Transformations in the Regulation of Work in Preventive Occupational Health Services: French Case Studies

A current research programm (Julhe, Dir ) is looking at the reorganisation of occupational health and prevention services in France since the advent of the new law (2021), ‘Santé au travail’, reinforcing the objectives of prevention and workers' health. The implementation of this law is leading to major changes (organisation of services, competitive tendering, delegation of tasks, etc.). This is now leading to a rapid reorganisation of occupational health services, which is necessary in order to obtain certification from an independent body, whose standards were published in August 2023 (AFNOR SEPC 2217). The changes underway affect three aspects of the organisation of services and work: the formal organisation of work groups, which are now multi-professional (new forms of coordination), work rhythms and the monitoring of professional practices. Occupational doctors can now delegate a number of tasks to health nurses. On the other hand, the management of the departments employing the occupational health physicians partly determines their working methods. But for each of these professional groups, the challenge of preserving their autonomy, their ‘mandate’ (Hughes, 1996), and ultimately their ‘professional identity’ (Barel and Frémaux, 2012; 2015; Perrenoud and Sainsaulieu, 2018), remains.

Based on case studies of collective organisations (Hamel, 1997; Passeron & Revel, 2005; Zimmermann, 2011; Buscatto, 2012; Dumez, 2013) and individual interviews with several categories of health service staff, the study highlights the heterogeneous effects of the new regulations on services, particularly in terms of work regulation, as well as their various influences on the work of occupational health professionals (doctors, nurses, assistants, ergonomists, etc.).