Gaining health : analysis of policy development in European ...

to reduce work accidents and profession-related risks and
diseases.
However, a lack of focus on public health in the work of
INRS led the Ministry of Health to create a special department
for occupational health in InVS in 1999 (26). This
decision indicated a willingness to integrate “health at the
workplace” into public health policy and symbolized a
shift of approach from occupational health care to health
promotion at the workplace. This trend continued during
the following years and the report of the Commission on
Prevention, published in 2006 (7), also clearly reflected this
change by dedicating one of eight action priorities to health
promotion at work. Referring to the Bangkok Charter, the
report argues for more attention to health promotion
and primary prevention as well as occupational health and
workplace safety.
The report was made in the spirit of some public health
experts at INPES who reported in 2003 on needs for controlling
alcohol consumption and smoking at places of work.
Moreover, one of the key areas of action of the National
Nutrition Health Programme is the improvement of healthy
nutrition at workplaces. Businesses were encouraged to
participate in screening and awareness-raising measures,
including within the framework of the Cancer Plan. Based
on the positive results of these efforts, the Commission on
Prevention suggests implementing more programmes at
workplaces and it stresses the need for both individual and
community-based approaches to prevention and recommends
the following actions:
• developing an epidemiological database specifically for
this setting;
• building an information system on the main occupational
risks as a contribution to regional health policy;
• establishing a network of health issues at the workplace;
and
• improving collaboration among enterprises on occupational
health issues.
2.10. Policies for specific population groups – older
people
Healthy ageing is a highly relevant issue in France and first
received attention in the Laroque report of 1962. Over
the following decades, however, policy and debate on the
challenges of an ageing society were linked exclusively to
questions of reforming the retirement system, the labour
market, housing and the increasing health care costs. Public
health aspects were marginalized and ageing brought under
the aegis of the Ministry of Labour and Solidarity.
This trend changed in 2003 following the record-breaking
heatwave that caused over 14 800 deaths during August
of that year and affecting mainly old people (27). As a
result, the Prime Minister at the time, Jean-Pièrre Raffarin,
launched a four-year National Programme on Ageing and
Solidarity to improve the living conditions and care of the
elderly. Genuine efforts were made to create greater independence
for elderly people in society. Between 2003 and
2007, 25 000 new places were created in homes for elderly
people. The Programme aimed mainly at reducing the dependence
of elderly people; public health aspects appeared
as a horizontal perspective but were not the main focus.
In 2006, a follow-up to the programme was prepared by
the Ministry of Social Security, Elderly and Disabled People
entitled “Solidarity for the Elderly”, setting 17 objectives in
5 groupings. The overall objectives of the new programme
were to improve the socioeconomic models of ageing and
to enable a healthier life. This five-year programme has a
budget of €2.3 billion, which is foreseen to be spent on creating
more long-term care facilities and improving care for
elderly people who wish to stay at home. The programme
aims to develop a modern financing system based on the
value of solidarity and to reinforce geriatrics research.
Similar to the model of cancerpôles in the field of cancer
Chapter 4
91
Case studies: policy development in countries for tackling noncommunicable diseases