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

Executive summary
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on the capacity rather than the incapacity of disabled people and review the current
system of disability assessment to take into account both the physical and cognitive
abilities of people with disabilities to support them in the labour market for longer.
Organisations, such as The Bulgarian Organisation for Patients with Rheumatology
Diseases should be supported in educating GPs and specialist consultants about the
physical, social and psychological aspects of chronic diseases.
• Think beyond legal compliance. Employers have to be aware of implications of
ill health of employees on engagement and productivity. Simple interventions will
help manage existing MSDs and prevent new cases of occupational diseases at the
workplace. Managers should work together with employees in adjusting the ways
work is organised to help prevent existing MSDs getting worse and to help people with
MSD to stay in, or return to, work. They need to do this in a way which preserves job
quality, avoids excessive or damaging job demands and takes heed of ergonomic good
practice.
• Assess the direct and indirect costs of MSDs. The quality of data on MSDs needs
to be improved through monitoring the clinical and labour market impact of MSDs in
a more ‘joined-up’ way. Currently the data on the costs and prevalence of MSDs in
Bulgaria, their impact on sickness absence from work and lost productivity are not
consistent, sufficiently comprehensive and reliable to allow good analysis or informed
policy-making. A national register of occupational diseases would improve data quality
considerably.
• A national plan for MSDs. Such is the impact of MSDs on the working age population
of Bulgaria we suggest that a national plan for the early diagnosis, treatment and
rehabilitation of people with MSDs be established. This plan might establish national
standards of diagnosis and treatment, support coordinated effort between local and
state government and establish mechanisms which help GPs and employers to support
job retention and return to work among people of working age with MSDs. Other
countries (eg Ireland) have also appointed a National Clinical Director with oversight of
such plans. We recommend that Bulgaria considers such an appointment.
The evidence presented in this report illustrates that a large proportion of working age people
in Bulgaria are, or will be, directly affected by musculoskeletal conditions (MSDs) in the coming
years. This can have very significant social and economic consequences for these individuals
and their families, it can impede the productive capacity of the total workforce and parts of
Bulgarian industry and it can draw heavily on the resources of both the health system and the
benefits regime.
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