Worker health and safety representatives on South African mines: A compassionate voice in the face of employer dominance and health complexity

Abstract There is a triple disease burden on South African mines; occupational disease, communicable disease and non-communicable disease (NCD) are all of concern. The Mine Health and Safety Act No 29 of 1996 introduced for the first time, worker elected health and safety representatives (HSRs). Globally, although arrangements for HSRs are associated with better health and safety outcomes, employers increasingly dominate their activities. In-depth interviews (n = 40) were conducted with HSRs (n = 10) and OHS practitioners (n = 15) on four underground mines (gold, platinum and diamond) over 12 to 18 months in 2015-16, to understand how HSRs engaged with health issues, and how the employer responded. Activities across the triple disease burden were categorized as either employer or worker-led activities. While the employer supported HSRs working under their instruction, HSRs faced impediments to their statutory representative role. Employers took advantage of gaps in regulatory guidance. As a consequence of health complexity, and employer dominance, where HSRs acted independently, it was as the compassionate voice to workers. HSRs in middle-income countries take on a meaningfully different role to their counterparts in highly industrialised nations. There are implications, for both regulatory policy and trade union strategy.