Keynote address by the Minister of Labour on the occasion of the official opening of the Husamed orthopaedic & oncology centre held at Modderfontein, Gauteng

Master of Ceremonies

Deputy Minister of Health; Dr Joe Phaahla

Executive Chairperson of Busamed; Dr Diliza Mji

CEO of the National Empowerment Fund; Mrs Nelisiwe Mthethwa

CEO of the Public Investment Corporation; Dr Daniel Matjila

Government Officials here present

Distinguished Guests

Ladies and Gentlemen

It is indeed a privilege for me to be here to witness the official opening of what can be described as a game-changer in the Occupational Injuries and diseases world of work. In April this year I had the opportunity to take part in the official opening of the RMA Care Facility in Welkom; A state of the art facility which caters solely for the clients of the Compensation Fund. Today is yet another testimony that our occupational injuries and diseases practices rank among the best in the world.

A facility of this nature ticks all the right boxes. The Compensation for Occupational Injuries and Diseases Act was designed primarily to cater for workers who are injured on the job or who develop occupational diseases, as well as survivors' benefits and families of victims of occupational fatalities.

There has however been disturbing trends lately, where service providers have jumped the queue, and they are often the ones who stand at the front of the line. This they do, using various methods including holding the workers at ransom by refusing to treat them until such time they get their payment from the Compensation Fund. Some of the service providers even resort to Courts to force the Fund to pay their claims, even in cases where the validity of such claims are suspect and/or, are still under investigation.

What does this mean for the medical Practioners who refuse to administer treatment to an injured worker, purely because they have not been paid, against the Hippocratic Oath they took, especially the part which enjoins medical Practioners to Do no harm? Most medical facilities hang the historical Hippocratic Oath alongside their Medical Degrees in their practices. When they turn away injured workers, one begins to wonder whether the oath they took was merely for admission to medical practice, or a real conviction. Whether donning their walls with nicely framed Oaths is nothing but part of a marketing gimmick; You be the judge.

There has been a large debate on whether doctors administering or facilitating lethal injections to prisoners are breaking the Oath.

For example in 1991, Jose High was set to be executed in Georgia, United States. The execution team could not gain access to Jose High's vein due to extreme drug use from his past. The execution team brought in a doctor who had critical care training and was an expert at finding deep veins in the human body. Once the doctor was hired for the sole reason of inserting the execution drug, the doctor at that point became part of the execution team which some have argued, goes against the grain of the Do no Harm part of the Oath.

Will it be safe to say that medical establishments that refuse to treat injured workers are in direct violation of the Do no Harm conviction of the Oath? Could this also amount to a Medical Practioner and/or a Medical establishment becoming part of the Execution team as per the story of Jose? Again you be the Judge;

Master of Ceremonies; It is remarkable that to this point, doctors would not take part in placing an execution drug or administering the drugs, but only attend the execution chambers solely to pronounce the death of the inmate. It said however, that a group of doctors sued the Georgia State Medical Board for not disciplining the doctor, stating that he violated federal law and broke the Hippocratic Oath (although the Hippocratic oath is not legally binding, but perhaps more binding to one's conscience). In response, the Georgia legislature passed laws protecting doctors who take part in lethal injections from civil and criminal prosecution.

Ladies and Gentlemen; the philosophy of our Occupational Health and Safety Inspection seeks to inculcate a culture of zero workplace injuries and diseases. Therefore employers should have zero as their targets for workplace injuries and diseases as anything more, will be morally and ethically unacceptable. The other reality with occupational diseases is the length of time which may elapse before the medical condition occurs. This has been the case most notably with asbestos-related diseases such as asbestosis, lung cancer, which may take thirty to fifty years to develop after the workers were exposed to asbestos fibres.

For example the asbestos related diseases in Germany take about 38 years before it shows up on the worker. The other challenge is that in some countries, workers are paid in lump sums as compensation and this often results in workers exhausting these monies far too quickly and the worker and/or family often return to Government to seek additional assistance. On the other hand, there can also be problems where compensation is paid out in stages, if that compensation is not inflation-linked. The effect is that the living standard of the individual worker affected gradually declines and an accident or illness has left them unable to return to work.

While social insurance largely avoids this problem by providing periodic payments, many of these schemes experience the erosion of the purchasing power of pensions by inflation.

According to the recent ILO Study, only Mauritius provides automatic annual indexing of pensions for inflation.

South Africa on the other hand has consistently granted increases in line with the consumer price index over the last decade.

It is therefore important, Master of Ceremonies; that a multifaceted and a holistic approach to compensation of occupational injuries and diseases legal framework is pursued. Prevention before rehabilitation, and rehabilitation before compensation should be the logical sequence of interventions in the normal scheme of things, but we know though that in real life, mistakes, accidents, oversights, injuries can happen and workers do become ill even in the safest workplaces. Ironically these things usually occur when least expected and inadvertently cause harm to workers.

According to ILO estimates, two million men and women die from work-related diseases and accidents each year - a death toll averaging some 5,000 workers a day.

It is for these reasons that we need to keep fine-tuning the law so that it is always equal to the challenges that workers face on a daily basis. To this end we have commenced a process to amend the Compensation of Occupational Injuries and Diseases Act in order to bring it in line with the current case law and some elements of international best practice. The new amendments under consideration seek to broaden the scope of coverage to include domestic workers; introduce a patient-centred approach in the delivery of health services by aggressively reducing the time patients have to wait to receive services and medication.

The patient-centred approach is a direct response to addressing the medical establishments jumping the queue and in a process, relegating the real beneficiaries of the Fund; that is workers, to second class citizens. This cannot be correct as this is the workers own, and in most cases the only medical aid in the event of occupational injuries.

This facility, by all accounts, is an important step and a new paradigm in our quest to provide quality service to our workers. Of course this facility takes our vision a step further by ensuring that ordinary citizens are also entitled to top-notch medical care and not only the well-off who can afford private health care.

This facility Ladies and Gentlemen, is also an expression of our desire to provide accessible top of the range quality care to workers who incur injuries whilst in the line of duty. It is a living example of what is possible if we work together as social partners. BUSAMED, as one of the designated service providers for Compensation Fund, indicates a much deeper understands of our vision and mission as this government in general, and that of the Department of Labour in particular.

BUSAMED facility is indeed a beacon of hope and it resonates perfectly with the broad principles guiding the government's vision on the National Health Insurance policy construct. I am particularly pleased by the number of specialists in different disciplines across all 15 medical services that are synonymous with occupational injuries.

Congratulations to the Leadership and stuff of BUSAMED, Compensation Fund Leadership and the Leadership of the Department of Labour; You have indeed raised the bar in the provision of care for workers. It will be great to see more facilities of this nature in other provinces.

Just to let you know that the Supported Employment Enterprises, previously known as Sheltered Employment Factories, will soon be moving into the manufacturing of assistive devices, and I have no doubt that this facility will become one of its customers.

By the way I hope that BUSA in BUSAMED means, INHLALAKAHLE and not to be confused with being a Business Unity South Africa Medical Facility? I think the latter may attract a jaundiced reaction from workers, just like a COSATUMED may to business people.

I THANK YOU.

Source: Department of Labour

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