This book is an attempt to evaluate the efficiency of the Employees State Insurance Scheme (ESIS) in providing occupational health services to the workers in India. It provides an insights not only into the working of the System and its correlates but also brings to fore some serious issues for discussion. Systems Analysis Approach enables us to highlight the limits of intervention in the core system without touching the supportive components and the contextual domain. It highlights how delineating the larger issue of the socio-political framework, that influences the functioning of the core ESI System, is critical in any effort to improve ESI services.It begins by discussing the external factors viz the power and politics of occupational diseases and injuries, vested interests of the principal players in the ESIS, their class base and linkages with the Government administration, institutions and legislation. This is followed by a discussion on the internal linkages of the ESIS that are critical for the working of the core and supporting components. Finally, suggestions for systemic intervention, which in author's view, will help improve the system are given.