Healthcare workers in PPE

Guaranteeing the Occupational Health and Safety of Healthcare Workers

Need for a dedicated occupational health and safety framework for healthcare workers

Problem

In the battle against the Covid-19 pandemic, the lack of Personal Protective Equipment (PPE) for healthcare workers has itself turned into a significant public health risk. While the lack of PPE has often been highlighted, it is the incidents of violence against healthcare workers that have received the most attention. To address this, the Central government passed an ordinance amending the Epidemics Diseases Act, 1897 to make violence against healthcare workers during an epidemic a cognizable and non-bailable offence with enhanced punishment. 

This is an understandable political response. But it is inadequate in protecting health workers from the gamut of obstacles that they face. As far as the issue of violence itself is concerned, the ordinance protects healthcare workers only during an epidemic, although it is clearly a systemic problem that exists outside of the current situation. It also fails to recognise that violence in healthcare settings cannot be deterred by criminal punishment alone, but needs more structural reforms. 

More importantly, other critical facets of occupational health and safety such as the mental well-being of healthcare workers (exacerbated during this time), clean and hygienic workplaces, quarantine facilities for healthcare workers who have direct contact with patients, and an adequate supply of PPEs remain unaddressed. This is because there is no legal framework to guarantee occupational health and safety for healthcare workers, unlike other sectors. 

The Government of India introduced the Occupational Safety, Health and Working Conditions Code, 2019 (Code) in Parliament last year. The Code attempts to consolidate and amend thirteen different laws that regulate the occupational health and safety of persons employed in an establishment. It provides a broad legislative framework under which occupational safety standards can be framed for different sectors. Though an establishment under the Code includes all places with ten or more employed workers where any industry, trade, business, manufacture or occupation is carried on, it is unclear whether it extends to healthcare establishments.

There is no legal framework to guarantee occupational health and safety for healthcare workers, unlike other sectors. 

Solution

Healthcare workers must have a dedicated occupational health and safety framework. The International Labour Organisation mandates that all member nations shall establish a national system for occupational safety and health, which shall include laws and regulations as well as an authority responsible for occupational health and safety. While the re-hauling of the occupational health and safety framework by the Code is a step in the right direction, its application to the health sector is the need of the hour to ensure safe working conditions for healthcare workers and to provide protection from occupational hazards likely to cause death or serious physical or mental harm. This is the least we can do for our frontline health workers.

While the re-hauling of the occupational health and safety framework by the Code is a step in the right direction, its application to the health sector is the need of the hour to ensure safe working conditions for healthcare workers.

Implementation

  • Extend the applicability of the Code to healthcare establishments. 
  • Ensure representation for healthcare workers on National and State Occupational Safety and Health Advisory Boards proposed to be established under the Code.
  • Issue enforceable occupational safety standards for the health sector under the Code once it is enacted. 
  • Update requirements for healthcare establishments under other laws and schemes to reflect these standards. This includes updating the Indian Public Health Standards, which set norms for healthcare establishments under the National Health Mission as well as standards under the National Board for Accreditation of Hospitals and Healthcare Providers and the Clinical Establishments (Registration and Regulation) Act, 2010.
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