An intersectoral agreement of 13 September 2000 on health in the workplace and the "social modernisation" law of 17 January 2002 provided for an overhaul of the occupational health system. Disagreement over the reform persists between the government and employers’ organizations on one side and trade unions and health professionals on the other.

A decree published in late July 2004 makes some further changes to the occupational health system, including the following two major amendments, which had been rejected in earlier talks:

• the frequency of medical check-ups, which employees currently undergo annually, is to be scaled back to once every two years. However, employees under a 'heightened health watch' will continue to have a check-up at least once a year - this may also now apply to occupations and positions defined by extended (ie made binding on non-signatory employers and employees) sectoral collective agreements. All employees will also be eligible for a medical check-up on request; and
• occupational health doctors will be required to devote a third of their working time (150 half-days per year) to activities at the workplace. They will only be allowed to cover a maximum of 450 companies or worksites and 3,300 employees, and to undertake 3,200 medical examinations a year.

In addition, from January 2006, occupational health doctors will be required to draw up and to keep up-to-date records - including information on occupational hazards and the number of employees exposed to them - for each company or business facility (including those with a workforce of under 11) for which they provide services.

The minister responsible for labour relations, Gérard Larcher, believes that the new decree addresses the shortage of occupational health doctors, as well as refocusing and boosting the monitoring of the health of employees exposed to occupational hazards. The French Democratic Confederation of Labour (Confédération française démocratique du travail, CFDT), is also of the view that the decree strengthens occupational hazard prevention.

However, the occupational health doctors’ union questions the Ministry’s contention that the decree tackles the issue of the shortage of such doctors and has expressed concern over an increase in their workload. The national council of the Order of Physicians (Ordre des médecins), has spoken out against a perceived lack of dialogue and has asserted that it will not accept any deterioration in the quality of the consultations and other healthcare provided by occupational health doctors.

Mr Larcher has stated that a workplace health plan to be unveiled in late 2004 will address the problems emphasised in a series of General Social Affairs Inspectorate (Inspection générale des affaires sociales) reports.