried out by the medical technical committee
- The integrated occupational health services provide medical surveillance for 10 percent of employees.
- They are administered by the employer.
- The occupational doctor is on salary in the company.
- An integrated health service is specific for a company : it is permitted only if the enterprise employes more than 500 workers ( according to the French Labour Code article D4622-5 )
When an employer has the choice between an inter-company occupational health service or to create his own integrated occupational health service, he has to make his own choice (according to the French Labor Code article D4622-2 ).
The missions are defined in French Labour Code with article L 4622-2 :
The occupational health services have an exclusive mission : to prevent deterioration of health by harmful influences at work.
The Occupational health services must :
- undertake activities
- to preserv the physical and mental health of workers throughout their professional careers,
- advise the employers, the workers and their representatives to :
- avoid or reduce the occupational risks,
- improve the working conditions,
- prevent the addictions, use of alcohol or drugs in the work place,
- prevent or reduce painfulness of work and occupational deintegration,
- contribute to help workers to keep their jobs,
- monitore health status of workers according to
- risks related to their security and health at work ,
- the painfulness of work,
- and their age,
- contribute to the traceability of occupational exposures and health monitoring.