Incapacity leave and ill-health retirement: briefing by Departments of Public Service and Administration, Health, Correctional Services

Meeting report

Minutes:

Public Service Commission presentation

Mr Khumbula Ndaba, Deputy Director General, Department of Public Service and Administration (DPSA), said the public service Policy and Procedure on Incapacity Leave and Ill-Health Retirement (PILIR) had been developed by the DPSA to deal with challenges that had been raised by the Public Service Commission (PSC). It had been implemented in a phased approach with effect from June 2006. The objectives of PILIR were to set up structures and processes which would ensure intervention and management of incapacity leave in the workplace to accommodate temporary or permanently incapacitated employees, and the rehabilitation, re-skilling, realignment and retirement, where applicable, of temporary and permanently incapacitated employees would be facilitated where appropriate.

In the management of incapacity leave and ill health retirement, the DPSA had developed and maintained PILIR, and was centrally responsible for the appointment of a panel of accredited health risk managers to provide advice on the application and interpretation of PILIR. The Government Employees Pension Fund (GEPF) was responsible for dealing with the processing of employee-approved applications for ill health retirements.

The Health Risk Manager was an entity of independent multi-disciplinary medical experts specializing in occupational medicine, appointed by the DPSA to a panel of accredited Health Risk Managers and individually contracted by the employer to assess and provide advice to the employer in respect of an employee’s application for incapacity leave and ill health retirement within specified time frames. The systems and administrative capacity for handling the volume of forms, as well as medical knowledge and experience to do incapacity leave and ill health retirement assessments, were the responsibility of the Health Risk Manager. The employer was responsible for processing applications and completing reports within the specified time frames and where applicable, the employer would engage the DPSA, the GEPF and the Health Risk Manager. The employer would submit applications for either incapacity leave or ill health retirement, medical certificates and reports, as determined in terms of PILIR and in accordance with leave determination.

During the 2009/10 financial year, the PSC had conducted a study to evaluate the impact of PILIR on sick leave treads in the public service. The objectives of the study were to

• Assess sick leave trends, and the reasons for them, in the national departments of Labour, Health, Basic and Higher Education, as well as the provincial departments of Health and Education in all nine provinces;
• Do a comparative analysis per financial year, reflecting trends prior to the implementation of PILIR in order to assess whether there had been any change in sick leave trends or not;
• Identify factors that were critical to the effective implementation of PILIR;
• Identify barriers impacting on the implementation of PILIR in the public service; and
• Generate recommendations to improve the implementation of PILIR and sick leave management in the Public Service.

The findings of the evaluation had been:

• 60% of all respondents from the sampled departments indicated an understanding of PILIR and the different functions of the key role players;
• Leave policies were in place in almost all the sampled departments, and there was 100% utilization of the services of Health Risk Managers;
• In the national departments, there was an average 3.8% reduction in the number of sick leave days taken after the implementation of PILIR. This was in line with the 3% at the provincial level, where a decrease had been observed in only 66% of the departments of Health and Education;
• Despite the average 3% reduction in sick leave days taken post implementation of PILIR, the total cost of sick leave taken in three sampled national departments had increased by 26% post implementation of PILIR;
• Employees from both national and provincial departments were usually absent on sick leave on Mondays, and this had not changed post implementation of PILIR.

The PSC had recommended that managers in all departments must monitor sick leave closely and this information should form part of an employee’s performance agreement. All stakeholders must strive to meet the 30-day timeframe for processing applications for temporary leave incapacity, as well as communicating the outcome to the employee. The DPSA should review long term incapacity, permanent incapacity leave and ill health retirement leave, taking into consideration the challenges experienced by employees when requesting completion of such forms by medical practitioners.

National Department of Health briefing

Ms Valery Rennie, Head of Corporate Services, National Department of Health, said the initial Health Risk Manger contract had expired on 31 December 2012. Subsequently, 21 PILIR applications had been received for the period 1 January 2013 to October 2013 which had been recorded in a register. A communiqué had been received from the DPSA dated 19 September 2014, in which the appointment of Metropolitan Health Risk Management (MHRM) was confirmed. In December 2014, all 21 stockpiled applications had been packaged and submitted to MHRM, which was given until 31 March 2016 to finalise stockpiled cases. To date, no feedback on the stockpiled applications had been received. On 1 November 2013, the Soma Initiative was appointed as the Health Risk Manager to process all PILIR applications. Between 1 November 2013 and 5 March 2014, 11 PILIR applications were sent to the Health Risk Manager -- 85 for short-term incapacity leave, 21 for long-term incapacity leave, and five for ill health. 45 applications were still being processed.

Department of Correctional Services

Mr Teboho Mokoena, Chief Deputy Commissioner: Human Resources, Department of Correctional Services (DCS) said that the Department had resumed the implementation of PILIR in July 2003 and had enforced it to date. However, this process had been halted from January 2013 to 31 October 2013 due to a court interdict that prevented the appointment of a Health Risk Manager by any of the National and Provincial Departments. The halting of the process created the stockpile of cases which could not be handled and as a result, the decision to approve or decline cases could not be taken. Currently, there was a stockpile of 343 cases for long-term incapacity leave, a 1 378 stockpile for short-term incapacity leave applications and 32 ill health retirement applications -- with none of them approved yet.

The DPSA had appointed MRHM as the health risk manager for processing all stockpile cases for all national and provincial departments. The DCS was in the process of signing a service level agreement with MHRM. The DCS had appointed Alexander Forbes Health Risk Manager from 1 November 2013 to December 2018, to assess and provide recommendations on all cases of temporary incapacity leave and ill health retirement.

The coastal regions were the highest for reporting incapacity leave, More males applied for incapacity leave than females, and incapacity leave ages ranged from 40 to 49. The most common conditions reported were psychiatric conditions, followed by respiratory disorders and musculoskeletal systems and disorders. The nature of the work environment could be a contributory factor that led to the highest number of officials reporting sick due to psychiatric disorders.

Discussion

The Chairperson said the DPSA was moving towards a professionalised public service, as required by the National Development Plan (NDP). As public service practitioners, the DPSA had to be compliant with the vision of the ruling party. Since the piloting had ended, implementation had been very slow. A document that was more than six years old could not be used as reference. Furthermore, the methodology was quantitative, and the numbers had changed. The DPSA had to conduct further research. The Chairperson asked the Director General to explain the legal challenges.

Mr Ndaba replied that a Health Risk Manager was contracted for a period, and when the period expired, it had to be contracted again. During the contracting period, the DPSA invited service providers to present themselves. One of the service providers invited had not been contracted for lacking certain requirements for the contract. When the outcome of the bid process was made known, the service provider that had lost had taken the DPSA to court, saying the DPSA had erred in not considering them as a service provider, and had asked for an interdict in the Gauteng High Court. The essence of this had been to give them a second chance to come and present their case. In considering their application again and making a determination, time was lost and implementation was stopped.

The Chairperson said that there was no need to ask consultants to review a policy. The Departments of Health and Labour, and other government departments, could come together and review the policy.

Ms Z Dlamini-Dubazana (ANC) said she was hurt by the presentation. Being frank and honest, the Department consisted of two heads. The first one was a political head, who ran around to make sure political issues were being addressed. Then there was an administrative head, who sat in the office to ensure that all administration was up to scratch and all policies were effective and aligned. She asked the Deputy Minister, Ms Ayanda Dlodlo, why the Department had not come to her to say there was a problem. There was no need to talk about the backlog in Correctional Services because the problem was in the DPSA. One could not choose to establish and monitor a panel, and when it suited the administration of your department, shift and say it must decentralise. The objectives of the policy were to ensure intervention and management of incapacity leave in the workplace, to accommodate temporary or permanently incapacitated employees, and that rehabilitation, re-skilling, realignment and retirement, where applicable, of temporary and permanently incapacitated employees were facilitated where appropriate. If the DPSA chose to decentralize, it had to decentralize everything. How had DPSA chosen to be a star in managing 34 departments, with the Department of Monitoring and Evaluation sitting in the Presidency? There was R27 billion, R2.2 million was for ill retirement leave, and R8 million was given to incapacitation fees, whether assessed or not. How could there be a policy that was not measurable and achievable, especially playing with tax-payers money like that? The other objective was to rehabilitate and re-skill -- could a person be re-skilled at the age of 78 when he had wisdom and experience, as well as academic knowledge? This objective was not measurable and achievable. She was deeply disappointed, as the DPSA was supposed to monitor other departments, yet it was sitting with such a policy, which was a problem. The GEPF had a subsidiary called PAE. Instead of appointing human resource managers, it was advisable to utilize the GEPF. Accessibility and centralization of PILIR was a problem. The DPSA had to start the policy all over again with relationships clearly defined, devolved, and with budgets. The policy was not legislatively correct. She could not continue with other questions because she was completely devastated with this policy.

Ms R Lesoma (ANC) said the current government, through the NDP, enabled the Committee to monitor all departments. Departments should not wait for the PSC to come with reports. The DPSA could not carry other departments when it was sick itself. The DPSA was not addressing the passive resistance work ethic, where people worked like tortoises. She asked which sections of the policy needed to be addressed. The high court case had been because the DPSA had not addressed its supply chain department to achieve the goals of the Department. There was a need for the DPSA to find alternative ways to address issues while there was a court process.

Mr M Dirks (ANC) said the public service should be professionalised to ensure that the Department ran smoothly, gearing up departments for the effective implementation of service delivery. When Members went to the House, they would hear a motion stating that at the next sitting, it would debate a motion on the ANC’s failure to implement PILIR. Luthuli House had not been there when the policy was implemented. When the officials were appointed to run the Department, it was not considered whether one belonged to ANC or not, but as competent officials to run the Department. It was unacceptable when officials kept on embarrassing the ruling party. To get a two-thirds majority in the next election, it would be good to get rid of these officials, because all the other public servants would campaign for the ANC. Things could not continue like this. The heads of departments must control their departments. In fact, the officials were not members of the ANC, yet the blame lay with the ANC government. This could not be accepted.

Mr A van der Westhuizen (DA) asked the DPSA to inform the Committee with a measure of certainty that all leave was captured on the Persal system, and if not, why? The studies were old and there was a need for a new one. He asked if the management of sick leave was still a problem, as was pointed out during previous studies. Were any comparative studies done between sick leave and incapacity leave within government departments, including the provinces? Was there a culture of abusing sick leave within certain departments, rather than others? What was the annual cost for incapacity leave? The employer must consider adaptable work circumstances, where employees could be offered alternative employment within the public sector if they had a problem with a hip and could not walk around, yet still possessed the knowledge and expertise.

Mr S Motau (DA) said there was a truism in management, that employees did not do what was expected, but did what was inspected, and the pilot study done by the DPSA demonstrate that. When employees failed to adhere to time frames -- were there any consequences and implications? Who ensured that Health Risk Managers were paid? In the DCS, he noticed with interest that in Western Cape there were no outstanding short term and long term applications. What was it that the people in the Western Cape were doing, which other people were not doing? The coastal regions were higher in reporting incapacity leave than inland regions, but included the Western Cape. What happened at the coast and what happened inland?

Mr J McGluwa (DA) assured Mr Dirks that he was not going to put forward a motion to discuss the failure of the ANC government to implement PILIR, but would put forward a motion to discuss the R27 billion and R122 million that had been lost in the process. When this was discussed, solutions would come out, because there was a sick department where people were now overweight, not exercising. He himself was looking healthy because he had stopped consuming a lot of starch and was exercising, runs and plays soccer.

The Chairperson said this was interesting because the opposition understood wellness as having a massage and not exercising when wellness had been discussed at a strategic planning workshop.

Mr McGluwa said people in the DCS must exercise beyond standing on their feet and saluting. The DOH must assist the broader community to prevent ill health and sickness. The Minister was the one who started the cadre deployment, and he hoped people would be deployed again to this ministry. Every time, the Committee was trying to get things right in the Department, which was difficult. Last week, there had been a presentation on the high vacancy rate and the misrepresentation of qualifications, which was very negative. This week, there was another report on the R27 billion estimated on ill health and the R122 million, on incapacity. He congratulated the Department on identifying these problems, as this meant that there were endless efforts to solve these problems. He was of the opinion that the number of people involved was huge. The triangle -- of health risk manager, employee and doctor -- must be broken. Too many of these employees were going to the same doctor. He asked if the package was different for ill health and retirement, because there must be something wrong in the system. There were a lot of discrepancies with the Accident Fund, and the same situation must be happening when it came to applications for leave. On rehabilitation, were the employees sent to the gates of Correctional Services to count cars? The interesting contrast from the presenters was that employees must be rehabilitated, but later it was said there was difficulty in finding suitable jobs for them. Why should rehabilitation be considered when facing the bigger problem of not finding a job for them? It was clear that the system had been abused and the Department had gone on an offensive -- congratulations on a job well done. He asked about the punitive measures against absentees on a Monday. What was it about a Monday, and who were the doctors who were always giving sick notes on a Monday? He commended the Director General on changing the policy, but would like to know how he would do it with the capacity and skills available. The DPSA must give a report and have a microscopic zoom into departments, or to call them to account before the Committee, to assist the public service.

Ms N Nqweniso (EFF) was concerned with outsourcing. How was the DPSA training human resource officials in terms of PILIR, in order to capture lateness, including the correctness of it? Doctors who gave sick notes could be identified and the issue taken to the national level, including the Health Professions Council. Injury on duty tended to be abused too much. A person with a broken ankle at work tended to have a longer leave period than when it was broken at home. Prevention was better than cure, and opting to revive employee health and wellness would dramatically reduce the issue of psychiatry problems among employees.

Dr M Cardo (DA) asked about the extent to which sick leave was seen as an extension of annual leave and an entitlement to be booked. Were the provisions of sick leave too generous, and did they need to be revisited? The last evaluation by the PSC on sick leave days was done in 2011, and it was found that the highest amount of sick leave was taken by the Department of Labour. Was this a general trend across the public service? It had registered over 126 000 sick leave days taken, and the total cost was less than R50 million. He asked which the biggest three sick leave departments were, and how much they cost.

Mr M Ntombela (ANC) said simple logic and arithmetic told one that the Western Cape had achieved more because it had nothing to do. He asked why Gauteng and Free State were trying to opt out, when the objectives in the NDP were clear on the need to create a responsive and functioning public service.

The Chairperson said the Department would be given an opportunity to go and think deeply on the issues raised, and should provide written answers. The Health Professionals Council should be invited to the Committee and to discuss the sick certificate issue. The Gauteng and Free State health officials should be called to explain why they were opting out of state policy.

Ms Dlamini-Dubazana said it was also critical to invite the GEPF, as it was contributing to delays in paying out pension funds. The DPSA must zoom in all departments.

The meeting was adjourned.