Disability management in a public-private health care facility in South Africa: an organisational perspective

BACKGROUND: Job retention, long-term absenteeism and medical boarding pay-outs are significant concerns for employers within the public health care sector of South Africa. OBJECTIVE: To describe disability management policies, procedures and programmes of employees following impairment and disability in a public-private healthcare facility in South Africa. METHODS: An exploratory qualitative study design was used with key informants in senior management and nursing managers (n=12) selected via purposive sampling. Audio-recorded data from semi-structured interviews and a focus group were thematically analysed using inductive reasoning. RESULTS: There is poor adherence to occupational health and disability management policies and the current referral process is informal with managers using discretion to manage employees with ill health and acquired disability. The procedures prescribed in the policy and procedure on incapacity and ill-health-retirement need to be followed, and an early return to work programme within the health care facility needs to be implemented. CONCLUSIONS: Despite South Africa having many policies on recruitment and reasonable accommodations, there is a lack of implementation of these policies. An integrated disability management policy and programme encompassing health prevention, early return to work strategies, vocational rehabilitation and the implementation of reasonable accommodation is required to ensure that employees who have acquired disabilities or ill health are successful in the workplace.