'Establish Occupational Health Fund' — CDA Consult tells govt

The Communication for Development and Advocacy Consult (CDA Consult) has proposed the establishment of a dedicated Occupational Health Fund to cater for both current and former employees who suffer work-related health challenges, even years after exiting active service.

The Occupational Health Fund should be anchored on the CDA Consult-proposed Routine Health Assessment and Occupational Health Surveillance (RHAOHS) system.

Mr. Francis Ameyibor, Executive Director of CDA Consult, stated in an interview with Modern Ghana News and stressed that the Fund should be financed with main contributions from employers, the Social Security and National Insurance Trust (SSNIT) and the State.

He said the Fund will eliminate the discretion of former employers to decide whether to fund a former worker's health bill, making it the responsibility of the Fund Administrator and ensuring health justice.

"Decent work is not just about salary. Decent work means you enter healthy, you work healthy, you exit healthy, and you retire healthy. If your work makes you sick, your employer must be responsible – not just today, but years after you retire, and through the Occupational Health Fund you are catered for," Mr. Ameyibor stressed.

He said CDA Consult with partners will submit a comprehensive “Routine Health Assessment and Occupational Health Surveillance" memorandum to the Labour Act 2003 (Act 651) Review Committee aimed at transforming Ghana's labour framework from a wage-focused law to a health-focused, preventive law.

CDA Consult explains that RHAOHS seeks to institutionalise a Four-Stage Mandatory Medical Examination System comprising Pre-Entry, Continuous Annual, Pre-Exit, and 10-Year Post-Exit Compulsory Medical Examinations, and to make the Occupational Health Fund operational to sustain it.

He called on the Minister for Labour, Jobs and Employment, the Trades Union Congress (TUC), Ghana Federation of Labour (GFL), Ghana Employers Association (GEA), and Parliament to be purposeful, progressive and people-centred in the review.

The cornerstone of the proposal is the mandatory 10-year post-exit medical surveillance. Mr. Ameyibor argued that many occupational diseases – cancers from chemical exposure, silicosis, kidney diseases, hearing loss, musculoskeletal disorders and mental health disorders – manifest two to five years or more after exposure.

"If within ten years of exit or retirement, a former worker is diagnosed with an illness that can be traced to their previous employment, the former employer must bear full responsibility for treatment, compensation and care. The employer benefited from the worker's labour for years. Responsibility must follow the worker into retirement," he said.

The proposal, he noted, is anchored on smart international standards. In the European Union, United Kingdom, Canada and Australia, occupational health law mandates health surveillance for years after exposure, particularly for asbestos, silica, radiation and chemicals. The International Labour Organisation (ILO) Convention 161 on Occupational Health Services and Recommendation 171 also call for surveillance beyond employment.

According to him, thousands of formal and informal workers and retirees are suffering from work-related health challenges without support.

Many retirees develop health complications two or three years after retirement which are actually work-related, but at that point the employer bears no responsibility.

He warned that the situation undermines Ghana's pursuit of a 24-hour economy and a 10-billion-dollar industrialisation agenda.

"You cannot achieve this with workers who are afraid that their work is silently killing them and that no one will take responsibility when they fall sick after retirement," he said.

Currently, many employers in mining, manufacturing, banking, security services, public and civil services and industry demand compulsory pre-employment medical examinations to ensure they hire healthy workers, this has become one-sided and exploitative.

"Employers want to know your health status before they employ you to ensure you are fit and will not be a liability. But when you are leaving, after 10, 20, 30 years of service, no one checks what the work has done to your health.

“The worker is simply issued an exit letter and dumped. That is unjust, defective and must be fixed," Mr. Ameyibor stated, describing it as a "use and dump" employment culture.

The pre-entry examination, he explained, must be standardised, regulated and non-discriminatory. Its purpose should not be to disqualify workers with manageable conditions but to establish a baseline health record to be kept by both employer and a National Occupational Health Registry to determine future deterioration.

The continuous annual examination will track health during employment, while the pre-exit examination, to be conducted not more than one month before exit by retirement, resignation, termination or end of contract, will establish the worker's health status at exit.

"Any work-related health issue discovered at pre-exit must become the full responsibility of the employer," he emphasised, including full medical treatment, compensation and rehabilitation under the Workmen's Compensation Act.

Mr. Ameyibor reiterated that whatever work one does today has associated hazards which manifest tomorrow when financial inflows are low, hence the need to shift from reactive treatment to proactive prevention.

CDA Consult is therefore calling “for a progressive health justice framework that guarantees that every worker enters healthy, works healthy, exits healthy and retires healthy, and ends the culture of using workers and dumping them when their health fails.”