What stands behind the red ticket: medical surveillance under section 13 of the Mine Health and Safety Act

A contractor arrives at the gate with a crew. The gate officer asks for one thing. A certificate. If it is current, the shift starts. If not, the shift waits.

Most people on a mine know that ticket by sight. Far fewer can say what stands behind it. This article follows the law from the ticket back to the system.

Two Acts, two duties

ODMWA section 15(1) says no person may perform risk work at a controlled mine or controlled works unless they hold a current certificate of fitness, and that no owner or contractor may permit anyone to do so except as that certificate authorises.^[1]

Under ODMWA section 23, the director may issue a certificate of fitness on application, with the prescribed fee and prescribed medical report. The certificate is valid for a period the director determines, not exceeding three years, and may be restricted to a particular mine, kind of mine, or occupation. That is the legal ticket. The everyday name "red ticket" is industry usage, not a phrase in the Mine Health and Safety Act.^[2]

How that application, medical report and director decision work in ordinary mine practice needs review by a qualified occupational medical practitioner and a mining health lawyer. This article does not describe a Care Net role in that process.

The MHSA works from a different angle. It places a duty on the employer to establish and maintain a system of medical surveillance of employees exposed to health hazards, either because a regulation or Gazette notice requires it, or because the employer's risk assessment under section 11(1) shows it is necessary.^[3]

The practical reading is this. The certificate answers "may this person do this risk work?" The surveillance system answers "is the work harming the people doing it, and what are we doing about it?" A mine needs both.

What section 13 requires

Every system of medical surveillance must be appropriate to the health hazards, designed to give the employer information it can use to eliminate, control and minimise risk or to prevent, detect and treat occupational diseases, and consist of an initial medical examination and other medical examinations at appropriate intervals.^[3]

The employer must also:

• engage an occupational medical practitioner, part-time or full-time;
• supply the practitioner with the means to perform their functions;
• keep a record of medical surveillance for each employee exposed to a health hazard;
• inform the Principal Inspector of Mines in writing within seven days of the appointment of the practitioner.^[3]

The Mine Health and Safety Amendment Bill (B10-2026) proposes changes to section 13, including a duty to implement the surveillance system and scope to appoint other occupational health practitioners registered with the Health Professions Council of South Africa or the South African Nursing Council. PMG and the Parliament bill page record that it was introduced in the National Assembly on 07 April 2026. It is still before Parliament and is not law. Section 13 as currently enacted applies.^[9][10][11]

The cycle, from the first examination to the last

The Act describes a cycle, and it helps to see it in order.

1. Initial medical examination. Section 13(2)(c) names it as the start of the system.^[3]
2. Other examinations at appropriate intervals. The Act does not fix the interval in section 13. It says "appropriate", so the interval comes from the hazard and from the mine's own arrangements.^[3]
3. Exit examination. If an employee was, or was required to be, under medical surveillance and their employment at a mine ends for any reason, the employer must arrange an exit medical examination. It must be held before, or within 30 days after, termination of employment. The employee must attend.^[4]
4. Exit certificate. The occupational medical practitioner must produce an exit certificate showing the results of all medical surveillance and the presence or absence of any occupational disease, and enter a copy in the employee's record.^[4] Section 19(2) says that practitioner must also give the employee a copy of the exit certificate.^[7]
5. Records. The employer keeps them. More below.

Under section 18, the employer must pay the costs of all clinical examinations and medical tests performed in terms of the Act unless the Act expressly provides otherwise.^[5]

The records outlive the job

Section 15 says an employee's record of medical surveillance must be kept confidential. It may be released only in accordance with the ethics of medical practice, if required by law or court order, or if the employee has consented in writing.^[6] Anyone required to maintain the record must store it safely and may not destroy it for 40 years from the last date of medical surveillance.^[6]

Section 13(8) adds that the employer must retain records until the mine closes, and then deliver them to the Medical Inspector.^[3] Section 19(1) says an employee may ask for a copy of their own record, and the employer must provide it.^[7] A paper file in a storeroom is a weak answer to all of that.

What if the worker is declared unfit?

A finding that a worker is fit or unfit is an individual clinical decision by the practitioner who examined the worker. Section 13(6) says that if an employee is declared unfit as a result of an occupational disease, the employer must investigate in terms of section 11(5).^[3] Section 13(7) covers temporary unfitness where health is expected to improve: the practitioner must record this and notify both employer and employee.^[3]

Section 20 gives the employee a right to appeal to the Medical Inspector against a decision that they are unfit for a particular category of work, or against a finding in an exit certificate. The appeal must be lodged within 30 days of the decision or finding. The Medical Inspector arranges a re-examination by a practitioner not employed by the employer.^[8] That is a worker's right, and a supervisor should know it exists.

Four questions for your own file

Use these as questions for your own site file before the next shutdown.

1. Can you show a current certificate for every person doing risk work, including contractors?
2. Does the practitioner have a completed job description in front of them, or a blank form?
3. Do you have a plan to arrange exit examinations within the 30 day window?
4. Could you retrieve a record in 20 years' time?

This article explains the two Acts. It does not sell a mining medical, a red ticket, or a mining pack. How the director's certificate under ODMWA section 23 works in ordinary mine practice needs review by a qualified occupational medical practitioner and a mining health lawyer.

Questions people ask

This article is general information for employers and is not legal or medical advice. It is not a description of industry practice. Read the regulations for the full requirements and speak to a qualified practitioner about individual health concerns.