|Towards Good Practice in Health, Environment and Safety Management in Industrial and other Enterprises (WHO, 1999, 13 pages)|
35. The successful implementation of an integrated HES approach at the enterprise level depends on the action of social partners at work; however, it also depends on concerted support from the relevant ministries and governmental agencies concerned with health, environment, labour and social policies.
36. National commitment should consist in specifying the policy and action to be taken or initiated at the government level. This includes a policy statement on GPHESM, explicitly clarifying the commitment of the government and of the ministers involved, and a government policy document specifying national objectives, the underlying principles, the necessary legislative and non-legislative tools, and the principles of monitoring and evaluation. It also includes a national strategic action plan, intended to identify the actions necessary to achieve objectives specified in the national policy on GPHESM. The strategic action plan should also specify the role and action to be taken by each stakeholder, including government institutions and local authorities. Finally, the entire national system should be audited and evaluated periodically, so that adjustments can be made as necessary, and to ensure continuous feedback from society.
37. Several issues should be addressed while developing a national policy. One issue would be which general principles to apply, such as the precautionary principle, legal compliance, democratic control, extended producer responsibility and the preventive principle. In establishing the policy, defined and measurable goals should be set, a time frame determined and a scheme for monitoring, evaluation and auditing agreed. All relevant stakeholders should formulate, implement and periodically review an integrated national policy that should be holistic and cover all aspects of HESM. In the process of policy development, accountability, transparency and the use of self-control and self-regulation should be observed. A national policy should create economic and social incentives for enterprises to implement GPHESM. It should also encourage the development of economic appraisal of HES in enterprises. It should reduce the opportunities for enterprises to externalize the costs of poor practice in HESM.
38. The national economic and social policy and legislative framework in each Member State have a dominant impact on occupational and environmental health practice in most enterprises. There is a trend in many of WHO'S European Member States towards reorienting occupational health and safety practices to help reduce the increasing economic and social costs of work-related and non-work-related ill-health and work disability. At national level there is increasing concern that enterprises may seek to pass on or "externalize" the costs of work-related injuries and ill health, even when the enterprise itself is responsible for causing the costs as a result of its poor HESM. Internalization of such costs can help to reduce this economic burden on society. Economic appraisal in this context is the process of assessing and establishing the economic effects of HESM. This consists in a wide range of measures, that may vary from evaluating the total cost to society of work-related ill health, to forecasting the economic returns of a better workplace in an enterprise. Economic appraisal is a useful tool to stimulate GPHESM, for a number of reasons. It can increase awareness in both society and the enterprise, by highlighting the importance of the economic effects of health and environment management; it can support decision-making at the national and enterprise levels, by helping to structure discussion; and, at the national level, it can support the development of structures in social security and legislative authorities that offer incentives to enterprises to improve HESM. National financial, fiscal and insurance systems may provide incentives for the implementation and demonstration of GPHESM in enterprises.
National infrastructure and major stakeholders
39. At national level, the infrastructure for supporting GPHESM consists in the existing government ministries and institutions responsible for different legislative and non-legislative tools enforcing and/or supporting government policy on HESM in enterprises. Central government is expected to play a leading role in encouraging the commitment of all appropriate stakeholders to GPHESM in enterprises.
40. These stakeholders will use existing preventive multidisciplinary infrastructures in occupational health and safety, workplace health promotion, environmental health and social and health insurance.
41. Stakeholders who should cooperate in this joint strategy include:
· government ministries and enforcement agencies (health, labour, environment, economy, finance and others);
· employers and their organizations, policy-makers and management leaders in industry, agriculture and other economic sectors;
· employees and trade unions;
· financial and insurance institutions;
· occupational health services, cleaner production centres, environmental health services, and environmental and social consultants;
· nongovernmental organizations, and associations of professionals in health promotion, occupational health and safety, environmental health, environmental protection, and economic and social development; and
· education and training institutions, including those for quality management training.
Monitoring, evaluation and auditing
42. Monitoring should be an integral part of target-setting and programme development. The key criteria and performance indicators to be used for monitoring and evaluating the national system should be selected and developed by consensus among the major stakeholders. The national policy, as well as progress in implementation of the strategic action plans, should be evaluated on a regular basis. Schemes for auditing should be developed in order to verify the functioning of national or local systems supporting GPHESM in enterprises.
Information, education and training
43. If they are to collaborate in developing GPHESM, employers, employees and their trade unions must have a sound understanding of the basic principles used to control and act on environmental, social, occupational and lifestyle determinants of health, and of the value of (and methods for) cleaner and safer production and pollution prevention. Education and training increase awareness of the need for GPHESM. A key issue for the development of GPHESM in enterprises is the availability of know-how, tools and information to provide practicable solutions, awareness of the economic and financial benefits, and an active public relations and communication strategy to disseminate solutions. Collecting and disseminating good examples of HESM could be a useful tool in marketing the concept.
44. The implementation of good practice requires the cooperation of professionals from a variety of different disciplines. A clear description of the training curriculum, the competence and the code of conduct of each profession will increase the efficiency of their work. The principles of quality management should be part of the education and training curricula of all professionals working in multidisciplinary occupational and environmental health teams.
Research and development
45. Research and development programmes should be encouraged that specifically aim at providing the data and products required for developing, monitoring and assessing GPHESM at the national, local and enterprise levels.