The place and role of occupational medicine and of specific care for workers\u27 health

Specifičnu zdravstvenu zaštitu radnika već godinama gotovo i ne provodimo iako smo je propisali. Time smo ozbiljno ugrozili zdravlje radnika sa svim posljedičnim, osobito dugoročnim štetama. Osnovni uzroci ovakvu stanju jesu nepostojanje jasno definiranih obveznika financiranja i izvršavanja pojedinih mjera specifične zdravstvene zaštite radnika, kao i kaznenih mjera za pojedine izvršitelje. U društvenodogovornom okruženju, to je rezultiralo nezainteresiranošću poduzeća, nezainteresiranošću i neadekvatnom organizacijom djelatnosti koja je trebala biti ključni izvršitelj mjera specifične zdravstvene zaštite radnika (djelatnost medicine rada) te popustljivošću sudskih, inspekcijskih i drugih nadležnih tijela. Navedene uzroke možemo neutralizirati samo radikalno izmijenjenim pristupom što je primjeren tržišnoj privredi. Država bi trebala propisati okvirna pravila a provođenje specifične zdravstvene zaštite radnika treba, osim iznimno, prepustiti zainteresiranim subjektima (ponajprije poduzećima) i objektivnim zakonitostima potražnje i ponude. Po sebi se razumije da ovakav pristup može oživjeti samo u pravnoj državi s definiranim titularima vlasništva (nad poduzećima i stručnim organizacijama) i s nezavisnim sudskim i inspekcijskim organima što jedino može na odgovarajuću, visoku razinu podići odgovornost glede kršenja propisa, oštećenja zdravlja radnika i nestručnog rada zdravstvenih i drugih stručnih radnika. U takvom okruženju mora se korjenito izmijeniti ne samo mjesto i uloga nego i naziv djelatnosti medicine rada.Specific care for workers\u27 health has been largely deficient during the past decade, despite the existing legislation. Consequently, the protection of workers\u27 health has been seriously endangered, with the resultant long-term damage. The main reasons for this were the absence of early defined responsibilities regarding the financing and execution of the specific health care measures as well as lack of penalty for their non-implementation. As a result, there was indifference on the part of enterprises, indifference and inadequate organization of occupational health services as executors of the specific health care measures, and indulgence on the part of the court, inspecting services and other competent bodies. The situation could be helped only if a completely different approach, suited to the market economy, were adopted. The State should prescribe only the general rules, while the carrying out of specific health care should, with rare exceptions, be left to the interested parties, enterprises in the first place, and to the law of supply and demand. Naturally, such approach can be successful only in the legal State where the ownership of enterprises and professional services is strictly defined and the court and inspection services are free to act independently. Only then will the responsibility of the owners in respect to the breaking of rules, impairing workers\u27 health and ..:.., professional work of health and other personnel be raised to an appropriately high level. In such an environment the place and role of occupational health activity as well as its name are bound to see a radical change