Should I provide any additional health check-up for my domestic helper?

Before a domestic helper starts any employment in Hong Kong, they are expected to be physically and mentally fit for the job. A good domestic helper brings you peace of mind as they fulfil duties around the house and take care of your family. Therefore, it is in the employer’s best interest to ensure the domestic helper’s health is taken care of throughout the 2-year contract and every contract thereafter.

In this article, we will evaluate the different factors you should consider before providing any additional health check-up for the domestic helper. We also provide practical suggestions on how to communicate your expectations about the domestic helper’s physical and psychological fitness that may not be covered by the basic body check. If you want to know more about domestic helper medical certificates and what is included in the pre-employment health check-up package, read our comprehensive article here.

According to the Secretary for Labour and Welfare, Clause 9(a) of the Standard Employment Contract requires that in the event that a domestic helper falls ill or suffers from personal injury during the period of employment, regardless whether it is attributable to their work, the employer shall provide free medical treatment to the domestic helper. Know more about the employer’s obligation to provide free medical treatment in this article. 

Factors to consider for providing additional health check-up for domestic helpers

Employers may sometimes feel the need to provide the domestic helper with an additional health check-up. The reasons for this decision could include the following.

Hidden illnesses that cannot be detected through the pre-employment medical exam

There are different diseases and health conditions that may not be identified through basic medical screenings. This can include tumour markers, cancer, leprosy and stroke. Some diseases may only be diagnosed after a long period of time, making it difficult for a patient to identify it at an earlier stage.

In most cases, employers are looking for a domestic helper to stay with their families for the long term. Hence, it could be beneficial for an employer to provide an additional health check-up to ensure that the domestic helper is healthy and able to stay in their employment without the concern for frequent sick leave or any work suspension due to illness or injury.

Vulnerable family members as the primary care recipient

Employers may hire a domestic helper with the intention of providing daily care to elderly parents, newborn children, or family members with special needs. If primary care recipients are physically vulnerable to diseases, special care must be taken to ensure that their primary caretaker will not compromise their immunity.

By providing additional health check-up to the domestic helper, employers can eliminate the worry of hidden communicable diseases contracted within the family.

Ability to shoulder medical costs

According to the Standard Employment Contract, the employer of a domestic helper should cover all medical expenses in Hong Kong. Any costs incurred from doctor consultations, hospital stays or dental treatment should be borne by the employer.

As such, an employer should carefully assess their own ability to shoulder medical costs. By providing an additional health check-up to the domestic helper, employers can focus on preventive measures and purchase the right insurance plan to support the specific needs of the domestic helper.

Insurance coverage for the domestic helper

A medical exclusion is the absence of insurance coverage for certain health-related items, such as pre-existing conditions, medical treatments or surgical procedures. Employers should note that it is not mandatory for a domestic helper’s insurance coverage to provide medical exclusion. Depending on the worker’s health condition, the plan’s coverage and the employer’s obligations may vary.

If the employer decides to provide an additional health check-up, a better review of the insurance plan’s terms and conditions can be done to ensure full understanding of the coverage received.

Do I need to get the domestic helper’s consent before arranging an additional health check-up?

Yes, employers who want to arrange an additional health check-up must get the consent of the domestic helper. It is important to communicate the employer’s need and purpose for ordering a particular medical examination.

For example, a domestic helper may express a severe headache, bone injury, or chronic pain that is affecting their ability to work. According to the “Code of Practice on Employment under the Disability Discrimination Ordinance” issued by the Equal Opportunities Commission (EOC), the Disability Discrimination Ordinance (DDO) (Cap 487) does not prohibit employers from asking a person with a disability to undergo a medical examination.

If the domestic helper refuses to undergo a medical examination, the employer may refuse to sign any new contract employing the domestic helper or terminate the existing contract after considering all of the following relevant factors:

• The helper’s past training, qualifications and experience relevant to the job
• The helper’s performance as an employee (where the person is already employed by the employer)
• Does the helper’s disability make him/her unable to fulfil the inherent requirements of the job?
• Is the employer’s accommodation suitable for the helper or would it create unjustifiable hardship for the employer?

How do I talk to my domestic helper about the additional health check-up?

It is important to communicate the need and expectations clearly for the additional health check-up of the domestic helper. This can help to alleviate any concern that they have about their conditions or beliefs about medical procedures.

Ask the helper if they are open to receiving additional health check-ups.

Whether it’s due to cultural background, family upbringing, or personal beliefs, every person can feel differently about undergoing medical examinations.

Since basic health screenings are done prior to a domestic helper working in Hong Kong, the domestic helper may not feel like it is necessary to receive additional health check-ups. Explain each voluntary test clearly and why you would like them to take it. Also, provide more information about the procedures and emphasise that as the employer, you will pay for all the expenses. If the domestic helper refuses to undergo additional medical exams, you should respect their wishes while explaining the consequences of not going through with your requirements.

Align on the importance of conducting additional health check-ups.

A domestic helper’s compulsory employment insurance may not include any body check package or vaccinations, so it is the employer’s prerogative to send them to a clinic and undergo the regular medical exams.

If you notice any physical symptoms while the domestic helper is working, or perhaps a family member has been diagnosed and become more vulnerable to illness, then it is recommended to take precautionary measures rather than suffer the consequences later. Align on the importance of health to your family especially if you have an upcoming travel arrangement, a spike in influenza cases in your neighbourhood, or other reasons such as changing the domestic helper’s insurance plan.

Ask your helper if they have any underlying health concerns.

A domestic helper’s job can be physically demanding. Combined with the need to adjust to life abroad, a worker’s mental health may also be impacted, possibly leading to physical conditions. By asking the worker’s health history and underlying symptoms, the employer can be more effective with their choice of additional medical tests.

It is the employer’s responsibility to provide a safe and healthy work environment for the domestic helper. Set up your household for success and build trust with the domestic helper so that they can openly share any underlying health concerns that can impact their performance at work.

Following up after providing additional health check-up for domestic helpers

If the results from the additional health screenings show that the domestic helper is or may no longer be fit to work, below are practical steps on how to handle the situation.

Discuss medical treatment options.

Would the helper wish to remain in Hong Kong or go home for the treatment? What are the available treatment options for them in their home country? Even if you are not a medical professional, it may be helpful to provide information and resources to the helper to guide them in making an informed decision.

Understand legal implications.

As an employer, you should be aware of your obligations in case the domestic helper falls ill, requires treatment in Hong Kong, or is no longer able to work. Understand the medical expenses you should provide for, sick leave arrangements and recognise that a domestic helper cannot be terminated when she is on paid sick leave. Read more about domestic helper sick leave here.

Be patient and understanding.

While your helper falling sick is not an ideal situation, approach the issue with care and empathy. Suffering from health conditions and looking for treatment, lacking household support and feeling the pressure of finding a suitable replacement are all difficult situations. Be patient with your helper and aim to have the best possible outcome for both parties in this situation.