oa South African Health Review - Disabling health : the challenge of incapacity leave and sickness absence management in the public health sector in KwaZulu-Natal Province

Volume 2016, Issue 1
  • ISSN : 1025-1715



Sickness absence and long-term incapacity leave contribute substantially to the national service delivery challenges that are particularly evident in the public health sector. The Auditor-General's reports, and the Department of Public Service and Administration, have highlighted these challenges.

Recognising this as an area requiring intervention, the Department of Public Service Administration developed the 'Policy and Procedure on Incapacity leave and Ill-health Retirement' and outsourced the management of sickness absence to private agencies. Management of ill-health among health-care workers is not addressed at the workplace; this has resulted in poor decision-making about fitness to work, and to work incapacity contributing to levels of absenteeism that exceed international benchmarks for the healthcare sector.
This chapter reviews and critiques current approaches in the management of ill-health among healthcare workers and assessment of their ability to work. A review was done of the literature on current benchmarks and approaches to managing sickness absence; secondary data from national and provincial Department of Health reports were also reviewed. A description is given of a small sample of short-term sickness-absence cases (n=151) at a hospital in KwaZulu-Natal. Two of the cases are highlighted.
Healthcare workers experience a significant burden of disease caused by a range of workplace hazards. This, together with inadequate institutional management of sickness absence, results in a high number of lost work-days. In 2004-2006 and 2007-2009, the national cost of sickness absence was R7.3m and R8.8m respectively, while the provincial costs were R208m and R303m respectively. In 2014, sickness absence resulted in an average of seven days (senior management), eight days (skilled supervisors) and eight days (lower categories), among all those workers taking sick leave.
The authors propose an approach that ensures institutional responsibility for sickness absence, involvement of the Employee Health Service in the case of five days of absence, and involvement of the Occupational Medical Practitioner in cases of repeated short-term absence and assessment of fitness to work.

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