Cost to access: On health check-up for workers

Source: The post “Cost to access: On health check-up for workers” has been created, based on “Cost to access” published in “The Hindu” on 11th May 2026.

UPSC Syllabus: GS Paper-2- Governance

Context: The Union Labour Ministry has announced a free annual health check-up programme for workers aged 40 years and above through the Employees’ State Insurance Corporation (ESIC). The programme aims to improve occupational health and provide early detection of diseases among workers.

Positive Features of the Programme

1. Free annual health check-ups

• The government will provide free annual health check-ups to workers above 40 years of age.
• This step can help in the early identification and treatment of diseases.

2. Special focus on hazardous occupations

• Workers handling toxic chemicals or heavy machinery will undergo mandatory health check-ups.
• This can reduce occupational health risks and improve workplace safety.

3. Free treatment facilities

• ESIC hospitals and dispensaries will provide free treatment if any illness is detected during screening.
• This can reduce the financial burden on workers.

4. Legal support for workers’ health

• The programme is supported by laws such as the Factories Act 1948, the ESI Act 1948, and the OSH Code 2020.
• These laws aim to protect the health and safety of workers.

5. Availability of financial resources

• The programme will be financed through the well-funded ESI scheme.
• The government is also increasing the number of beds and doctors through PMJAY-empanelled facilities.

Challenges and Limitations

1. Limited coverage of workers

• Only around 31 crore out of 94 crore workers are registered on the e-Shram portal.
• Many workers may remain outside the benefits of the programme.

2. Problems faced by informal workers

• Women working as domestic workers or in home-based units often do not have formal employers.
• Such workers may not be able to access maternity and healthcare benefits.

3. Gender-related difficulties

• Women workers require specialised healthcare services and medical staff.
• Many ESIC camps remain overcrowded and are dominated by male workers.

4. High opportunity cost of healthcare

• Workers lose wages when they visit healthcare centres for check-ups.
• Referral to multiple centres for tests increases both time and expenses.

5. Inadequate recognition of occupational diseases

• Heat-related illnesses are not clearly recognised under the ESI Act.
• Construction and agricultural workers remain highly vulnerable to such diseases.

6. Neglect of infectious diseases

• Waste pickers and sanitation workers face diseases such as hepatitis and leptospirosis.
• The programme focuses mainly on screening and does not ensure preventive vaccination.

7. Weak healthcare infrastructure

• Many ESIC hospitals face shortages of doctors, beds, and medical facilities.
• This can reduce the effectiveness of the programme.

Measures Needed

1. Expand worker registration

• The government should increase registration on the e-Shram portal.
• Better integration between e-Shram and ESIC should be ensured.

2. Reduce opportunity costs

• Workers should receive compensation for the time spent on health check-ups.
• Mobile occupational health units should be provided near workplaces.

3. Improve healthcare access for women

• More female medical staff should be appointed in ESIC facilities.
• Separate and accessible healthcare services for women workers should be ensured.

4. Recognise more occupational diseases

• Heat-related illnesses and infectious diseases should be included under occupational disease coverage.
• Preventive vaccination should also be promoted.

5. Strengthen workplace healthcare delivery

• Healthcare services should be provided directly at workplaces as required under the OSH Code 2020.
• This can improve accessibility and participation among workers.

Conclusion: The ESIC annual health check-up programme is an important step towards improving workers’ health and occupational safety in India. However, unless issues such as limited coverage, opportunity costs, poor infrastructure, and exclusion of informal workers are addressed, the programme may not significantly improve healthcare access for workers.

Question: Despite several legal provisions for workers’ health in India, access to affordable and effective healthcare remains limited.” Discuss in the context of the new ESIC annual health check-up programme.

Source: The Hindu