ESTONIAN- FINNISH TWINNING PROJECT ON OCCUPATIONAL HEALTH MOSA Legislation Natl. programmes

Network Kari Kurppa Policy Jorma Rantanen Policy and strategy MoSA Departments of Labour and Public Health Working Environment Council OHS infrastructure Occupational Health Center Network on Occupational Health and Safety Agricultural organizations OHS and primary health care specialists OHS WRD Helena Taskinen Work-related diseases Occupational Health Center Polyclinic of Occupational Diseases OHS, other specialists and rimary health care specialists Labour Inspection Network of Training Institutions on Occupational Health and Safety PAA Kari- Pekka Martimo Coordinating Committee at FIOH Chaired by Professor Jorma Rantanen Steering Committee in MoSA Increase of the coverage and effectiveness of occupational health services in Estonia Key components and MS key personnel MS Project Leader Jorma Rantanen CC Projece Leader Tiit Kaadu Information Suvi Lehtinen Kari-Pekka Martimo

Major events 1. Kick off meeting for start. March 2003 All project element managers + other partners and involved persons 2.Steering Committee 1st Meeting Steering Committee 2nd Meeting Nov Steering Committee 3rd Meeting Feb Final Seminar.All managers and partners + others involved 6. Steering Committee Final May 04.

Policy and Strategy ELEMENT OBJECTIVE I Development of policy implementation 1) Supporting the implementation of the strategic and substantive elements of the Estonian Occupational Health Development Plan (until 2007) and associated Action Plan 2) Supporting the efforts of for implementation of MoSA strategy for Occupational Health and Safety ) Strengthening collaboration between authorities,social partners and other stakeholders for development of OHS system

Element I: Activities 1. Organizing two Workshops for planning the implementation of the above strategies 2 Establishment of working methods and links for joint activities between OH&S authorities and public health authorities at all levels for development of coverage of OHS 3. Supporting collaboration between the Occupational Health and Safety Administration and Public Health Administration for development of OHS infrastructure 4. Planning of a follow-up system for evaluation of coverage and quality of OHS 5. Drawing up a description and analysis of OHS system in Estonia in view of the above strategies and programs

Policy and Strategy II Element Objective II 1) Defining policies and actions for coverage of OHS 2) Evaluation of Estonian Occupational Health Development Plan (until 2007) as an instrument for development of multidisciplinary OHS and networking OHS and public health activities and institutions

Element II: Activities 1. Consultation on strategy and methods in the expansion of coverage 2. Planning and initiation of specific projects for implementation of the Action Plan 3. Activation of relevant partners to participate in thr work of National OH&S Network for facilitation of the implementation of the Action Plan Projects ("Support Seminar")

Element objective III OBJECTIVE: Support to the planning and evaluation of legislation on Insurance System for Occupational Accidents and Diseases 1. Follow-up and consultations 2. Introduction of policies and models 3. Consultations on the methods needed in the enforcement and implementation of the insurance legislation

Element Objective IV Comparative analysis of registered work injury risks by sector of economy between Finland and Estonia

Element Objective V Consulting on the establishment of thr National Topic Center for Good Practices in Occupational Health and Safety

Concept and view of OHS system in Estonia Implementation of OH elements of Estonian NEHAP Practical support for the implementation the MoSA Strategy where promotion of quality of work and improvement of work ability will be among the main topics (Actions for OH&S and Public Health Joint activities included). Joint action plan: OHS-PHS OHS Action Plan final acceptance and implementation Follow-up model for WRDs a) systems for official statistics and registry (new govt resolution is prepared on registration and investigation of accidents and Odiseases) Policy I

b) survey-based collection of data from practitioners -Instructions and guidelines in the connection of training element -Seminar on recognition, notification and surveying of ODs and WRDs (OH practitioners, PHC physicians and labour inspectors also involved) Insurance Act on Occupational Accidents and Diseases -Black scenario: very adversarial (wrkr- insurance) leads to underreporting and under-estimation of real situation -White scenario: OH criteria decide.Real situation is registered. Evaluating the final draft of insurance act Comparing accident and OD risks between selected countries an Estonia and publisising the results Topic Centre on Good Practices; consultation Policy II

Consulting establishment of Bilbao Agency Topic Center Located in the OHC Good practices on health and safety Dissemination of TC outputs Participating in EU TC activities PL/MC contact with Bilbao to clarify the principles of TC for applicant countries To the Covenant: 1-2 day visit by the Finnish TC oordinator to introduce the principles and practices

Steering Committee Four quarterly meetings Tasks: Informing the partners Activation of partners Evaluation of quarterly reports Evaluation of final results Membership MoSa Social partners Agriculture Public health EU Delegation PAA PL/CC, PL/MS

OHS Good occupational health practice guideline Development of coverage & models - Collaborative links FD-OHP and its financing - Action plan provisions for cov & models - Amendment of OSHA act - Branch OHS approach ( to be piloted in agriculture) - Involvement of family doctors Facilitation of the passing of insurance act Agriculture OHS, including pilot Development of indicators for functioning and status of OHS (part of national profile) Increasing awareness and disseminating information through networks Follow-up and research

WRD (WRD = work related diseases; OD = occupational diseases) Preparing the curriculum for training on WRD and OD Delivering the training on WRD and OD to OH specialists, physicians diagnosing occupational diseases, and family physicians Training of trainers of OH specialists, physicians diagnosing occupational diseases, and family physicians on WRD* and OD* Planning and starting the register of occupational diseases Fact sheets on WRD and OD

Network National OH&S Network County and community OH&S profiles Networking in training (WRD) Tartu county OH&S network Subnetwork on OH&S in agriculture Sectoral profile of OH&S in agriculture

Information Awareness raising Identifying information gaps in OH&S and making a plan for producing relevant information packages Updating Network Strategy; planning and producing information material for Internet Providing detailed information materials to OH&S experts Preparing and publishing information and training material (both in paper form and Internet)

Next steps Time schedules and dead-lines for draft and final Contact to Bilbao, TC issue FIOH PAA and OHS element manager Further drafting an circulation-agreements by element managers

Conclusions 1. Overall situation Covenant Budgets Workshops Detailed objectives and actions BSC cards for each objective Experts are mobilsed

2. Objectives/Elements Most of the elements seem to be implementable Experts on both sides are available but have much other work too. Competing objectives. Financing on the national side should be ensured/mobilised National policy development may be unexpected

3. Risks and opportunities Every element is expected to analyze for each quarterly report for the risks for Guaranteed Results Risk: a. Events,developments or obstacles outside our control b. Our own causation Response: a. Prediction of likely risks b. Prevention of risks in time/ Planning c. Adaptation: - Do what can be done - Modify the objective - Produce an alternative output that satisfies the original need

4. Stability Guaranteed results cannot be compromised Keeping all the time the final objective in mind Changes through side letters (comments from the previous Twinning) The projects never will be ahead of time but they use to be behind the schedule Start in time, finish early

Critical Mobilization of the policy level Calling upon the social partners Raising awareness in the society at large Mobilising forces in the MoSA sector Mobilising the local and practical actors and field workers

Next steps Good start to be demonstrated by the beginning of July and reported in the first quarterly report Utilising as much as possible the work already going on and that should be done anyway Looking at the activities of other Twinnings and informing on ours

General spirit Fair open and happy atmosphere in the spirit of good neighborhood Collegial respect and support On equal footing Learning by doing attitude If problems, take contact preferably sooner rather than later Demonstrating the impact International Conference on OHS in 2005.Preparing for it.