South Africa: Storm Brewing Between Government, Striking Doctors & Unions

In the last few months there has been a storm brewing between different parties here in South Africa related to the public health care system. Doctors, unions and government are at odds without being able to come to a compromise. There have been accusations made by all sides and doctors have started striking so their demands can be met.

At the heart of the matter is a grievance by public sector doctors that they are paid as much as 50% less then other public sector employee's at a similar levels. Additional issues include long shifts, conditions at hospitals and doctor to patient ratios. The doctors have set up a facebook group for supporters where you can find a full history of the events up to now as well as grievances.

According to the facebook group, they also feel they are not being sufficiently represented by unions such as the South African Medical Association (SAMA) and SAMA have come to an agreement with government without the support of their members.

SAMA states

We would like to reassure our members of SAMA’s commitment to advancing the interests of members, by negotiating for an OSD that reflects the aspirations and needs of our members. It is on this basis that we have attempted to keep members continuously and accurately updated on the employer’s proposal. Communicating the employer’s proposals is however, not an indication that SAMA accepts such proposals. Pronouncements by the doctor-grouping that SAMA has reached an agreement with the Department of Health are disingenuous, blatant untruths, and disrespectful to all parties involved in the OSD-negotiations.

While traditional media has reported on the hardline stance taken by the ANC on the striking doctors.

The African National Congress and Cosatu in KwaZulu-Natal have released a press release condemning doctors for their “unprofessional” strike action in the province.

In a strongly worded statement, the alliance partners suggested doctors were being unreasonable and had thwarted attempts by National Minister of Health Dr Aaron Motsoaledi and the provincial MEC, Dr Sibongiseni Dhlomo, to reach an agreement.

They accused doctors of refusing to stick with the process and channels available to them.

The provincial department of health in Kwa-Zulu Natal have also fired over 200 doctors for not appearing at work after an interdict was granted against them by the courts:

More than 200 doctors have been fired for failing to report to work in different hospitals in KwaZulu-Natal, SABC radio news reported on Monday evening.

The provincial health department said it had issued 226 letters of dismissal to health care professionals so far.

Some of the perspectives from the blogosphere

Fhuluphelo writes

One thing that I learnt while sitting in that ward was the impact the doctor’s strike is doing to these poor patients. According to this lady, it took her more than 10 hours to receive attention on arriving at the hospital as there were not doctors available and the nurses are not authorized to administer any medication before the patient is admitted and seen by a doctor. Not even pain killers and this woman was lying there all that time in pain.

An anonymous doctor at moralfibe writes

I had mixed feelings about striking and abandoning our patients in what is seen by the general public as just a dispute over salaries. The protest action is in fact a culmination of years of abuse that medical professionals have endured at the hands of the government.

Let’s start with working conditions. The hospitals are over-capacity, and the doctors are overworked. In my ward, we officially have place for 65 patients. We had more than 85 for the best part of last week. Doctors work 30 hour shifts when they do overtime, working a minimum of 60 hours a week in my hospital, but it’s not like this everywhere. Usually it’s worse. Although, this certainly is an improvement since 2002 when as an intern, I worked 100 hours a week and 30 hour shifts every third day. We are expected to do procedures with needles potentially putting ourselves and others at risk of contracting HIV by needlestick injuries, this even after having been awake and on our feet for 24 hours and more.

Further he/she writes

To do the job I do in the hospital I have three degrees in the medical field, but earn less than a gym personal trainer. If you compare my job requirements and qualification to any other professional in the government sector, I am being underpaid by at least 50%. In private practice I would be earning at least 300% of my current salary.

and he/she also believes the government is using sneaky tactics to remove support for the strike action

When the Minister held that press conference on Wednesday, it was a sneaky political move. When has any employer presented a wage offer to the public without first taking it the bargaining chamber? It was a move that they knew would be highly publicized and designed to remove public support for the strike action.

Karren Little writes about the ethics

It's a very sticky ethical situation. The public is suffering, and there is a good chance that people will die as a consequence of the strike. On the other hand, the public suffers massively and thousands of lives are lost every day as the government continues to under-fund and mismanage the health care system.

Karren is not striking, but fully supports the strike action.

In The Crater, we're not striking – we're the only source of emergency care in a hundred-kilometre radius, and it really would be unethical to strike. But I would like to say that I support the strike and am grateful to my colleagues who have been brave enough to take action – and put their jobs on the line – for the sake of us all.

Sandile questions the morality of it all

It is all about the alleged poor salaries that medical doctors and only medical doctors get.

Well, what about their colleagues who are administrators, clerks, cleaners, drivers, nurses and others in the emergency services? There is something that is fundamentally wrong when medical doctors abandon wards with sick and dying people simply because they want more money.

Tourism radio South Africa writes

In my opinion, both parties are wrong. Both are in a position that they feel they cannot budge from but this goes beyond money. Here, I tell you what, throw some money at terminal patients and lets talk again. I don't believe in the health care system in SA, public or private, never have. I don't believe in medical aids either, its like playing a reality TV version of Fear Factor with a cash prize naturally. Can you be a capitalist and a doctor or politician? Seems so. Are those the only options? Apparently. So here's my argument…Above all, do no harm. I think all parties involved could take a lesson from the oath or at the very least, don't promise what you can't deliver.

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