shireen pardesi, muzimkhulu zungu and sam molautsi 27 august 2014 annual performance plan of...
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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
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