CDA Consult calls for mandatory medical checks before and after employment

The Communication for Development and Advocacy Consult (CDA Consult) has called for an end to what it describes as a “use and dump” employment culture and proposed a comprehensive health justice framework to strengthen the protection of workers in Ghana.

The Executive Director of CDA Consult, Mr Francis Ameyibor, is urging the committee reviewing the Labour Act 2003 (Act 651) to introduce a four-stage mandatory medical examination system covering workers before, during and after employment.

The proposed system would comprise pre-entry, continuous, pre-exit and post-exit medical examinations, with employers bearing the cost of the assessments.

Mr Ameyibor said the proposal was intended to address what he considers a major gap in the current employment system, where employers often require prospective workers to undergo medical examinations before they are hired but do not similarly assess their health when they leave.

“If the law requires or allows employers to check the health status of potential employees before employment, then it must equally require employers to check the health status of workers before they exit employment,” he asserted.

He said compulsory pre-employment medical examinations are common in sectors including mining, manufacturing, banking, security services, public and civil services, and other industries.

However, he argued that the practice becomes unfair when employers use medical examinations to establish workers' fitness at the beginning of their employment but fail to determine whether the work has affected their health over the years.

“Employers want to know your health status before they employ you, to ensure you are fit and will not be a liability.

“But when you are leaving, after 10, 20, 30 years of service, no one checks what the work has done to your health. The worker is simply issued an exit letter and dumped.

“That is unjust, defective and must be fixed in the review of Act 651,” Mr Ameyibor stated.

Four-stage health assessment

CDA Consult is proposing that the amended law introduce provisions for routine health assessments and occupational health surveillance covering the entire employment cycle.

The framework would include a mandatory pre-entry medical examination, annual medical assessments during employment, a compulsory pre-exit examination and medical surveillance for ten years after a worker leaves employment.

Mr Ameyibor said the cost and responsibility for organising the examinations should rest with employers rather than employees.

He explained that the pre-entry examination should be standardised, regulated and conducted without discrimination.

According to him, its primary purpose should be to establish a worker's baseline health condition rather than exclude people with manageable medical conditions from employment.

He proposed that the baseline records be maintained by both employers and a National Occupational Health Registry to help identify possible work-related deterioration in a worker's health over time.

He said the continuous annual medical examinations, together with the pre-exit and post-exit assessments, would provide a mechanism for monitoring workers' health throughout and after their employment.

Pre-exit assessment

Mr Ameyibor said the pre-exit medical examination should be conducted no more than one month before a worker leaves employment, whether through retirement, resignation, termination or the expiration of a contract.

He said the assessment would establish the worker's health condition at the point of exit and help identify illnesses or conditions that may have developed as a result of the person's employment.

“Any work-related health issue discovered at pre-exit must become the full responsibility of the employer,” he stated.

He said such responsibility should include medical treatment, compensation and rehabilitation as provided under the Workmen’s Compensation Act and applicable international labour standards.

Ten-year post-exit monitoring

Mr Ameyibor said the proposed post-exit surveillance was necessary because some occupational diseases may take years to become apparent after exposure.

He cited conditions such as cancers associated with chemical exposure, respiratory diseases including silicosis, kidney diseases, hearing loss, musculoskeletal disorders and mental health disorders.

According to him, some of these conditions may emerge several years after exposure, making post-employment monitoring necessary to protect former workers.

CDA Consult is therefore proposing that the revised Labour Act provide for mandatory medical surveillance for ten years after a worker leaves or retires from employment.

“If within ten years of exit or retirement, a former worker is diagnosed with an illness that can be traced to their previous employment, the former employer must bear full responsibility for treatment, compensation and care.

“The employer benefited from the worker’s labour for years. If that labour causes illness within ten years of retirement or exit, the employer cannot walk away. Responsibility must follow the worker into retirement or exit,” Mr Ameyibor said.