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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