Active inclusion for people with health problems Czech Presidency Conference on Social Services Prague, 23 April 2009 Robert Anderson European Foundation for the Improvement of Living and Working Conditions 05/05/2019

The general orientation to ‘active inclusion’ A global approach based upon: Active linkages to the labour market + An adequate level of income support Access to quality social services = Decent living standards for all, including those who can not be in employment. 05/05/2019

Focus upon participation in employment for those who can work: Recruitment + Retention Reintegration Addressing multiple and multifaceted needs – housing, basic education, debt, family difficulties, substance abuse, care 05/05/2019

Health and employment Complexity illustrated by people with LSHPD Increasing attention to ill-health as a cause of exclusion from employment, especially for: Older workers People with disabilities Carers of people with ill-health or disability 05/05/2019

Causes of LSHPD: all countries Source: Eurostat, 2003 A majority of workers with a disability have developed this during the course of working life – and many disabilities are not visible. 05/05/2019

Major causes of early retirement 05/05/2019

Employment ratio among disabled and non-disabled people Source: European Commission, 2005 05/05/2019

Health challenges for policies and services to promote inclusion Ageing of the workforce Increasing rates of work disability, especially due to mental illness Big differences between countries in duration of sick leave Attitudes of workers, health professionals and employers Coverage of occupational health services, particularly for SMEs Processes are complex and demand coordinated approaches from services in and outside the workplace. 05/05/2019

Recruitment to employment on open labour market Services: Employment services Vocational rehabilitation General health and social services Income maintenance/management Incentives: Anti-discrimination measures Quotas and levies Quality of work Security of employment Most responses depend upon social services and medical / vocational rehabilitation, training and employment guidance / placement services outside the workplace. 05/05/2019

The disability management model – main pillars Promoting employee health to create a healthy working environment Managing identified risks through proactive responses to emerging conditions Intervening early when an employee suffers an injury or illness Case managing or coordinating return to work for long-term absent employees 05/05/2019

Challenges for effective implementation of “active inclusion” measures Engaging and maintaining participation in activation programmes and decent employment Changing negative attitudes to employment among and towards excluded groups; combat discrimination Effective coordination of policies and services at local, but also regional and national levels Development of tailored quality services and trained providers/professionals Provide incentives for workers and employers to promote insertion and retention Develop continuing support for active and coordinated integration measures, including both employment guidance and social services 05/05/2019