Health surveillance: what the law actually asks for, and what September exposes
Health surveillance is the set of medical activities an employer must guarantee for its workforce. What each examination contains depends on the risks of the specific job. In Spain, Article 22 of Law 31/1995 sets the duty. However, it is not a general medical check-up: it is built on the risk assessment. September is when the gap shows. July hires, temporary contracts that quietly become permanent and long absences ending now all pile into the same two weeks.
What health surveillance is, and what it is for
Article 22 of Law 31/1995 is explicit. The employer shall guarantee periodic surveillance of workers’ health according to the risks inherent to their work. Guaranteeing means organising it, paying for it and making it available to each person. In other words, naming it in the prevention plan is not enough.
It serves three purposes. First, it detects work-related harm early. Second, it shows whether preventive measures actually work. Finally, it establishes whether someone can do their job without risk.
Main requirements of health surveillance
The rules draw a fairly precise frame. These are the requirements any programme has to meet:
- Employer duty: the company organises and pays for the activity. Under Article 14.5 of Law 31/1995, the cost cannot fall on the worker.
- Risk specificity: the content follows the risk assessment of the job. In addition, the Ministry of Health publishes specific protocols agreed with the regions.
- Consent, with a closed list of exceptions: it requires the person’s consent. However, the law names specific exceptions, subject to a report from worker representatives.
- Confidentiality: results go to the worker. The employer only receives fitness conclusions and the need to improve protective measures.
- No discriminatory use: health data is a special category. Therefore, nobody may use it against the person who provided it.
- Frequency set by protocol: there is no single interval for a whole workforce. Instead, each risk protocol sets it. In addition, jobs with occupational disease risk need pre-placement and periodic checks.
- Traceability: every appointment and every fitness conclusion needs a record, with an owner and a date.
All of it rests on a living risk assessment. Put differently: an outdated assessment produces useless health surveillance.
How it is organised: protocols, frequency and cost
Occupational health staff from the prevention service run it, in-house or external. The content of each examination comes from the protocol attached to the risk of the job. Therefore, two different jobs do not get the same examination. And the frequency follows that protocol, not the company calendar.
The cost sits with the employer. In addition, jobs with occupational disease risk need a check before placement. Article 196 of the consolidated Social Security Act imposes it. Even so, the law sets no tariffs. They depend on the prevention service, the number of people and the content of each protocol.
When a programme fails, the cause is rarely medical. In most cases it sits in the structure of the prevention system.
The three moments the law defines and almost nobody plans for
The Prevention Services Regulation sets out the timing. First, an initial assessment after hiring or after assigning tasks with new risks. Next, an assessment when someone returns from a long absence for health reasons. Finally, surveillance at periodic intervals.
The second one is the forgotten one. However, it yields most of the signals about musculoskeletal disorders and psychosocial risk. These harms rarely reach an accident report. Instead, they surface in the absenteeism figures. Therefore, a programme that only looks forward gives up half its preventive value.
Health surveillance versus a company medical check-up
- Nature: health surveillance is a preventive duty. In contrast, a general medical check-up is a voluntary company benefit.
- Design: the first one follows the risks of the job and a protocol. The second applies the same battery of tests to everyone.
- Output: surveillance returns a fitness conclusion to the employer. However, a general check-up generates clinical data the employer should not receive.
- Consequence: swapping the first for the second does not meet the legal duty. And that holds even when it costs more.
Health surveillance software: what it should deliver
Most of the failures that surface in an audit are not ideological, they are calendar failures. Nobody decided to skip the protocol. The person simply changed jobs and their appointment did not change with them. Or the periodic check expired in August and no alert was waiting in September. In addition, a spreadsheet full of expiry dates warns nobody. Someone has to remember to open it.
A useful system connects four things. First, the risk assessment of the job and the applicable protocol. Then, the appointment and the traceability of what was done. In addition, it keeps clinical data separate from fitness information. We covered this when explaining how health surveillance gets automated. The case of Hospital de Sant Pau shows it at scale.
Health data is a special category. Therefore, the platform holding it should prove its security with more than a sales promise. That is why certifications such as ISO 27001 and the Spanish National Security Framework are no longer decoration in a tender. If you want to see it against your own protocols and calendar, request a demo.
Frequently asked questions
Is a workplace medical examination mandatory?
As a rule, it requires the worker’s consent. However, the law sets a closed list of exceptions, subject to a report from representatives. In addition, jobs with occupational disease risk carry mandatory pre-placement and periodic checks.
What can the employer know about the result?
Only the fitness conclusions for the job. Also the need to introduce or improve protective measures. In contrast, the diagnosis stays inside the medical team.
How often should health surveillance be carried out?
There is no single interval for a whole workforce. The protocol attached to the risk of the job sets it. In addition, you have to add the initial assessment and the review after a long health-related absence.
Who pays for health surveillance?
The employer. The cost of health and safety measures cannot fall on the worker.
