broad range of workplace health promotion programmes and activities. The big branches of health insurance funds therefore allocated a small part of their research resources to health promotion.

In 1997, the health insurance funds were re-regulated. They could no longer fund community health promotion activities, and their workplace-related activities were restricted to research into possible relationships between hazardous working conditions and work-related diseases. At the same time, the responsibilities of the statutory accident insurance funds in the area of prevention were expanded. These changes resulted from adapting German statutes to the European Framework Directive on Health and Safety (Worker Protection Act 1996), which extended the obligations and responsibilities of employers with regard to health and safety. They strengthened co-operation between health and accident insurance funds.

Following the inauguration of the new German administration in 1998, the German Health Ministry started a new health care reform initiative aimed at containing escalating public health care costs. As part of this initiative the Federal government again revised the legal basis for health promotion investments by health insurance funds. Beginning on January 1, 2000 the health insurance funds were again authorised to develop and finance workplace health promotion, including the organisation of primary prevention and workplace health promotion activities. All activities have to be based on a national quality assurance system established by the health insurance funds and must bring in other key players in public health such as the federal health agency, public health services, public health sciences, and the medical profession.

The new law defines workplace health promotion as a supplementary field of action to health and safety. It requires the health insurance funds to engage in preventing work-related health risks. Total expenditures of the health insurance funds may not exceed 5 Deutschmarks per insured per year for health promotion.

Based on the Worker Protection Act and the extended prevention role of the accident insurance funds, the new strategy to ensure health and safety at work comprises the following elements:

* Hazard and stress analysis (risk assessment)

* Planning of interventions

* Prevention of accidents at work and work-related diseases

* Health and safety at work

Health promotion interventions in the workplace are defined as any activity which contributes to preventing workplace hazards by strengthening factors conducive to health at individual and organisational levels. The German approach reflects the concept of workplace health promotion laid down in the Luxembourg Declaration of the European Network for Workplace Health Promotion, which has been formally adopted by a number of German companies.

Discrimination and the right to work: the evolution of the legal framework

 

According to German law, "disabled people" are all those who are affected by a functional limitation originating from a physical, mental, or emotional state, which deviates from the norm for a person of that age and is not temporary. This reflects the three stages of the WHO definition of disablement: impairment, disability, handicap.

The right of all people to be treated equally is firmly rooted in the German Basic Law, to which the following statement was added in 1994: "No-one