Shireen Pardesi, Muzimkhulu Zungu and Sam Molautsi 27 August 2014 Annual Performance Plan of...
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Transcript of Shireen Pardesi, Muzimkhulu Zungu and Sam Molautsi 27 August 2014 Annual Performance Plan of...
Shireen Pardesi, Muzimkhulu Zungu and Sam Molautsi
27 August 2014
Annual Performance Plan of MBOD/CCOD
Presentation to Portfolio Committee on Health
OverviewOverview• History• Diagnostics of problems• Strategic Plan• Annual Performance Plan• Way forward• Conclusion
• History• Diagnostics of problems• Strategic Plan• Annual Performance Plan• Way forward• Conclusion
102 year old History…
Miners’ Phthisis Act 19 of 1912
In Summary…In Summary…• Problem – governance, claims
management, service delivery, infrastructure, sustainability
• Paradox – lots of data…• Pressure – multiple fronts (1867 –
diamonds; 1886 - gold)• Potential for change, Auditor General’s
report• Promise ….
• Problem – governance, claims management, service delivery, infrastructure, sustainability
• Paradox – lots of data…• Pressure – multiple fronts (1867 –
diamonds; 1886 - gold)• Potential for change, Auditor General’s
report• Promise ….
InterventionsInterventions
• Unified management structure (Medical Bureau, Compensation Commissioner)
• All activities now in one building
• Support from National Department of Health
• Development of the strategic plan and annual performance plan
• Unified management structure (Medical Bureau, Compensation Commissioner)
• All activities now in one building
• Support from National Department of Health
• Development of the strategic plan and annual performance plan
Strategic Plan (2013-2015)Strategic Plan (2013-2015)• Combines the Compensation Commissioner and
Medical Bureau (Occupational Diseases in Mines & Works Act (1973)
• Vision:• An accessible and effective occupational health
system and services that ensure …..compensation for workers and their beneficiaries
• Mission:• Enhancement of the health system to prevent
occupational diseases and provide services
• Combines the Compensation Commissioner and Medical Bureau (Occupational Diseases in Mines & Works Act (1973)
• Vision:• An accessible and effective occupational health
system and services that ensure …..compensation for workers and their beneficiaries
• Mission:• Enhancement of the health system to prevent
occupational diseases and provide services
Policy InitiativesPolicy Initiatives• Amendments to the Occupational Diseases in
Mines & Works Act (1973)• Expanding the coverage of controlled mines &
works• Provision of decentralised services for workers &
ex-workers• Explore models for service delivery (within &
outside South Africa)• Alignment of compensation (Department of
Labour & Treasury)
• Amendments to the Occupational Diseases in Mines & Works Act (1973)
• Expanding the coverage of controlled mines & works
• Provision of decentralised services for workers & ex-workers
• Explore models for service delivery (within & outside South Africa)
• Alignment of compensation (Department of Labour & Treasury)
Past PerformancePast Performance• Poor performance (annual reports; compliance;
management)• Administration covered by Department of Health (R34.4m)
– 1.4% of Fund
• Compensation Fund (R2.6b)• Mines account, Works account, State account &
Research account• R336m revenue & R149m expenditure• Compensation for occupational diseases (workers & ex-
workers in controlled mines & works) (R140m)• Pensions (R2.9m) (188 pensioners)• Eastern Cape project (R34m to ~14 000 claimants)• Actuarial valuation problems
• Poor performance (annual reports; compliance; management)
• Administration covered by Department of Health (R34.4m) – 1.4% of Fund
• Compensation Fund (R2.6b)• Mines account, Works account, State account &
Research account• R336m revenue & R149m expenditure• Compensation for occupational diseases (workers & ex-
workers in controlled mines & works) (R140m)• Pensions (R2.9m) (188 pensioners)• Eastern Cape project (R34m to ~14 000 claimants)• Actuarial valuation problems
Past PerformancePast Performance
• Medical Bureau for Occupational Diseases• No annual reports since 2000• Medical examinations of workers and ex-workers• 186 service providers• Review and certification• Training and outreach (provincial hospitals)• Risk Committee non-functional since 1998 (controlled
mines & works)
• Medical Bureau for Occupational Diseases• No annual reports since 2000• Medical examinations of workers and ex-workers• 186 service providers• Review and certification• Training and outreach (provincial hospitals)• Risk Committee non-functional since 1998 (controlled
mines & works)
GoalsGoals
• Make policy and legislative changes
• Improve governance
• Optimise management
• Enhance service delivery
• Ensure sustainability of the Compensation Fund
• Conduct research
• Make policy and legislative changes
• Improve governance
• Optimise management
• Enhance service delivery
• Ensure sustainability of the Compensation Fund
• Conduct research
Strategic ObjectivesStrategic Objectives• Policy & legislative changes• Implement the strategic plan• Improve corporate governance (various committees)• Reorganise claims administration• Consolidate outreach activities• Ensure financial sustainability• Develop a surveillance system• Conduct appropriate research• Assess the human resource, technical and infrastructural
needs
• Policy & legislative changes• Implement the strategic plan• Improve corporate governance (various committees)• Reorganise claims administration• Consolidate outreach activities• Ensure financial sustainability• Develop a surveillance system• Conduct appropriate research• Assess the human resource, technical and infrastructural
needs
GovernanceGovernance• Advisory and Audit & Risk Committees (CCOD)• Certification, Review and Joint Committees
(MBOD)• Risk Committee (MBOD)• Internal
• Health & Safety• Equity & Skills• Internal Audit
• Service providers
• Advisory and Audit & Risk Committees (CCOD)• Certification, Review and Joint Committees
(MBOD)• Risk Committee (MBOD)• Internal
• Health & Safety• Equity & Skills• Internal Audit
• Service providers
Claims Administration & Service DeliveryClaims Administration & Service Delivery
• Registry• Quantify files• Merge CCOD and MBOD files• Verify data• Sort files (year, claim type etc)
• Inspections of mines and works (database of 249 controlled mines & works)
• Link IT systems (Registry, Mineworkers System & Accounting System)
• Reconciliations
• Registry• Quantify files• Merge CCOD and MBOD files• Verify data• Sort files (year, claim type etc)
• Inspections of mines and works (database of 249 controlled mines & works)
• Link IT systems (Registry, Mineworkers System & Accounting System)
• Reconciliations
Outreach & AwarenessOutreach & Awareness
• Involvement in various forums (Health, Labour, Mineral Resources; Development Partners; conferences & workshops)
• Meetings with trade unions and employer groups• Through inspections• Continuing professional development of health
professionals• Links to provincial health departments and district
health• Links to parliament & its outreach activities
• Involvement in various forums (Health, Labour, Mineral Resources; Development Partners; conferences & workshops)
• Meetings with trade unions and employer groups• Through inspections• Continuing professional development of health
professionals• Links to provincial health departments and district
health• Links to parliament & its outreach activities
Sustainability of the Compensation FundSustainability of the Compensation Fund
• Ensure a functioning Risk Committee• Dusts• Vapours, gases, any other factor affecting risk
• Revenue• Assessment and collection of levies• Investments
• Inspections• Verification of data (risk shifts, contractors)• Prevention interventions
• Correct the base for actuarial valuation• Expansion of the base (controlled mines & works)
• Ensure a functioning Risk Committee• Dusts• Vapours, gases, any other factor affecting risk
• Revenue• Assessment and collection of levies• Investments
• Inspections• Verification of data (risk shifts, contractors)• Prevention interventions
• Correct the base for actuarial valuation• Expansion of the base (controlled mines & works)
Actuarial ValuationActuarial Valuation
Mines ? 500k
??? Ex-workers
• Depends on base (CCOD, MBOD, outside system – not diagnosed, do not know their rights)
• Depends on disease process (latency, more than 1 disease)
• Depends on base (CCOD, MBOD, outside system – not diagnosed, do not know their rights)
• Depends on disease process (latency, more than 1 disease)
Occupational Injuries• Abrupt break in …AGENT – HOST – ENVIRONMENT
balance• Cause established
Occupational Diseases• Not diagnosed / mis diagnosed• Lack of knowledge• Masked by other diseases• Long lag time• Need special investigations• Difficult to find cause
Surveillance
• “data for action” (Giesecke, 1999)• “ongoing, systematic collection, analysis & interpretation of data for planning, implementation & evaluation” (CDC, 1988)
Surveillance Data• MHSC / DMR / CoM• DoL, DoH• Pathaut• Special surveys
– TB incidence– Dust surveys
Wilson K. NIOH. 2011
FatalitiesTarget: 20% reduction in the incidence of compensated work-relatedfatalities 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 aslong as this improvement is maintained the 2012 target is achievable.
Aspirational targetTarget: Australia to have the lowest work-related traumatic injury fatalityrate in the world by 2009.Result: While Australia has one of the fastest falling fatality rates amongthe best performing countries world wide, it has remained in 7th place.
Safe Work, Australia.
2010
ResearchResearch
• Risks in mines and works
• Scientific approach to valuation• Quantification of numbers of workers /
ex-workers at risk + modelling studies
• Operational research (models for
delivery)
• Risks in mines and works
• Scientific approach to valuation• Quantification of numbers of workers /
ex-workers at risk + modelling studies
• Operational research (models for
delivery)
Human Resource, Technical & Infrastructural Needs
Human Resource, Technical & Infrastructural Needs
• Based on Strategic Plan
• Need for legal, accounting, economic, actuarial, health & social sciences, logistics
• Technical – Information Systems & Technology; digital X-rays, GeneXpert, lung function; financial models
• Infrastructural – buildings, vehicles & equipment, decentralised services
• Training & capacity building
• Based on Strategic Plan
• Need for legal, accounting, economic, actuarial, health & social sciences, logistics
• Technical – Information Systems & Technology; digital X-rays, GeneXpert, lung function; financial models
• Infrastructural – buildings, vehicles & equipment, decentralised services
• Training & capacity building
Annual Performance Plan (2014/15)Annual Performance Plan (2014/15)• Policy & legislative changes• Implementation of strategic plan
– Governance & management
• Service delivery– Re-organisation of claims administration– Outreach activities– Human resource, technical & infrastructural needs
• Sustainability of the Compensation Fund– Levies– Inspections
• Surveillance system• Appropriate research
• Policy & legislative changes• Implementation of strategic plan
– Governance & management
• Service delivery– Re-organisation of claims administration– Outreach activities– Human resource, technical & infrastructural needs
• Sustainability of the Compensation Fund– Levies– Inspections
• Surveillance system• Appropriate research
Occupational Health Services: Core Functions
• Preventive– Risk identification, assessment & management– Recognise high risk groups & priorities
• Health Promotion– Optimal physical & mental health– Healthy lifestyles
• Curative services– General practice level– Referral to specialists– First aid
• Rehabilitation & Compensation
Conceptual Model – Delivery of Services
PHC Nurse / CHW
Family Medicine / Nurses / Occ Hyg
Occ Med Spec / Nurses / Occ Hygiene / Rehabilitation
Academic / Reference Units
OH Service Model
REFERRAL
SUPPORT
One Stop Facilities
• Occupational Health Cluster (National Department of Health)
• The Compensation Fund (Trading Entity in Department of Health)
• Occupational Health Cluster (National Department of Health)
• The Compensation Fund (Trading Entity in Department of Health)
BudgetBudget
Occupational Health (Budget)Occupational Health (Budget)
R ‘000 12/13 13/14 14/15 15/16
Employees compensation
23 294 23 790 23 501 24 676
Goods & services
14 584 23 559 26 807 27 459
Transfer payments
2 916 3 062 3 215 3 215
Capital 2 277 2 389 2 389 2 389
TOTAL 43 071 52 800 55 912 57 739
Staff Establishment (July 2014)Staff Establishment (July 2014)
No of Posts
Management Filled VacantProfessional
& Support Staff
Filled Vacant
Administration 44 4 3 1 40 33 7
Claims Processing
57 2 2 - 55 47 8
Clinical Services
20 2 - 2 18 9 9
Revenue & Inspections
17 4 2 2 13 6 7
Governance 2 1 1 - 1 - 1
TOTAL 140 14 9 5 127 95 32
The Compensation FundThe Compensation Fund
R ‘000 12/13 13/14 14/15 15/16
Revenue 402 369 436 830 502 004 552 167
Expenditure 153 414 221 103 255 116 260 111
Investments 2 221 338 2 469 866 2 593 359 2 723 027
Fund Value 2 444 319 2 549 477 2 680 359 2 823 027