Perspectives on developing a Return-to-Work framework for occupationally injured and

diseased workers in South Africa

Presented at a German-South African workshop on Employment Policies, organised by the Department of Labour (South Africa), with German and South African experts: 19

April 2011

Professor Marius Olivier, Director: ISLP

1. Background2. Current South African framework3. Key dimensions of introducing a Return-to-Work

(RTW) framework4. Putting the building blocks in place – some

perspectives on implementation5. Some conclusions

Contents

Compensation Fund project – rationale, timeframes, process

Comparative approach adopted – ◦ Other systems, where RTW policies have been

introduced◦ Also in the developing world ◦ International & regional standards

SA context-sensitive framework required

Background

Development of –◦ Research report◦ Policy document, which also reflects on

Implementation, Piloting & roll-out; Legislative and policy changes Integrated involvement of stakeholders and

government departments Institutional framework

Background (cont)

Some examples of institutional models◦ Some insurance company interventions

(rehabilitation focus)◦ A few large companies/enterprises (e.g. mining)

programmes Employee wellness programmes Employee assistance programmes Job functionality approach

◦ Some public service initiatives E.g., Department of Defence

◦ A few rehabilitation centres No national or industry-wide programmes

Current South African framework

Insufficient disability/injury management training opportunities◦ Discipline-specific training for involved

professionals generally available Absence of audit tool(s) to monitor

enterprise readiness and/or progress Deficient institutional support framework,

e.g.◦ Employment services◦ Skills (re)training

Current South African framework (cont)

Insufficient and to some extent conflicting policy framework◦ Importance of INDS (Integrated National Disability

Strategy)◦ Some mention in departmental policies◦ No integrated perspectives (e.g., DSD

(Department of Social Development) policy foresees DSD leading role in areas of disability)

Current South African framework (cont)

Limited enabling legislative framework◦ Workers compensation law (COIDA)

Some mention of schemes aimed at rehabilitation◦ Employment equity legislation

On basis of affirmative action measures, certain obligations on larger employers to make special arrangements for persons with disabilities

◦ Labour law provisions insufficient

Current South African framework (cont)

Importance of overarching international and regional standards, e.g.◦ ILO Conventions and UN Disability Convention◦ SADC (Southern Africa Development Community)

Social Charter and Code on Social Security Supportive constitutional basis Employer and workplace focus

◦ General employer obligations (e.g. suitable employment; employment protection)

◦ Distinction between larger and smaller employers (e.g. regarding disability management)

Key dimensions of introducing a Return-to-Work (RTW) framework

Disability and case management approaches imperative

Role of the Compensation Fund◦ Policy framework and creation of institutional

framework◦ Smaller employees – Disability management (DM)

services (Larger employers – DM responsibility)◦ Employee services support framework, also for

employees of larger employers who are not accommodated

◦ Pilot

Key dimensions of introducing a Return-to-Work (RTW) framework (cont)

Role of the Compensation Fund◦ Accreditation (with Department of Health

involvement?)◦ Arranging DM/RTWC (Return-to-Work coordinator)

training and audit tool◦ RTW Code of Practice◦ Stakeholder communication and consultation◦ Public awareness◦ Supervision◦ Monitoring and evaluation◦ Dispute resolution

Key dimensions of introducing a Return-to-Work (RTW) framework (cont)

Central role of DM/RTWC Dedicated stakeholder involvement,

including health and occupational professionals◦ Multi- and inter-disciplinary cooperation

Inter-government cooperation Focus not merely on rehabilitation, but also

on labour market and social integration and on restoring employee functionality/wellness

Key dimensions of introducing a Return-to-Work (RTW) framework (cont)

The need for appropriate (system) incentives

Relate RTW to –◦ Occupational Health and Safety (OHS)◦ Compensatory framework

Key dimensions of introducing a Return-to-Work (RTW) framework (cont)

Policy adjustment◦ Streamlining existing government policies◦ New dedicated/targeted policy framework◦ Addressing inconsistencies, e.g. -

DSD policy Application in mining lung disease context?

Putting the building blocks in place – some perspectives on implementation

Legislative changes – dedicated provisions required, providing among others for:◦ Broadly describing roles, functions and

responsibilities of role-players◦ Incentives – e.g. links with compensation◦ Employment (including dismissal) protection◦ Links with employment services◦ Addressing deficiencies in Employment Services

Bill (e.g., perspectives on treatment of persons with disabilities)

Putting the building blocks in place – some perspectives on implementation (cont)

Developing an appropriate enabling institutional framework◦ Within the Compensation Fund◦ Within the Department of Labour – in particular,

rolling out employment services, job placement and multi-faceted skills (re)training services

◦ In collaboration with other government departments Dept. of Health – accreditation and functionality

standards Dept. of Social Development – social and community

integration

Putting the building blocks in place – some perspectives on implementation (cont)

Developing an appropriate enabling institutional framework (cont)◦ Links with service providers

Professional bodies Rehabilitation centres Product providers (e.g. assistive devices)

◦ Sufficient funding Appropriate pilot required Training provision/arrangements: building

capacity and professionalisation of RTW interventions

Putting the building blocks in place – some perspectives on implementation (cont)

Audit tool(s) Gradual implementation Communication and consultation

◦ Employer bodies◦ Trade union federations◦ Disability movement◦ Professional bodies◦ Government departments

Public awareness Dispute resolution structure

Putting the building blocks in place – some perspectives on implementation (cont)

Adopting an appropriate for determining functionality (e.g.: IDF; UDSMR; FCEs; Job-function matching; others)

Political endorsement and Nedlac approval Accreditation Appropriate M&E (Monitoring & Evaluation)

framework◦ What needs to be monitored◦ Who needs to be monitored at particular levels

Political oversight

Putting the building blocks in place – some perspectives on implementation (cont)

A dedicated RTW framework needed Rich comparative context and models Important guiding standards available Significant changes required

◦ At governmental, enterprise and professional service delivery levels required

◦ In several areas, including institutional, policy and legislative areas

Extended framework possible◦ Unemployment insurance◦ New National Social Security Fund

Some conclusions

Critical engagement within government imperative – e.g.:◦ Employment services◦ Skills training location

The value of international collaboration

Some conclusions (cont)