Audit Office: Major reorganization needed to tackle reduced work ability

The implementation of the work ability reform has been bumpy and left a number of people without the income of work incapacity pension payments.
The implementation of the work ability reform has been bumpy and left a number of people without the income of work incapacity pension payments. Source: Martin Dremljuga/ERR

According to the results of an audit published on Wednesday, the National Audit Office of Estonia finds that efforts to prevent a reduction in work ability have thus far been both untargeted and insufficiently active. As a result, the focus has so far mainly been on detecting violations and handing out fines.

In a press release, the National Audit Office stated that to prevent a general reduction in levels of work ability, a fundamental reorganization is required. To do so, it would be reasonable to change the focus from supervision to active and more precisely targeted prevention. To reduce levels of fear caused by supervision, it is also crucial to establish trust between employers and the Labor Inspectorate. According to the National Audit Office, these steps are fundamental in order to make workplaces safer.

The Estonian Ministry of Social Affairs, which had been responsible for the issue, has treated the high number of people with reduced working ability as partly inevitable. This is because the average Estonian person tends to begin facing health issues affecting their work ability while they are still of working age. According to the National Audit Office, it would be possible to slow down this decrease in working ability with the introduction more precisely targeted and meaningful prevention work.

Over the past decade, the Labor Inspectorate has focused on ensuring employers submit risk analyses of the working environment in a timely fashion. At the same time, employers also need practical advice on how to make the working environment safer. "There are over 40 inspectors at the Labor Inspectorate, but only two working environment consultants," said Ines Metsalu-Nurminen, chief auditor at the National Audit Office. "Although supervision is important, in order to preserve people's ability to work, it is necessary to shift the focus to more towards prevention than before."

According to a press release, the National Audit Office has found that to improve measures taken to prevent reduced work ability, the current organization of work in institutions in the field needs to be critically reviewed. For example, occupational conditions are currently diagnosed by the Center of Occupational Diseases and Health, which then sends the data to the Labor Inspectorate, which is required to use it to assess the state of the working environment.

The Labor Inspectorate sends this data to the Estonian Health Board almost a year later. The board then analyzes occupational conditions and in turn publishes them with another year-long delay. "Actually, the Center of Occupational Diseases and Health conducts the basic analysis, and, with the way the work is currently organized, no significant added value is created by passing this data through further stages," explained Metsalu-Nurminen.

The National Audit Office noticed that although the work ability reform has changed attitudes towards people with reduced work ability, it has not adequately addressed the underlying causes. During the audit, it became apparent that one common reason for this is fear. Employees tend to hide their work ability issues from both occupational health medical professionals and employers because they are afraid of losing their jobs. Employers are afraid to ask the Labor Inspectorate for advice on the working environment because they fear being fined for any mistakes.

Up to now, the Ministry of Social Affairs' only plan involves developing an intervention measure for people on long-term sick leave to encourage them to continue at work in adapted circumstances during the period when they temporarily incapacitated. The target group for the new measure is employees who have been on sick leave for more than 60 consecutive days and need at least another 30 days of sick leave but do not need hospital treatment. "The purpose of this measure is to encourage continued employment, not to prevent a decrease in working ability. It is a case of dealing with the consequences at a slightly earlier point," said Metsalu-Nurminen.

The National Audit Office's analysis suggests that this intervention alone would most likely not be sufficient, particularly for the most critical target groups such as those working in occupations with lower incomes, who often cannot afford to take extended sick leave for economic reasons. 

The analysis also showed that to prevent a reduction in work ability may require an approach based on occupational groups. For example, workers in occupational groups, who are not often on sick leave, may need the introduction of measures, which allow them to remain on sick leave under favorable conditions, in order to properly restore their health. In the long term, this may help to maintain their ability to work.

From July 1, 2023, the Ministry of Economic Affairs and Communications became responsible for preventing a decrease in work ability.

The National Audit Office has therefore recommended that the Ministry of Economic Affairs and Communications, in addition to focusing on employment in its labor market policy, specifically addresses work ability and develops a comprehensive approach to prevent a general decrease.

To reduce the existing fragmentation, the audit office also sad that it  is necessary to critically review the current tasks of the Labor Inspectorate, the Health Board and the Unemployment Insurance Fund (Töötukassa), assess the division between institutions as well as their capability to perform their designated tasks.

According to the National Audit Office, it is also necessary to make the process of obtaining help for matters related to work ability more comprehensive for people. This means both in terms of occupational health, assessment of work ability and the receipt if services, as well as the diagnosis of occupational and work-related conditions.

Ultimately, the National Audit Office recommends changing the way the Labor Inspectorate operates so that the focus of the institution shifts to active targeted prevention instead of simply supervision. It is also necessary to focus on supportive counselling for employers and employees, primarily in relation to everyday issues, how to increase occupational safety and ways to improve the working conditions for specific employees or work teams. This requires trust and cooperation between employers and the Labor Inspectorate in order to reduce fears connected to supervision.


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Editor: Michael Cole

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