140 Chapter 5 services from OHSs are mainly perceived as an advice and that OHPs are seen as advisors for employers: S7 (OHS): “But we have a responsibility to give the right advice to both the employer and the employee. So, we have, it might be good for you to realize that we have obviously as an occupational health service, we do not have care tasks like a hospital. It is actually, an occupational health service is not a healthcare facility, and we deliver business-to-business services. We deliver services to an employer that happen to be care related, and as an occupational health physician you have a legal obligation to deliver care, but in fact, it is mainly an advice what you deliver.” Several stakeholders, including stakeholders at organizational level, mentioned that some employers feel a responsibility to solve problems outside the workplace. Some of these stakeholders stated that these types of employers see their employees as valuable. Feelings of responsibility by employers, increases the opportunity to deal with problems outside the workplace (e.g. sleep workshops) and facilitate solutions that are provided by external services or interventions (e.g. support for financial problems). A few stakeholders stated that mainly large organizations with sufficient resources facilitate solutions, which are offered in the form of a menu (e.g. lifestyle interventions, support from a psychologist or social worker) where employees can choose from. Smaller organizations may experience difficulties with the funding of solutions for problems outside the workplace: S4 (OHS): “but my first reaction would be just a lack of resources, or at least the choice to use these resources for this. I think it is easier for large companies, that financing is simply easier”. Several stakeholders at OHS and socio-political macro level stated that there are also employers not feeling responsible to solve problems outside the workplace. Some of these stakeholders mentioned that this is especially true for employers of employees with a lower SEP, who do not see their employees as valuable and are putting economic interests first. Some of these stakeholders also mentioned that some employers quickly point to problems outside the workplace as a main cause for sick leave. Stakeholders representing small and medium sized enterprises (SMEs) stated that employers of SMEs in general do not feel responsible to solve problems on multiple life domains, but that it is the responsibility of the OHS or employees themselves. A SME employer does not have much expertise on healthrelated problems, and therefore completely relies on the services of an OHS: S12 (socio-political macro level): “In general you must say that the willingness to pay for that themselves is very low, because the entrepreneur thinks it is not their
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