Check four things before you sign: that the person signing your certificates is a registered occupational health practitioner, that the medicals are matched to each job's hazards instead of one generic test, that clinical records stay confidential while you receive an audit-ready register, and that the price per employee is stated up front. Speed, on-site days and reporting all follow from those four.
A certificate of fitness is only as good as the signature on it. It must be issued by an occupational health practitioner — an occupational medicine doctor, or a nurse holding a qualification in occupational health recognised by the South African Nursing Council. Ask for the registration number of the person who will actually sign, and check it with the SANC or the HPCSA. Ask, too, which occupational medicine practitioner abnormal results are referred to.
A good provider starts from your hazard identification and risk assessment and maps each job category to the surveillance it needs. A provider that quotes one standard package for every employee is doing one of two things: over-testing, which costs you money and can fall foul of the Employment Equity Act, or under-testing, which leaves a compliance gap you only discover in an inspection.
The certificate is only defensible if the tests behind it are. Ask how audiometry is done — the room or booth, the calibration of the audiometer, the noise-free period before a baseline test — and whether spirometry equipment is calibrated. For construction, confirm that certificates are issued on the Annexure 3 form, specific to each worker's task.
Clinical records are special personal information under POPIA. The provider should keep the clinical file and give you what you are entitled to: the fitness outcome for each employee and a consolidated register for your occupational health file. Ask how long records are kept, where, and how an employee or a future provider gets access to them. A provider who emails diagnoses to HR is a liability, not a convenience.
For a workforce of any size, the biggest cost of a medical is rarely the fee — it is the hours people spend travelling to a clinic and waiting there. Ask whether the provider runs on-site medical days, what they need from you (usually a private room and a power point), and how they handle shift workers and anyone absent on the day.
Ask for a per-employee rate by assessment type, and for what that rate includes: audiometry, spirometry, drug testing, travel for on-site days, the certificate and the register. Ask what costs extra — retests, referrals, after-hours sessions — and whether the company or the employee is invoiced. A quote you can compare line by line is a sign of a provider you can work with.
Who signs the certificates and what is their registration number; how medicals are matched to each job's hazards; how audiometry and spirometry are done and calibrated; who keeps the clinical records and what you receive; whether they can work on site; and what the per-employee rate includes.
For most occupational medicals, yes — an occupational health nurse practitioner is an occupational health practitioner under the OHS Act and may issue certificates of fitness. A good nurse-led practice will also have a referral route to an occupational medicine practitioner for findings that need one.