Policy and strategy for occupational health services in South Africa.

Recent events in South Africa have spurred policy thinking in many areas, including occupational health. Strategic thinking needs to take account of current and likely future economic and political conditions in the new South Africa. The present occupational health system, considered as a network of health services, educational and research facilities along with a mechanism of legal regulation of workplace conditions, and compensation for occupationally-related disability, is reviewed and found to be inadequate in several respects. A possible structure for an integrated occupational health system is outlined at national, regional and local levels. Both service provision and financing arrangements are addressed. The interrelation between occupational health services and general health services for workers and their dependants is approached from the point of view of the desirability of comprehensive primary health care services catering to all health needs of all workers and their dependants. Appropriate linkages between levels of care (primary, secondary and tertiary), and between relevant institutions required for an efficient occupational health system are outlined.