I. The EPO Health Insurance:
II. Making Us Sick And Making Us Pay For It?
Summary
The administration has submitted a document to the next GAC which proposes amongst others to effectively remove the 2.4% (of basic salary) ceiling on the Vanbreda staff contribution. The staff representation considers such a proposal inappropriate and premature at a time when the alternative solutions (e.g. the internal insurance) unanimously agreed by the Vanbreda working group have not yet been implemented. More importantly, however, the staff representation strongly opposes any increase in staff costs as long as the Office neglects its duty of care towards staff by not protecting staff health and not implementing essential parts of the EPO health policy.
A. INTRODUCTION
In 2007, after a decade of nagging by the staff representation, the Office finally introduced a health policy and founded an occupational health department. The health departments have, however, been understaffed from the very beginning. Repeated requests from the staff representation to provide the newly hired occupational health physicians temporarily with a project manager to help them set up their departments were refused with the effect that they spent most of their first year battling their way through the Office’s red tape in order to order their material, hire staff etc. Two years later “sick leave management”, essentially: staying in touch with sick staff in order to offer support for a return to work1, is in place. The ergo-WUC network has also largely been reactivated and "work-pace" soft-ware has been made available to staff. But more remains to be done. _____ 1 Contact with the Occupational Health Service is voluntary. If you feel that the contact is not helpful for you, you need not continue. The Occupational Health Service furthermore cannot challenge sick leave (full-time or part-time) prescribed by your treating physician. Only the Medical Advisor to the Administration (Dr. Koopman) can verify sick-leave, following the procedure foreseen under Art. 62(nn) of the ServRegs.
B. UPPER LIMB DISORDERS
In 2004, TNO2 found that a whopping 39% of the EPO staff suffered from Upper Limb Disorder3 (ULD), and that 19% had been treated for those complaints. Even the best ergo-WUC is helpless when faced with un-ergonomic software, especially when combined with long hours on the computer and high work pressure. Since 2004 our software has not improved significantly from an ergonomic point of view, the time spent on the computer has not diminished, and neither has the work pressure. There is thus no reason to believe that the situation has improved insofar as ULD / RSI is concerned4.
We note that the EPO’s health policy prescribes regular risk analyses. These should include a follow-up on the TNO study. The Occupational Health Department is working on a proposal for a risk analysis. However, none has been made thus far and, obviously, any follow-up in practical measures is even further away.
The major overhaul of the Office’s computer systems now planned could provide an opportunity to greatly improve the ergonomics of the Office’s software. We do not, however, have much evidence that ergonomics has a very high priority compared to e.g. (perceived) “efficiency”. In particular: we have seen no clear ergonomics policy or guidelines for the soft-ware, we have not seen a dedicated budget etc.
C. PSYCHOLOGICAL PROBLEMS
Another major factor for staff ill-health, and apparently the most frequent cause of invalidity, are psychological problems. It is our impression that a high percentage of these problems are caused by, or at least aggravated by the Office, in particular by a frequently inappropriate management style at all levels. This is confirmed by all psychosocial studies done so far, including the staff surveys, and also by the psychiatrist5 whom the staff representation advises to staff in need of support. Our highest management displays a serious lack of understanding of, and respect for, the work of the EPO staff. Constant, badly thought-through changes in working methods and tools, constant reorganisations and more recently: a constant threat to the working conditions make things worse. For some staff the situation is further aggravated by the Office’s inability or unwillingness to control and take measures against line managers who cause serious distress to their subordinates. Last but not least, there is furthermore a lack of effective support for staff with work-place related health problems. In particular for examiners there are no alternatives for search and examination work. A high work diversity (search and examination for examiners, several “procedures” for formalities staff, a whole range of services for staff in the Personnel Dept. etc.) is asked from all staff, including staff in bad health. The department as a whole is furthermore penalized for keeping sick staff on board on reduced time and/or capacity since the number of budgeted posts has been reduced to the minimum and there are no super-numery posts for staff with reduced capacity. Simpler work elsewhere is no longer available since almost all such work has been out-sourced. The above deficiencies seriously hinder effective reintegration and contribute to high sick leave and invalidity levels.
We note that a psychosocial health risk management, starting with a psychosocial health risk analysis, is now generally considered an integral part of any modern staff health policy. Extensive
____ 2 TNO report 3 also called RSI (Repetitive Strain Injury) 4 Dr. Bosch expresses the opinion that the level of RSI has gone down based on the lower number of complaints received by her department. This can, however, have other reasons like staff with long-term complaints no longer seeking advise from the Occupational Health department. 5 Report Dr. Teuschel, 2008
information about psychosocial health management is provided by World Health Organisation6. We are, however, not aware that the Office has undertaken any serious initiatives in this respect. On the contrary: existing psychosocial support staff (by the Personnel Department, Amicale, Kids e.a.) is constantly under threat of budgetary savings.
D. THE PRICE TO PAY
Under the circumstances, it is not surprising that the sickness and invalidity figures in the Office are relatively high. This in turn leads to relatively high costs, in particularly in Munich where the charges made by the medical establishment are higher than in most of the other places of employment. In order to address these specific local problems, the staff committee has repeatedly requested support from the Office against medical doctors who are blatantly over-charging, but staff is still left to struggle on their own with bloated invoices and aggressive “Abrechnungsstelle”. Similarly we have asked for a “white list” of reasonably priced doctors and ideally “preferred providers” near the Office buildings to whom staff can go, if they so wish. Thus far no progress has been made in this respect.
We note that e.g. the EU has a separate insurance for the costs incurred due to accidents at work and/or occupational disease, which is entirely funded by the employer. It stands to reason that health costs that have been caused through the work are carried by the employer. This also provides a motivation for the employer to keep the working place as healthy as possible (the sort of direct link between “performance” and “pay” that the Office seems to favour for its staff!).
E. THE OFFICE’S “CURE”
The “cure” proposed by our administration is, however, neither improving the health of the staff through improved prevention at work, nor taking over the costs of work-related health problems: the Office is proposing to make staff pay for the consequences of the increase in health costs. Already working spouses have been excluded from cover or been made to pay. As a next step the Office proposes the removal of the 2.4% of basic salary as the ceiling on the staff contribution. The next in line are the pensioners who will be charged a percentage of their final salary rather than a percentage of their actual pension, as well as spouses of pensioners who will have to make use of their primary insurance.
Whereas we would possibly understand such measures if everything else, in particular all more reasonable measures (e.g. the 6 unanimous measures of the Vanbreda working group), had been tried first and costs would remain well above the ceiling for several years, at this stage such measures are inappropriate:
at present the Office is making us sick and making us pay for it!
If the legislator has built in a ceiling then the intention must have been to protect staff from higher charges and to force the Office to manage staff health correctly. The latter has clearly not been done: a health policy has been adopted but essential parts such as risk analyses and management have not been implemented.
The staff representation therefore demands that the Office:
1) awaits the effect of the cost-saving measures already taken (amongst others increased reliance on the primary insurance), 2) implements the 6 further measures7 unanimously agreed by the Vanbreda working group, and awaits their effectiveness, and 3) awaits the full effective implementation of the OH policy,
_____ 6 PRIMA-EF brochures 7 e.g. the self-insurance, which should save around 1,5 million Euro per year; see su09117cp
before considering introducing further changes in the financing of the EPO health insurance scheme that negatively affect staff, either in the short term or in the longer term.
The Staff Committee will reiterate this position in the GAC that takes place in the second week of September and, if necessary, again in the October Budget and Finance Committee and Administrative Council meetings. If all this will be in vain we will file internal appeals. In our opinion such appeals would have a good chance of success.