The Department of Labour is serious about not only making the Compensation Fund more responsive to stakeholder needs, but also to respond positively to the needs of injured workers. This is what (DoL) Director-General (DG) Nkosinathi Nhleko told the Summit of the South African Society of Occupational Medicine (SASOM), a professional body of medical practitioners in Durban at the weekend.
Already the department has committed to dealing decisively with the backlog. For example, in the month of January and February 2013 the Fund had paid service providers an unprecedented R353 912 million in claims against a total value of more than R483 million lodged claims.
Nhleko said the ‘battery’ of direct interventions currently underway would also include employing best practices from other organisations that have undergone the same processes like the Road Accident Fund and the Unemployment Insurance Fund. One of these interventions includes engaging services of turnaround and forensic audit specialists. The potential service providers were briefed this week on the specifications of the work and the expectation is that this process would be well underway in April.
The DG said a stakeholder input was critical to address the claims backlog and other efficiency challenges, promising to consider their input into improving CF’s processes. While the service providers experienced a manner of frustrations in terms of payments, “our major frustration is the lack of protection of vulnerable workers as a result of our problems in settling claims on time. We have received reports, for example, that some doctors have refused to treat COID cases. We understand their frustration but equally, we have a duty for the care of injured workers,” he said.
The DG said there was now a clear recognition of the extent of the problems. “However, from our side in order to ascertain how deep the wound is, we first have to complete a forensic assessment. We can have a turnaround plan in place, but if we do not know the extent of the problem this will be a futile exercise,” he reiterated.
The Department of Labour’s interventions to address problems bedevilling the Compensation Fund comes at a time when the medical practitioners were beginning to refuse treating occupational injury patients, citing delays in payments from the Fund.
Also addressing the Summit, SASOM KwaZulu-Natal Chapter Chairman Dr Kevin Rainer said at the rate at which the CF was going the systems of the operations of Fund were not working. Rainer said the gatekeepers (medical practitioners) were now refusing to treat occupational patients. Rainer said medical practitioners had also resorted to providing medical treatment on condition that the patients pay upfront.
“We want to help normalise the operations of the Fund and help break the back of its problems,” he said.
Dr Jan Lapere, a lawyer and national member of SASOM said all was not lost as the Fund could still be made to work better. Lapere said while problems persisted it was the duty of the medical profession to ensure that the “patient comes first and worries about money come last.”
Nhleko concluded that the current short-term interventions would seek to address three broad areas of human resources, processes and systems operations. He said as the interventions unfolded, in the medium to long term attention would be paid to addressing the recent auditor general’s concerns in regard to leadership and performance management issues.
He said the Fund would also be pursuing alternative speedy processing methods and further stakeholder engagements to initiate appropriate solutions. Members of the committee were appreciative and positive that the department recognises the challenges and does not shy away from meeting and interacting with stakeholders.
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