Presentation to Portfolio Committee 25 September 2002

1
Presentation to Portfolio Committee 25
September 2002

• RESPONDING TO THE THREAT OF HIV/AIDS IN THE
  PUBLIC SERVICE

2
PRESENTATION OVERVIEW

• How is HIV/AIDS likely to impact on the Public
  Service?
• How are we responding to this threat?
• What can we do to improve this response?

3
IMPACT OF HIV/AIDS ON THE PUBLIC SERVICE

• HIV/AIDS likely to result in
• Increased demand for services (particularly in
  health and welfare)
• Decreased ability to render these services
  because of impact on our employees
• HIV/AIDS likely to impact differently on various
  sectors and departments based on the risk profile
  of their workforce
• Skilled and highly skilled employees appear to
  have the highest risk of infection - this
  includes groups such as teachers, nurses social
  workers

4
IMPACT OF HIV/AIDS ON THE PUBLIC SERVICE (cont)

• But even for low risk groups the impact will
  still be serious
• All workplaces that already have high workloads
  over-extended capacity will be particularly
  vulnerable. This includes services in remote
  areas disadvantaged communities. It also
  applies to functions that rely on scarce skills
• This requires of all departments to identify
  vulnerable services and to introduce effective
  workplace programmes

5
IMPACT OF HIV/AIDS ON THE WORKPLACE
More employees who are sick
More employees who die

• Higher rates of absenteeism
• Higher no of employees who require medical
  treatment additional costs
• Additional strain workload on those who remain
• Lower productivity

• Higher turnover rates
• Higher recruitment HRD costs
• Higher pension costs
• Lower morale

6
DPSA RESPONSE

• DPSA response grounded in National HI/AIDS
  Strategic Plan (2000 - 2005). This plan requires
  of different sectors of the state society to
  play their part in countering the threat of
  HIV/AIDS in their particular sectors - a number
  of goals are of particular relevance from a
  workplace perspective
• Goal Nr 1 Promote safe healthy sexual
  behaviour
• Goal Nr 6 Improve access to voluntary counseling
  testing
• Goal Nr 15 Develop an appropriate legal
  policy environment
• Programme of Action developed in April 2001 -
  focused on putting in place the required policy
  frameworks and systems
• All of the activities guided by the mission of
  sustaining service delivery and promoting the
  health and well-being of public servants their
  families
• Key focal areas
• Policy review development
• Review of conditions of service
• Capacity building

7
POLICY DEVELOPMENT

• In Resolution 8 of 2001 employer and employee
  parties to the PSCBC expressed support for
  HIV/AIDS and STD workplace programmes aimed at -
• prevention
• counselling and support for those infected and
  affected
• education
• resources and leadership to implement HIV/AIDS
  and STD workplace programmes
• creation of a non-discriminatory environment and
• protection of confidentiality of those who
  voluntary disclose their HIV status
• PSCBC Resolution expressed support for management
  of HIV/AIDS as part of broader wellness
  management programmes
• So what have we done to translate policy
  intentions into reality?

8
POLICY DEVELOPMENT (cont)

• Thorough policy legislation review completed in
  order to -
• identify key principles upon which workplace
  programmes should be based
• analyse existing legal framework of Public
  Service to assess the extent to which this
  supports/contradicts the key principles
• Key conclusion Although legal framework doesnt
  expressly violate any of these principles, also
  doesnt provide an enabling environment
• Hence two policy options developed widely
  consulted
• Option that was favoured sets out minimum
  standards underpinning workplace policies
  programmes - recognises the fact that departments
  are at different stages of developing
  implementing their policies programmes that
  their needs differ
• These minimum standards have been included in the
  PSR communicated to all departments

9
POLICY DEVELOPMENT(cont)

• Good Practice Manual has been developed to
  complement the Regulations and serve as a guide
  for depts to develop workplace programmes - will
  be launched during Public Service AIDS Indaba to
  be held in Oct 2002
• The Regulations indicate what departments have
  to do and the Manual how
• Key elements of regulations (these are part of
  the provisions relating to the work environment
  and health/safety)
• Every dept to introduce an education, awareness
  and prevention programme focusing on HIV/Aids and
  other sexually transmitted diseases
• This programme preferably to be integrated with
  broader programmes that promote the health
  well-being of employees (e.g. EAP)
• Create mechanisms to encourage openness,
  acceptance, care and support for HIV-positive
  employees

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POLICY DEVELOPMENT (cont)

• Designate a member of the SMS to be the champion
  of this programme and hold him/her accountable by
  way of his/her performance agreement
• Allocate adequate resources to the development
  implementation of the programme and form
  partnerships
• Establish an HIV/AIDS committee for the dept,
  with representation of all stakeholders,
  including union reps
• Ensure that the programme includes an effective
  internal communication strategy
• Occupational exposure
• Depts to identify units or employees at high risk
  of contracting HIV related life threatening
  diseases and take reasonable steps to reduce risk
• Facilitate access to VCT and post-exposure
  prophylaxis for those who have been exposed to
  HIV as a result of an occupational incident (e.g.
  needle prick injuries)
• Assist employee to access compensation if he/she
  has become HIV because of occupational injury

11
POLICY DEVELOPMENT(cont)

• Non-discrimination
• Depts to ensure that none of their employment
  policies and practices discriminate against
  employees on their HIV status or perceived HIV
  status
• Take active steps to promote non-discrimination
  in the workplace
• HIV testing
• Depts to promote VCT, and wherever possible,
  promote access thereto
• Not require HIV testing unless Labour Court
  authorisation has been obtained
• Confidentiality
• All employees to treat info on an employees HIV
  status as confidential and not disclose this to
  anybody else without the employees written
  consent

12
POLICY DEVELOPMENT(cont)

• We have also developed a broader three year
  strategy that focuses on supporting departments
  as they develop and implement their own
  programmes
• Three year strategy includes the piloting of
  workplace programmes and sharing the lessons with
  other departments
• Communication campaign soon to be launched so as
  to sensitise departments and individual public
  servants on their roles and responsibilities to
  communicate the policy framework and systems
  that have been put in place
• Discussions held with OPSC on the monitoring of
  policy implementation - departments will be
  required to report on their departmental
  programmesFirst report due end of this month

13
SYSTEMS DEVELOPMENT EMPLOYEE HEALTH WELL-BEING

• It is clear that in years to come there will be a
  steady increase in the number of public servants
  affected by the pandemic
• In this context access to a reasonable level of
  health care will be critical
• Hence ways and means of broadening access to
  medical assistance being considered - State also
  to ensure that medical assistance includes
  effective disease management programmes
• Another source of concern Adequacy of pension
  benefits for public servants their families
  Most important gap in GEPF - minimal provision
  for children and orphans
• To this end proposals under consideration on
  improved benefits
• Research completed on management of ill-health in
  the Public Service
• Draft new policy on incapacity management
  developed - provides for better health risk
  management and return-to-work strategies
• Suggestion is that GEPF will play much more
  active role in assessment of incapacity through a
  Health Risk Manager

14
EMPLOYEE HEALTH WELL-BEING (cont)

• Efficiency of claims processing in Public Service
  is a major concern - indications are that delays
  occur at deptal level and not at Pensions
  Administration. In the context of HIV/AIDS
  pandemic, this situation cannot continue
• Hence proposals being considered to expedite this
  process
• Guidelines developed on integrated HR planning
  since DPSA studies have shown that this is a
  critical weakness in the Public Service - have
  been made available to departments

15
CAPACITY DEVELOPMENT, TRAINING SUPPORT

• In line with training framework adopted by PSCBC,
  SAMDI has started with roll out of training
  programmes
• Major service delivery departments targeted first
• DPSA also collaborating with SANDF, SAPS and
  Education in roll out of their workplace
  programmes
• DPSA closely involved in programmes of Dept of
  Health - in particular activities of IDC
• Collaborated with Social Development in
  developing and implementing a course for
  Government planners
• First ever HIV/AIDS Indaba held last year - is
  now an annual event
• Several partnerships formed with business (e.g.
  Metropolitan and DaimlerChrysler) and donor
  community
• DPSA presently strengthening its internal
  capacity to provide support to depts - will soon
  have four full-time members of staff focusing
  exclusively on HIV/AIDS

16
WAY FORWARD

• Our view is that work done around policy system
  development should assist considerably in
  developing a sustainable response. However the
  key challenge lies in the implementation process
• Specific concerns
• Lack of integration of HIV/AIDS policies
  programmes into broader wellness initiatives HR
  practices
• Tendency of allocating HIV/AIDS responsibilities
  to junior officials with limited skills
  influence
• Limited data on HIV prevalence rates impact of
  HIV/AIDS on the workplace
• Inadequate understanding of specific workplace
  challenges such as existence of stereotypes
  prejudices
• Most depts have policies, but they are often in
  draft form

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WAY FORWARD (CONT)

• Strategies implementation plans on e.g.
  training/development of staff replacement of
  personnel often inadequate
• Most programmes focus on awareness prevention,
  with few focusing on sustaining service delivery
  and care/support
• Lines of accountability implementation
  monitoring often unclear
• Major problems are being experienced around
  stigma - hence employees are reluctant to
  disclose their status seek help
• In view of these challenges, critical to assist
  depts in strengthening their internal capacity
  analysing their risk profile and getting
  tangible programmes off the ground to manage this
  risk
• We believe that the planned communication
  campaign will be key to creating a climate
  conducive to non-discrimination openness and
  support and that the pilot programmes will open
  the way to more comprehensive strategies