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Annual Performance Plan of MBOD/CCOD Presentation

This presentation provides an overview of the history, diagnostics of problems, strategic plan, annual performance plan, and the way forward for the MBOD/CCOD. It addresses issues of governance, claims management, service delivery, infrastructure, and sustainability.

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Annual Performance Plan of MBOD/CCOD Presentation

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  1. Annual Performance Plan of MBOD/CCOD Presentation to Portfolio Committee on Health Shireen Pardesi, Muzimkhulu Zungu and Sam Molautsi 27 August 2014

  2. Overview • History • Diagnostics of problems • Strategic Plan • Annual Performance Plan • Way forward • Conclusion

  3. 102 year old History… Miners’ Phthisis Act 19 of 1912

  4. 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 ….

  5. Interventions • 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

  6. 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

  7. Policy 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)

  8. Past 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

  9. Past 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)

  10. Goals • Make policy and legislative changes • Improve governance • Optimise management • Enhance service delivery • Ensure sustainability of the Compensation Fund • Conduct research

  11. Strategic 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

  12. Governance • Advisory and Audit & Risk Committees (CCOD) • Certification, Review and Joint Committees (MBOD) • Risk Committee (MBOD) • Internal • Health & Safety • Equity & Skills • Internal Audit • Service providers

  13. Claims 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

  14. Outreach & 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

  15. Sustainability 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)

  16. Actuarial Valuation • Depends on base (CCOD, MBOD, outside system – not diagnosed, do not know their rights) • Depends on disease process (latency, more than 1 disease) ??? Ex-workers Mines ? 500k

  17. Occupational Injuries • Abrupt break in … AGENT – HOST – ENVIRONMENT balance • Cause established

  18. Occupational Diseases • Not diagnosed / mis diagnosed • Lack of knowledge • Masked by other diseases • Long lag time • Need special investigations • Difficult to find cause

  19. Surveillance “data for action” (Giesecke, 1999) “ongoing, systematic collection, analysis & interpretation of data for planning, implementation & evaluation” (CDC, 1988)

  20. Surveillance Data • MHSC / DMR / CoM • DoL, DoH • Pathaut • Special surveys • TB incidence • Dust surveys

  21. Wilson K. NIOH. 2011

  22. 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

  23. Research • 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)

  24. 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

  25. 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

  26. 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

  27. Conceptual Model – Delivery of Services

  28. OH Service Model PHC Nurse / CHW SUPPORT REFERRAL Family Medicine / Nurses / OccHyg Occ Med Spec / Nurses / Occ Hygiene / Rehabilitation Academic / Reference Units

  29. One Stop Facilities

  30. Budget • Occupational Health Cluster (National Department of Health) • The Compensation Fund (Trading Entity in Department of Health)

  31. Occupational Health (Budget)

  32. Staff Establishment (July 2014)

  33. The Compensation Fund

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