FfW Bulgarian report (English language) - Fit for Work Europe

Interventions
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Bulgaria (Georgieva et al., 2007; Tzenova, 2011a), possibly predicting the lack of psychological
support offered to those with chronic conditions. Research has shown that mental health
conditions are more common among people with chronic physical health conditions. For those
individuals with co-morbid physical and mental health conditions functional disability can be six
times higher than for those with just a physical or mental health condition. The number of days
absent from work is also higher for these individuals (Ashby and McGee, 2010). Responding
to the psychological needs, as well as the physical needs of those with chronic conditions is
therefore crucial if the impact of their disability is to be managed.
There is a good tradition of providing rehabilitation such as physiotherapy after medical
treatment both through inpatient and outpatient services, as well as through spa-like resorts
(Georgieva et al., 2007). Although reimbursable, payment usually has to be made by the patient
upfront, potentially affecting the number of people who can access treatment. 27
Nevertheless, there is lack of evidence that rehabilitation from illness is linked to the individual’s
return to work. The attitude amongst medical professionals towards return to work is not
clear and views of experts are conflicting. Whilst there is some indication that patients are
encouraged to return to work as soon as possible following treatment, 28 there is also some
indication that doctors view work as an extra burden for ill patients. 29 With the right support
in place and education for patients, employees and employers, work as a clinical outcome is
something that should be encouraged.
Regarding early intervention in the workplace, prevention is always easier than cure. There is
evidence that efforts are being made by the government to finance preventive methods in the
workplace. For example the ‘Working conditions’ FUND30 has the task of financing activities to
improve working conditions in accordance with legislation of the Republic of Bulgaria as part
of the programme on working conditions adopted by the National Council. The Fund finances
projects of national, sectorial and regional importance. In 2011 diagnosis and early intervention
for occupational diseases were one of the Fund’s strategic goals with 1 mln BGN available to
target this goal. They also made funds available to finance safety training programmes.
Ensuring that workers who have MSDs get access to appropriate health care and support
as quickly as possible must be a top priority for employers and health care professionals.
Increasing access to GPs, specialist health care professionals as well as experts in vocational
27 Expert interview
28 Expert interview
29 Expert interview
30 See Ministry of Labour and Social Policy http://fund.mlsp.government.bg/fund/f1.htm
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