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Maritime Health Seminar 2011

“Fitness and Fairness”

Fitness and fairness • Difficult decisions – who can work at sea without risk to themselves or to others? • Balance between: .personal risk . • Role of MCA • Role of AD .public safety risk .loss of employment opportunities.

. • Appoint.MCA: fitness and fairness • Provide standards: MSN 1822 and AD Manual guidance. advise and train ADs • Audit work of ADs • Manage referee system • Involve social partners in development and changes to standards.

investigations. . • Apply discretion within standards to decide on fitness • Discuss and engage seafarer in decisions. examination.AD: fitness and fairness • Perform medical in accord with requirements. • Ensure that true and fair view on any medical condition is taken – history. reports.

• ILO Maritime Labour Convention 2007– ratification. Public safety justification. Applies if recruited or substantially employed in UK. Safer ships.Legal overlays • UK equality/disability law. EHRC. . • Both ILO and IMO have medical requirements that UK has to align with. Decent working conditions • IMO STCW 2012.

• Agreed by maritime authorities. Dream of whole world being consistent! ILO/IMO medical examination guidelines .• Major task for me – special adviser • Meet requirements of MLC and STCW. unions. employers – medicine and politics! • Very similar to MCA approaches! • Text agreed – one year to get ILO and IMO endorsement.

Referee cases/restrictions/examinations. .000/50. • 80/2. • Few complaints • AD consistency/audit findings. monocular vision etc.MCA and AD performance • MCA – social partner support but challenges to standards: IDDM.000.

AUDIT VISIT RESULTS 2005 No follow-up required Minor nonconformities Major / multiple non-conformities Change in approval status TOTAL 12 15 4 2 33 2006 13 24 1 1 39 2007 16 23 2 1 42 2008 10 4 11 0 25 2009 10 8 7 0 25 2010 6 2 7 1 16 2011 1 16 7 0 24 .

warfarin • Not seeking supporting medical evidence. • Non-standard restrictions – incomprehension so not employed • Not checking/using current standards • Shortcomings in vision and hearing testing • Not following standards: BMI.Audit: fitness & fairness issues • Clinical information on ENG1 – employer discrimination. . physical fitness testing.

Summary • Performing well • Area of continuing change: medical. Developed/developing world • Explanations of reasoning essential. employment • International dimensions. social. .