A historically fragmented response to services for mineworkers and ex-mineworkers in Southern Africa has meant that the biggest challenge facing many has been compensation of ex-mineworkers for compensable diseases suffered while working in the mines. Despite the Occupational Diseases in Mines and Works Act (ODMWA) which makes it a statutory right for any person who has worked at a mine to be medically examined to determine existence of a compensable disease, many ex-mineworkers especially in rural areas had not undergone such medical examinations to enable the compensation process to take place.
As a result, in 2008, a R42 million project supported by involving the Chamber of Mines, SA Department of Health, and National Union of Mineworkers was established to improve the delivery of medical services for miners and to ensure that ex-mineworkers are given medical examinations and assistance in claiming any compensation due to them.
Following years of implementation of the project in different stages, the Enhancing Care Foundation was awarded a tender by the Chamber of Mines to assess the success of the project. On completion, a comprehensive Strategic Information Report was submitted to the Chamber of Mines.
- The following is a broad summary of the recommendations outlined in the report:
- The claim and assessment process for all Benefit Medical Examinations (BME) including submissions should be electronic and accessible to those assisting claimants with queries.
- The existing and recommended Compensation Information System should be improved on an ongoing basis, preferably by an outsourced service provider independent of the Department of Health (DOH).
- The DOH needs to play a stronger and more focused role in maintaining and managing the BME sites if integration and sustainability are to be realised.
- BME services need to be overhauled to ensure standards of practice (or standard operating procedures) are developed and applied across the board. Private stakeholders can be brought on board through a private public partnership (PPP) arrangement, to privatise certain elements of the BME processes such as service demand creation, increasing claimants’ accessibility to site and maintenance of service infrastructure.
- Occupational health should be recognised by the DOH as a specialised field to ensure staff working at the sites are incentivised to stay in the public sector and trained or up skilled to obtained the required skill set for the project. External human resources company should also be engaged to intervene in labour issues.
- The compensation process needs a robust monitoring and evaluation system based on a result-based management system.
- The various sites need to be strengthened by introducing or enforcing tangible measures by which to procure and support resources. Site staff also have a role to play in “marketing” their services to the leadership of the hosting hospitals so that they are aware of their relevance to the health system in South Africa as well as the challenges they are facing in order to solicit support.
- There is also a need to deracinate corruption within different structures of the compensation machinery as this curtails efficient and rational service delivery to the people in need.
- The recommendations assume that the project will continue to exist, at least within the broader DOH administration and independent of other parallel projects. There are also other alternative models that can be adapted include the following suggestions:
- Potential for the current project to be integrated within other existing projects such as the TB in the Mining Sector in the Southern African Region (TIMS) project which has a compensation module which integrates a robust compensation information system.
- The Ex-mineworker project can also adapted to the Rand Mutual’s IT-based compensation platform to expedite some of its operations.
- Non-governmental organisations and other stakeholders dealing with finding and transporting ex-mineworkers to BME sites can be re-engaged, or new ones identified, to improve on the number of claimants being attended to at the sites.
- Planned, well organised and sufficiently resourced outreach activities using mobile units can be used to reach people or redefined by way of provincial occupational health units.
Finally, although it remains the responsibility of the SA’s DOH to take care of ex-mineworkers’ health needs once there are outside the employ of the mines, it may be worthwhile to start a debate with mining corporations in South Africa to start carrying out BMEs for their former mineworkers. This could be done within the framework of corporate social responsibility and may also be a more efficient method of carrying out BMEs.