Regional Dialogue: Portability of Social Security Benefits Occupational Health and Workers’ Compensation (ODMWA) Regional Dialogue: Portability of Social Security Benefits Barry Kistnasamy Compensation Commissioner 26 March 2015 Slide 1

Overview Context Some macro issues Compensation & Services Way forward Slide 2

Context Multiple policy and legal frameworks covering compensation & other social protection benefits Migrant / Contract labour / within and cross-border Fragmented or non-existent services for workers / ex-workers Inability of claimants to access benefits Slide 3

Miners’ Phthisis Act 19 of 1912 103 year old History… Miners’ Phthisis Act 19 of 1912 McCulloch J. 2013 Slide 4

Workers’ Compensation Occupational Diseases in Mines & Works Act , 1973 Compensation for Occupational Injuries and Diseases Act, 1993 Administration Department of Health - R2.9b Department of Labour; Rand Mutual (RMA) & Federated Employers (FEMA) R40b Coverage Mine workers for heart& lung diseases only All workers in formal economy for injuries and diseases except mine workers under ODMWA Funding Levies on employers (risk-rated through Risk committee) – 246 mines & works; levies cover benefits only Levies on employers (risk-rated on claims record) – 400 000 employers; levies cover benefits, services & administration Organisation Office in Johannesburg (Braamfontein) – CCOD, MBOD & NIOH (service delivery) Offices in Pretoria with some decentralisation through Department of Labour regional offices; Rand Mutual and Federated Employees with some decentralised offices

Mr Thembekile Mankayi versus AngloGold Ashanti Contestation Cape PLC Asbestos settlement Silicosis claims settlement 2013 2003 Mr Thembekile Mankayi versus AngloGold Ashanti Chamber of Mines versus Compensation Commissioner & Dept of Health 2011 2012

The Mining Economy 20 Trillion Rand sector (net asset value) 7.7% of annual GDP DMR 2010 Slide 7

DMR Database of Mines & Quarries (2010) Province Coal Diamond Gold Platinum Other Total Eastern Cape 140 140 (8) Free State 2 6 40 61 (9) Gauteng 3 25 129 167 (5) Kwazulu-Natal 12 1 120 133 (7) Limpopo 134 156 (6) Mpumalanga 85 14 89 194 (4) North West 199 97 327 (1) Northern Cape 152 76 228 (2) Western Cape 20 177 197 (3) 108 395 53 45 1 002 1 603 246 controlled mines & works

Migrant Mine Workers Year RSA Mozambique Lesotho Swaziland % Non-RSA 1920 74 452 77 921 10 439 3 449 57 1940 178 708 74 883 52 044 7 152 49 1960 141 406 101 733 48 824 6 623 62 1980 233 055 39 636 96 308 5 050 44 1995 122 562 55 140 87 935 15 304 58 2000 99 575 57 034 58 224 9 360 2010* 152 486 35 782 35 179 5 009 34 * Data from TEBA

Ex-Mine Workers by Country (1984 – 2013)* Gold Platinum Coal Contractors Unknown Total % South Africa 507 256 115805 37358 231288 31181 922888 74 Lesotho 111281 7933 1519 16204 6358 143295 11 Mozambique 75324 8465 1402 13722 5619 104532 8 Malawi 24392 4076 116 33 237 28854 2 Botswana 20822 3241 1 572 307 24943 Swaziland 20406 1572 146 1657 647 24428 Other 173 30 31 323 36 593 759654 141122 40573 263799 44385 1249533 *TEBA data Slide 10

Ex-Mine Workers by Province (1984 -2013)* Total % Eastern Cape 281553 31 North West 168171 18 Gauteng 160530 17 Free State 112077 12 KwaZulu-Natal 92092 10 Limpopo 75527 8 Mpumalanga 27264 3 Northern Cape 4987 1 Western Cape 687 922888 *TEBA data Slide 11

Claimant Journey Slide 12

Certifications by Commodity

Claims by Province

Claims by Country

Country of Claimant Slide 16 COUNTRY No. % N/A 84436 41% SOUTH AFRICA 78492 38% LESOTHO 29567 14% MOZAMBIQUE 8416 4% BOTSWANA 3316 2% SWAZILAND 2966 1% MALAWI 549   TANZANIA 72 BRITAIN 71 SCOTLAND 65 ZIMBABWE 53 ITALY 38 POLAND 19 ENGLAND 15 AUSTRIA 12 BELGIUM 8 GERMANY 4 ZAMBIA 1 Total 208100 Slide 16

Compensable Diseases DISEASE No. % TB 115825 56% Silicosis 35788 17% N/A 27103 13% Asbestos 13966 7% Pneumoconiosis 7591 4% Obstructive Airways Disease 6110 3% Coal Workers Pneumoconiosis 673   Allergy Complex Salts Platinum 292 Carcinoma 291 TUBERCULOSIS + SILICOSIS + OAD 234 Progressive Systemic Sclerosis 151 Mixed Dust Diseases 75 Total 208099 Slide 17

Gender of Claimants GENDER No. % FEMALE 5173 2% MALE 168929 81% N/A 33998 16% NOT PRESENT 1   Total 208102 Slide 18

CERTIFICATE OF COMPENSATION No. % NOT PRESENT 20993 11% PRESENT 2   PRESENT - ID CORRECT 52915 27% PRESENT - ID DIFFERENT 715 0.36% PRESENT - ID NOT CONFIRMED 123440 62% Total 198065 Slide 19

Payment Status PAYMENT STATUS No. % NOT PAID 103465 50% PAID 104633 Total 208098   PROOF OF PAYMENT No. % NOT PRESENT 104094 50% PRESENT 104004 Total 208098   Slide 20

Record of Service / Fingerprints No. % NO 149736 72% YES 58362 28% Total 208098   TEBA FINGERPRINTS No. % NO 150934 73% YES 57164 27% Total 208098   Slide 21

Going Forward

Social Protection Reforms Policy & legislative changes - alignment of compensation and other benefits towards an enhanced social protection system Reorganisation of Compensation System One Stop Service Delivery

Reform of MBOD/CCOD Reform legislation Preparation for valuation / audit Organogram / Recruit staff Decentralise services Quantify the numbers of workers Sustainability of the Fund Work with stakeholders MBOD- 700k files CCOD 200k Mines ? 500k ??? Ex-workers

Interventions Database Mapping Surveillance Current workers Ex-workers Current & ex-workers Mines; ther sectors over time Services Surveillance TB Silicosis

Infrastructure Slide 26

Mapping Slide 27

One – Stop Service Framework Health Services Medical examinations Rehabilitation assessment & services Post mortems Health Promotion Social Services Social Development Counselling Bursaries Financial Services Compensation UIF, pension, provident and other funds (tracking & tracing)

Occupational Diseases Not diagnosed / mis diagnosed Lack of knowledge Masked by other diseases Long lag time Need special investigations Difficult to find cause Slide 29

One Stop Service Sites Eastern Cape - Mthatha (NMAH)* Gauteng - Carletonville (Hospital)* Northern Cape – Kuruman (2015/16) Limpopo – Burgersfort (2015/16) Others to follow including Mobile units Neighbouring countries (2015/16) * Opened April 2014

One Stop Facilities

Working Together Leadership of Minister of Health & Deputy Minister of Mineral Resources; SADC / Ministers of Health/Labour Distressed mining communities (Presidency) Development partners & NGOs Chamber of Mines, Trade Unions & Ex-mineworker associations Developmental agenda Rural development / labour sending areas Build on government processes Slide 32

Thank You Ms Doreen Leseyane Manager: Claims (MBOD/CCOD) leseyd@health.gov.za +27 (0)11-356 5600 Dr Barry Kistnasamy Compensation Commissioner Department of Health, South Africa kistnb@health.gov.za barry@fnbconnect.co.za +27(0)11-356 5602 / +27(0)828067210 Slide 33