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Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and

Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and Workers’ Compensation. Overview. Background Occupational health issues Compensation system Activities of Department of Health Way forward. Global Worker Health.

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Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and

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  1. Presentation to the Portfolio Committee on Health 22 August 2012 Occupational Health and Workers’ Compensation

  2. Overview • Background • Occupational health issues • Compensation system • Activities of Department of Health • Way forward

  3. Global Worker Health • 7 billion people with 3 billion workers • 2m die every year from occ injuries & diseases • 160 m new cases of occ diseases • 250 m occ accidents & 300 000 fatalities • 4% of world GDP

  4. Occupational Health in South Africa fragmentation of policy and legislative framework (Health, Labour, Mineral Resources) inadequate occupational health system no surveillance of injuries and diseases deficient occupational health services lack of human resources for occupational health problems of access, coverage and equity in compensation systems concerns about mining sector, migrant workers (internal and cross border)

  5. Workers’ Compensation in South Africa

  6. Demography of Workers in South Africa • 17m work (13m formal & 4m informal)

  7. Workers per Employment Sector (‘000) Labour Force Survey. Statistics South Africa, 2008

  8. Gender Distribution of Workers Labour Force Survey. Statistics South Africa, 2008

  9. The Second Economy

  10. Migrant Mine Workers in South Africa * Data from TEBA

  11. Occupational Ill-health hard to find data; if found, difficult to interpret 3822 persons with occ diseases reported to DoL in 2005 (45 per 100 000 workers) 3 die every day from accidents Mine Health & Safety (2005) 196 411 miners exposed to airborne pollutants (44.5%) R50m paid to 1392 miners (occ lung disease) 480 000 undiagnosed / uncompensated persons* Naidoo R. WAHSA Project Report 2.1.10. 2007, * Nogueira C, et al. WAHSA Project 7

  12. Disease Rates per 1000 autopsies Pathaut: 1998, 2008

  13. Reference: PATHAUT Database, NIOH Pathaut, NIOH. 2010

  14. Nelson et al. Three decades of silicosis: disease trends at autopsy in South African gold miners. Environ Health Perspect. 2010

  15. Gold Price (2000 – current)

  16. Wilson K. NIOH. 2011

  17. Fatalities Target: 20% reduction in the incidence of compensated work-related fatalities by 30 June 2012 with an interim target of 10% by 2006–07. Result: The interim target was achieved in 2006–07 and a 17% decrease has been recorded up to 2007–08. Figure 2 shows that as long as this improvement is maintained the 2012 target is achievable. Aspirational target Target: Australia to have the lowest work-related traumatic injury fatality rate in the world by 2009. Result: While Australia has one of the fastest falling fatality rates among the best performing countries world wide, it has remained in 7th place. Safe Work, Australia. 2010

  18. HIV Prevalence (Review)

  19. TB Incidence (Review)

  20. Incidence Rates of TB by Commodity Global and SA TB incidence 139 and 948 per 100 000 population respectively

  21. Occupational Exposure Limits for Silica (2008) *Advisory organisation Source: Maciejeska A. 2008. Int J of Occ Med & Env Health 21 (1): 1-23

  22. Mining Sector in South Africa • 18 Trillion Rand sector (net asset value) • Employs 500 000 persons • 2 200 entities • 7.7% of annual GDP DMR 2010

  23. DMR Database of Mines & Quarries (2010) * Diamond mines were mostly mineral rights rather than active mines

  24. In summary… • Problem – lack of proper system, fragmentation, measurement ? • Paradox – collecting lots of data, little or no analysis, some reports • Pressure – multiple fronts • Potential for change • Promise …. COM. 2011

  25. Approach of Department of Health to Development of the Occupational Health System

  26. Workers Compensation (CCOD) • Phase 1 • Review and restructure CCOD, MBOD and NIOH (unified management structure) • Review of Strategic Plan • Policy & legislative reforms to ODMWA • Enhance corporate governance and management • Develop surveillance system • Conduct research • Effective and efficient compensation system for miners / ex-miners

  27. Workers Compensation (CCOD) • Effective and efficient compensation system for miners / ex-miners • Clear backlogs • Improve Turn-Around-Times (claims certification, processing & payments) • Ensure financial sustainability of the Fund • Decentralised benefit examinations (labour sending areas inside and outside South Africa)

  28. Major Urgent Interventions • Preparation of 2010/11 and 2011/12 annual reports • Development of 2012/13 APP • Response to Auditor-General’s report • Establish medical inspectorate • Strengthen links to Dept of Mineral Resources (Risk Committee) • Enhance Governance and Management

  29. The Compensation Fund (2012/13) • One national office (Johannesburg)

  30. Fund Review • 188 monthly pensions • 14094 claims paid since 2003; 41 claims last year (Eastern Cape project)

  31. CCOD Preliminary Analysis (2010/11)

  32. CCOD Preliminary Analysis (2010/11)

  33. CCOD Preliminary Analysis (2010/11)

  34. CCOD Preliminary Analysis (2010/11)

  35. CCOD Preliminary Analysis (2010/11)

  36. Gender & Race of Claimants (2010/11)

  37. Development of Occupational Health System • Links to Primary Health Care • 1 nurse at each facility trained to recognise work related injuries & diseases • 1 doctor and 1 nurse at district hospital trained to manage work related injuries & diseases • Links to social services • Links to SA State Social Security Agency (payment of claims) • Links to private providers

  38. Development of Occupational Health System • Occupational health unit at specialist hospital to manage workers with ill-health • Occupational health academic units • Links to NHI • Ensure collection systems in pilot districts get revenue from compensation system for work related diseases and injuries • Development of surveillance system for occupational health

  39. Occupational Health System • Phase 2 • Innovative models for occupational health services • Support the development of an integrated social security system for workers • Development of infrastructure and human resources for occupational health • Ensure appropriate funding for the occupational health system (prevention, treatment & care, rehabilitation & compensation) • Work with the Departments of Mineral Resources, Labour and Public Service & Administration in achieving a better health system for worker's health

  40. Policy, Planning, Co-ordinating & Funding Inputs • Briefing to Minister of Health • Briefing to Portfolio Committee • Briefing to Ministers of Labour, Mineral Resources & Finance • Briefing to National Health Council • Information to trade unions & employer bodies

  41. In History… Barrier Miner (Broken Hill, NSW : 1888 - 1954), Monday 13 November 1922, page 1 National Library of Australia http://nla.gov.au/nla.news-article45589068 MINERS' PHTHISIS IN AFRICA Tile South African Union legislature's select committee on public accounts reports that the compensation fund out of which compensation has to be paid to miners' phthisis victims on the Rand has still to face a liability estimated at £l4,000,000. As the exhausted mines close down it falls with cumulative effect on the surviving mines. The committee considers that no time should be lost in laying down measures to ensure the adequacy of the fund. Miners’ Phthisis Act 19 of 1912

  42. 1500 BCr 1556 1633-1714 • Hippocrates – Lead (4th BC) • Pliny – Zinc & Sulphur (1st AD) – animal bladder • Galen – Lead & Copper (2nd AD)

  43. 1907 1913 1910 1902 - 3 Milner Commission

  44. COM Dust Committee 1914 1930Int. Silicosis Conf 1959 AJ Orenstein’s pioneering work on dust (NIOH)

  45. Erasmus 1975 1994Leon 2011 2012 Mr ThembekileMankayivs AngloGold Ashanti COM vs CCOD & Health

  46. “Mine boss who smeared coal on face arrested” pg 16 Tuesday, Nov 15, 2011 “Pravin targets bonuses” LONMIN ... 16 August 2012 34 miners died & 9 trapped – Sizhuang Coal Mine in Yunnan province

  47. About a hundred years ago… "Two hundred thousand subterranean heroes who, by day and by night, for a mere pittance, lay down their lives to the familiar 'fall of rock' and who, at deep levels, ranging from 1,000 to 3,000 feet in the bowels of the earth, sacrifice their lungs to the rock dust which develops miners' phthisis and pneumonia." Sol Plaatje, first Secretary General of the African National Congress, describing the lives of miners in 1914

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