It is well known that in the recent years, numerous claims arised from the illness of seafarers due to medical conditions which pre-existed at the time of signing on, but were not detected by the routine pre-employment medical examination. The consequences for shipowners are drastic, exposing them to potential liability under the contractual obligation. The best method of preventing this kind of claim is not to employ any seaman having any health problem and therefore the importance of the Pre-employment medical examination (PEME) is nowadays fully recognized.

The PEME protects shipowners from claims arising from medical conditions existing prior to employment and provides crew with a health check before going to sea, which will point to cost savings on claims. The percentage split by claim types and by value from various P&I Clubs shows that personal injury and illness claims are basically the second largest category, both by number and by value, after cargo claims. The number of passenger vessels / ro-ro ferries / cruise ships entered in a Club will obviously affect the number and types of claims. The intention of a PEME is to ensure that as many aspects as possible of the seafarer’s medical condition are known at the time when the decision is taken by the clinic whether or not to issue a fit for sea duty certificate.

The quality of pre-employment medical examinations is however one factor in the high numbers of repatriations and medical bills. The problem may be caused by the inadequacy of the clinics. There should be consistency in examination standards, sufficiently high to protect shipowners from claims arising from pre-existing medical conditions. Furthermore, clinics have to be satisfied that no disease or condition is present in crew applicants, which could be aggravated by working at sea or which represents an unacceptable health risk to himself or to others.

Having investigated about pre-employment medical examinations in the port of Barcelona, one of the most important cruiser and passenger ports in the Mediterranean region, we have found that whilst various competent clinics are ready to provide the service in Barcelona, however their prices can vary from Euro 480 to Euro 1,050 per PEME, which variation depends on the clinic, on the tests to be performed and on the number of the crew members to be examined.

We therefore identified four experienced facilities in Barcelona capable of performing the medical tests and, following our liaisions, at a competitive price. Three of them are well known clinics and one of them is a small and private centre belonging to the Medical College of Barcelona, which is dedicated to performing medical examinations such as heath certificates, driving license pre-employment and employment certificates, sports certificates, residential certificates, invalidity certificates and others, therefore ready to examine up to 30 to 40 crew per day.

These four facilities have agreed to provide two levels of fixed-price pre-employment medicals on behalf of the club’s members. The first level, where there is a standard 11- part examination which includes a Medical Exam, Eye test, Audiogram, Lung function tests, Chest X-Ray, ECG, Analysis and Food handler’s screening for salmonella, the cost of which is between Euro 140 and 390 depending on the clinic. And a second level where additional tests would be undertaken, if deemed necessary by the clinic or by the shipowner, where the price would be increasing depending on the tests performed.

Two of the four clinics we recommend have experience in performing PEME for crewmembers. We have checked that the four facilities perform all the tests at their centres by qualified Doctors. The results can be handed over in between 24 – 72 hours, depending on the tests performed in each case. The four centres are ready to perform the medical examinations without previous advice and are ready to perform at least 10 /20 medical examinations per day.

In case a positive result shows up in any of the examinations carried out, the clinics are ready to provide further tests such as CT Scan, Magnetic Resonance, Exercise Tolerance Test, Gammagraphy, Echography, Densitometry, Digestive Endoscopy, Bronchoscopy, Colonoscopy. etc. which would not be included in the quoted rate.

Instituto Social de la Marina (ISM) or Social Institute of Seafarers. If the crew recruited is of Spanish or European (EC) nationality, they are then covered by the Spanish Social Security. This cover includes health assistance and also the pre-employment medical examination, which exam will be provided by the ISM on a free basis for Spanish and European crew and will follow the State medical form. This medical examination does not include certain tests such as Chest X- Ray, ECG Results, Serology, Audiometry, Spirometry, etc… as the state budget does not cover certain tests. These tests will be only performed in exceptional circumstances.

Our guidance on any comments as to whether there are any specific standards or guidelines and certainly any government legislation which the shipowner or manager should be aware of whilst recruiting from Spain. According to the clinics approached, as well as to our research up to date, there are no specific standards or government legislation which the shipowner should be aware of whilst recruiting from Spain.

Finally, we would like to point out that given that stress or depression illnesses are very common nowadays, we would advise that in case a crew member shows depressive symptoms, a psychological test would be very useful. A general psychological examination to start with would be sufficient and in case the crewmember shows any pathology, then a specific test to confirm whether the crewmember suffers from stress/depression would be advisable. Co-ordination and concentration tests, which are also provided by the clinics approached, are also advisable, but obviously the cost of the PEME will increase.

We believe that the clinics we recommend, whose competitive prices vary from one another, are able to fully comply with the service and pricing requirements, which method will help to prevent personal injury and illness claims.