“Less people with long-term illness? Update federal Well-being Act” – Opinion

The pressure on the labour market, businesses and social security is becoming unbearable. The political proposals on the table right now are useful, but by no means enough. A fundamental change in the regulations is essential.
The Codex Well-being and Health at Work needs to be updated urgently, according to Dr. Gretel Schrijvers, CEO Mensura Group, and Hans Maertens, managing director Voka, Flemish enterprise network. “Give occupational physicians more responsibility.”


Belgium is the European champion, but sadly in the wrong discipline. Over half a million people are currently suffering from long-term illness and are therefore absent from work. There have never been so many people on the sidelines and things continue to move in the wrong direction.

Each government in this country targets an employment level of 80%. This is unlikely to change with future governments, and quite rightly so. In order to achieve this, we must break the rising trend of people suffering from long-term illness. According to Mensura and Voka, this can only be done if the regulatory frameworks relating to well-being and health at work are modernised.

Restrictive legislation

Occupational physicians play a key role in helping to prevent absenteeism and in guiding the large group of people with a long-term incapacity to work back into employment. However, occupational physicians are being held back. The current regulatory framework in the federal welfare legislation dates back to 1996 and is hopelessly out of date. The law is too rigid and takes no account of the new roles of care professionals and technological progress.

No profession is more restricted by law in its range of tasks than an occupational physician. These specialists spend most of their time on ‘obligatory’ tasks, such as a periodic or intermediate examination, regardless of the employee’s health situation. Considerably more well-being and health would be possible, if the law is modernised.

The corona crisis clearly demonstrated the fact that things can be done differently. In no time at all, occupational physicians and external services reinvented themselves to help with vaccinations in homes for the elderly and hospitals, they were involved in screening, contributed to research into new vaccines, and used video consultations to keep employees healthy at work. The potential exists to work differently. However, there is no regulatory framework allowing this to be maintained effectively and sustainably.

Delegation of tasks and technology

Occupational physicians do not need to do everything alone. Their tasks could be taken over by an ergonomist or psychologist in specific situations. Today, the law does not allow this. Similarly, an occupational nurse could help in monitoring certain health parameters. The task delegation from occupational physician to nurse could extend to simple examinations and consultations. This is already the case in the care sector - thanks to new regulations. The prevention sector would also benefit from following this path.

Today’s welfare legislation has a big deficiency: it does not allow preventive medicine to apply new technologies, such as teleconsultations or automated data capture. While elsewhere in the care sector, such technological developments have allowed giant steps to be taken, for example, by using artificial intelligence. Modern prevention depends on technological support. So, a legal foundation also allowing this at work is essential.

Better care, lower costs

A more modern statute for occupational physicians would also be good news for general practitioners, who are currently drowning in work. Why not involve occupational physicians in the wider promotion of health among the working population? This question is not only being asked by the external services. Patient associations, such as Diabetes Liga or Stop Darmkanker, also support this request, because otherwise they cannot reach a section of their target audience.

Occupational physicians are specialised doctors. They respect the same deontology and confidentiality as other doctors. Yet - unlike other doctors – they face hurdles to access the medical files of employers’ patients. This generates extra administration, double registration and duplication of care. So, give occupational physicians access to the medical files too, allowing them to respond efficiently and quickly to employees’ care requirements. In this way, we can provide better care and help in reducing the strain on social security.

We appeal to all political parties to put more focus on preventive health care. If fewer people become ill, it benefits society as a whole. For this reason, place confidence in external services for well-being and prevention at work. And adapt the regulatory frameworks so that employers and occupational physicians can make the difference in combatting long-term absence due to illness.