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ORIGINAL FRENCH ARTICLE: En 2004. " Les salariés et leur souffrance "

by Lucy Bateman

Workers and the Psychological Price of Work

Translated Saturday 19 August 2006, by Patrick Bolland

The work of nine industrial health officers in Bourg-en-Bresse:
A discussion of the health problems in their area of specialisation – the physical and psychological health of workers on the job and how the medical team has dealt with these, as a collective rather than working individually.

The Bourg-en-Bresse (east of Lyon) industrial health collective was formed in 1994 after yet another attack against the independence of one of its future members. “We were often confronted with situations in which industrial health officers were simply moved on when they reported too many problems”, Odile Chapuis recalls. “In this case we knew it was a colleague who was professionally irreproachable.”

Out of this grew a solidarity movement, around a hub of doctors who had been harassed for years in carrying out their work. This subsequently became a collective: “We were unable to keep up with an increasing number of workers suffering from work-induced psychological problems, which we were unable to understand”, one member of the collecitve says. “In the 1980’s we would see 12 workers in a day’s consultation, without the workers being rushed” recalls Jean-Michel Lauze. “The problems were simple, and we’d learned how to treat them, by adapting the machinery, by changing the workers’ posture.

Then workers began to come to see us for something quite different, a kind of psychological suffering. My colleagues told me not to play the role of the parish priest, that we weren’t psychologists, that we didn’t have to listen to people telling their personal stories.”

The doctors were begining to question their own interventions. “Were we doing our work badly? Was our work helping?” They all say that by joining the collective they found the key to understanding what they had to do. Mireille Cellier, who arrived on her first assignment as an intern at Bourg-en-Bresse in 1995, remembers how she felt “scared” when she realised that her training had never mentioned the hostility that exists in the world of work. The other members of the collective assured her: “It’s not you who are crazy!” As a member of the group, Yusuf Ghanty, often tells his colleagues: “The collective helped us point our heads in the right direction”. Added to the difficulty of dealing with the hew health hazards relating to work, the industrial medical officers were faced with the impossibility of carrying out their profession adequately. The “head pointing in the wrong direction” refers to the doctors who, caught in a double bind, are forced to break their own code of ethics in carrying out their work.

The first twist of the ethical bind: Medical health is a managerial prerogative, and so the doctors depend on the employers. The collective pointed out what this means in an open letter sent to the then Minister of Health, Élisabeth Guigou: “It has be be stated unambiguously that the party that generates the risks cannot also be in control of the actors who are dealing with the workers’ health”.

The second twist of the bind: “The measurement of aptitude, and the writing of ‘aptitude certificates’ and, with it, the notion of the selection of workers”, Élisabeth Delpuech, one of the doctors in the collective, explains. “Aptitude certificates finger the individual worker, not the job he or she is required to do”. A 2001 government notice makes this selection process worse: the directive states that if a worker is to be exposed to carcinogenic agents, those which may cause genetic mutations, or some other product potentially harmful for human reproduction, they have to get a medical certificate, provided by an industrial medical officer, stating that they present no counter-indications for this type of work.

As Yusuf Ghanty points out: “This certificate of aptitude shows the hypocricy of our system, by refusing us the possibility of doing preventative work. We sign 15 million certificates of aptitude a year. This means that work is no longer dangerous!” For the last 10 years the collective has been arguing that it is not possible for them to provide real prevention in the workplace, unless they can break these two institutional binds: the aptitude certificates and management control over health and safety at work.

The strength of these troublemakers, and what protects them, at least partly, against attacks on their independence is the fact that they use their right of freedom of speech for strictly professional purposes. A 1946 law requires them to “avoid any deterioration of health as a result of work”. This objective is impossible, at least without serious reflection on their own working practices. “We eventually found ways in which we could elaborate our own ethical values ourselves, based wholely on the objective of the 1946 law,” a member of the collective reported last year at a professional meeting of medical health officers.

As well as their annual report, which makes the collective a regional monitoring group on health in the workplace, the Bourg-en-Bresse doctors have taken training courses in ergonomics (the study of working conditions) and in the psychodynamics of work (studying psychological suffering resulting from work organisation).

Élisabeth Delpuech underlines the importance of “discussing these practices together, with our colleagues – this is a key aspect of the collective”. She adds: “None of us could have done so much alone”.


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