In 2014, 46 per cent of occupational physicians never reported a single occupational disease, which shows how quickly occupational health can become a paper subject. That underlines the importance of clear arrangements for preventing absence and keeping people at work safely and healthily. The basic contract with an occupational health service is therefore more than an administrative obligation under the Working Conditions Act.
Every employer with staff has to have a written agreement with an occupational health service or physician setting out how the statutory working-conditions tasks are carried out, such as absence guidance and the possibility of a second opinion. Where that is missing, it can lead to enforcement and fines from the Netherlands Labour Authority. In this article you can read what a basic occupational health contract is, what it has to contain and what to watch for in practice.
What the contract has to arrange as a minimum
A basic occupational health contract is the written agreement in which you record how you are supported in the statutory working-conditions tasks under the Act. According to Arboportaal on the basic contract (in Dutch), such a contract is compulsory for every employer with staff. So it is not a non-binding service arrangement but the minimum occupational healthcare that has to be in place.
That minimum has a clear purpose: employees must have access to independent occupational health support, while employers know which tasks are assigned and how the legal obligations are met. The government emphasises on the Dutch government's page on working-conditions policy (in Dutch) that this contract sets out the minimum rights and duties of employer, employee and provider.
In practice that means a basic contract says something not only about absence guidance but about prevention, access to the occupational physician and cooperation with others involved within the organisation.
Which tasks the contract covers
The Working Conditions Act requires employers to be supported by core experts for certain tasks. According to Arboportaal on the requirements for the basic contract (in Dutch), these are at least:
- expert guidance during sickness absence and reintegration;
- testing of and advice on the risk inventory and evaluation;
- occupational health examinations, such as a periodic examination where that applies;
- support with prevention and protection of employees.
For you as an employer it matters to realise that the basic contract only covers the legal minimum. Organisations often add further arrangements as well, for instance about employability, preventive clinics, training for managers or extra support with long-term absence. That changes nothing about the core: without a properly set-up basic contract, the legal basis is missing.
That distinction matters to employees too. A contract that exists only on paper, without clearly arranging how access to the occupational physician works or how a second opinion is requested, offers little to hold on to in practice.
The compulsory parts
Access to the occupational physician
An employee must be able to consult the occupational physician, even when there is no absence yet. The amended Act strengthened this explicitly through the walk-in clinic. The NVAB confirms on access to the occupational physician for employees (in Dutch) that employees must be able to attend this clinic without the employer's permission.
For employers that means the contract has to make clear how that access is arranged. Simply writing that employees "can get in touch" is usually too vague. It is better to record through which channel this happens, how confidentiality is safeguarded and within what period an appointment is possible.
Free access for the physician to the workplace
According to Arboportaal on what the basic contract has to meet (in Dutch), the occupational physician must be free to visit any workplace. That matters because good advice does not only come from the consulting room. A workplace visit makes it possible to assess risks, strain and organisational circumstances better.
For the physician this is needed in order to work preventively. For employers it helps make advice fit the reality of the floor. In sectors with physical strain, shift work or psychosocial workload it is often extra valuable.
The second opinion
Employees must be able to request a second opinion from another occupational physician when they doubt the advice given. The NVAB also states that the cost of this is for the employer, within the agreed procedures. This right has to be clearly included in the basic contract.
In practice a clear arrangement prevents unnecessary argument. Employees then know where they stand, and employers prevent delay because the route was set out in advance.
A complaints procedure and professional independence
Every occupational health service or physician has to have a clear complaints procedure. That too belongs in the basic contract. Employees have to know where they can turn when they are dissatisfied with the service or the way they were treated.
Professional independence matters as well. An occupational physician has to be able to work from medical and professional standards, not under pressure from organisational or financial interests. Which is exactly why it is wise to be clear in the contract about roles, responsibilities and reporting lines.
Consultation with the prevention officer and the works council
The contract also has to arrange that the physician and other experts can work with the prevention officer and the employee representation. According to Arboportaal that belongs explicitly to the minimum content. That looks administrative, but in practice it matters for good working-conditions policy.
The prevention officer knows daily practice within the organisation. The works council or staff representation represents employees' interests. By organising that cooperation well, the basic contract becomes more than a paper obligation: it becomes a workable part of your approach to working conditions and absence. Our article on your obligations as an employer on working conditions and absence can be useful in that context.
The contract and reporting occupational diseases
One part that sometimes stays underexposed in practice is the duty to report occupational diseases. The amended Act states explicitly that the occupational physician has to have the time and opportunity to spot and report occupational diseases. Arboportaal names this explicitly among the changes to the Act from 1 July 2017.
For employers that means you have to make room for this task in the basic contract. Where that is not arranged, prevention suffers. Reports contribute to better insight into health risks on the floor and can be a reason to adjust processes, workplaces or policy.
For employees it matters because work-related complaints are then not only looked at individually but can lead to wider improvements in the organisation.
Safety-net arrangement or tailored arrangement?
When do you choose the safety net?
According to Arboportaal on the tailored and safety-net arrangements (in Dutch), many employers conclude their basic contract through the safety-net arrangement. You then contract one certified occupational health service that organises the compulsory support.
That is often clear, certainly for smaller and medium-sized organisations. The lines are shorter, responsibilities are set out more clearly and you have to coordinate less yourself.
When is a tailored arrangement possible?
With the tailored arrangement you choose yourself which experts or services you contract. That is only possible with written agreement from the works council, staff representation or through the collective labour agreement, as explained on Arboportaal on the basic contract and the tailored arrangement (in Dutch). In that construction at least one occupational physician remains compulsory for the statutory tasks.
For larger organisations a tailored arrangement can be attractive, for instance when internal expertise is already present. At the same time it calls for more direction. You then have to not only conclude contracts but make sure all compulsory parts actually connect.
What it means for employers
For employers a good basic contract is in the first place a legal obligation, but it is also a practical steering document. It helps you create clarity in advance about:
- who carries out which working-conditions tasks;
- how absence guidance and prevention are set up;
- how employees gain access to the occupational physician;
- how the second opinion and complaints handling work;
- how cooperation with the prevention officer and works council is arranged.
That prevents uncertainty at moments when speed is needed, for instance during sickness absence or at signals of unhealthy workload. Anyone who wants to know how the division of roles works in practice can also look at what an occupational physician actually does and at engaging an occupational physician: how it works and what it costs.
What it means for employees
For employees the basic contract offers protection and clarity. They have to know that the occupational physician is accessible, preventively as well. They have to be able to request a second opinion. And they have to be able to count on a careful complaints procedure.
In practice that contributes to trust. Employees go to the physician sooner when complaints are just starting if the route is easy and if it is clear that a consultation is not only meant for people already at home ill. That supports early spotting and can help prevent drop-out.
What it means for the occupational physician
For the physician the basic contract creates the conditions for acting professionally and independently. That covers access to the floor, room for consultation, time for preventive tasks and the possibility of reporting occupational diseases.
Without those conditions, practice quickly shifts too far towards absence guidance alone. A good contract helps make the physician's wider role real, for instance in prevention, sustainable employability and advice on working conditions. In organisations where that cooperation is wanted more intensively, an in-company occupational physician can be a fitting next step.
Common mistakes
A recurring pitfall is that employers assume any standard contract automatically suffices. That need not be so. Watch for these points:
- the contract names a provider, but employees' compulsory rights are not worked out;
- access to the walk-in clinic is not arranged practically;
- the second-opinion procedure is missing or unclear;
- cooperation with the prevention officer or works council is not named;
- free access for the physician to workplaces is not recorded;
- the duty to report occupational diseases gets no place in the arrangements.
Because the employer remains responsible for the content, it is wise to test the contract periodically against current law and against the practice of your organisation. A basic contract has to be not only legally correct but workable for everyone involved.
With good working-conditions arrangements you prevent absence and keep people at work safely, healthily and with confidence.
With a firm, well-considered basic contract with your occupational health service you create clarity, meet the Working Conditions Act and make it possible to support employees sooner and better, preventively as well.
Key takeaways
- A basic occupational health contract goes further than absence guidance and also arranges access to the physician, second opinions and complaints handling.
- Record clearly how employees can use the walk-in clinic and how the physician gains access to the floor and to workplaces.
- Make sure cooperation with the prevention officer, works council or staff representation and the reporting of occupational diseases are clearly described.
- Check regularly that your contract is not only legally in order but workable in daily practice for managers and employees.
- With clear arrangements in the basic contract we can spot things sooner, advise better and work together on healthy, safe and enjoyable work.
By investing now in a clear basic contract, you lay a valuable basis for sustainable employability, early prevention and an organisation in which healthy work becomes a matter of course.