About 500 community healthcare workers who are contractual employees of Gauteng Health blocked Johannesburg city streets last week, demanding that the health MEC come to address them and accept a memorandum of their demands. Sibusiso Nkasa, Johannesburg regional chair of the National Union of Public Service and Allied Workers (Nupsaw), which is leading the strike action, said in a report in The Sunday Independent: “We are resolute. As you can see all roads are closed. All gates have been barricaded, none can go in and no one can walk out.”
Roads barricaded during the rowdy but largely peaceful protest were around the square block of Ntemi Piliso, Commissioner, Kort streets and Albertina Sisulu Road in the Johannesburg inner city. Shops within the block were barricaded and no-one could leave the precinct or enter through its gates.
Pointing in the direction of the striking workers, Nkasa said: “All these community healthcare workers are members of Nupsaw. Nupsaw is affiliated to Saftu (South African Federation of Trade Unions).”
Nkasa is quoted in the report as saying workers want to be permanently employed by the department. “We are here to demand permanent status. We want workers put into permanent posts.” Nkasa said Nupsaw had been in discussions with the Gauteng Health and reached a resolution last year at the bargaining council to elevate community primary healthcare workers from contractual to permanent status.
The report says he accused the department of reneging on the agreement and not responding to their communication concerning their demands. “The department is not responding. They promised to revert to us. We’ve granted them time and they have not come back to us. They are not even willing to come out and address us. The department has been reluctant to come on board and actually resolve some of the issues which go hand-in-hand with the (June) resolution. We are waiting for a response from the department.”
He said the workers’ demands included: a R3,500 a month stipend with “permanent status”; elevation to level-5 remuneration rate, which means R12,000 a month; the department to share their employee database details with Nupsaw; and implementation of the June 2018 resolution reached with the department and a resolution to all these matters by the end of June.
He said: “Workers want to ensure that, come end of June, they are permanent. We are concerned that when the administration of the province changes hands (after the elections on 8 May), when a new administration comes in they may not recognise the permanent status of the workers. So, all the more reason it must be resolved now. The Smart Purse contract will fall away come 1 May.”
The report says Nkasa denied the workers represented by his union were opportunistic in their labour action so close to the poll date. “This thing started way back. They (workers) started way back, as far back as 2015, 2016. They have come a long way to earn the R3500 they earn presently plus level-5 status which we are pushing for. At some stage we have to be listened to.”
Several attempts to contact the spokesperson for MEC Gwen Ramokgopa were fruitless. However, the report says, Gauteng Health spokesperson Vuyo Sabani, who does not speak for the MEC in her official capacity – and there seems to be much confusion and uncertainty in the department regarding line responsibilities of spokespeople – said: “That issue is being dealt with at the level of the national Department of Health. It concerns community healthcare workers.”
The report says although Sabani was informed that the Nupsaw-led community healthcare workers had made it clear they wanted Ramokgopa to address them and that they were contractually employed by the Gauteng Health, he insisted that that enquiries were directed to Popo Maja, the spokesperson for Health Minister Aaron Motsoaledi. Maja said though he could not confirm if Ramokgopa had had any talks with Motsoaledi concerning the absorption of contractual workers into permanent employment, he could confirm that many of the workers had “been absorbed on renewable contracts at minimum wage of R3,500”. Said Maja: “Unfortunately, the national fiscus is unable to absorb all 53000 of them.”
The report says efforts to reach Khutso Rabothata, head of communications in MEC Ramokgopa’s office, his colleagues Lesemang Matuka and Khanyisa Nkuna and Professor Mkhululi Lukhele, head of department’s office, were unsuccessful by the time of publication.
South Africa’s Health Minister Aaron Motsoaledi, in his reaction to the protests, said in a Cape Argus report: “The allegation that the Department of Health is reneging on any agreement with community health workers is a distortion of the true state of affairs. It is not clear whether the distortion is based on a genuine misunderstanding or a deliberate act of convenience.
“It is common knowledge that the country went through an unfortunate and difficult period when the government was not providing ARVs for HIV-positive people. As such, there was a lot of suffering in homes, communities and hospitals because people were not in treatment. Many South Africans volunteered to offer home-based care to the sick. Later, others volunteered to be lay counsellors, who counselled people on HIV and even screened them.
“Many of these volunteers came from NGOs, churches and even government departments such as the Department of Social Development. Because they were not regarded as public servants, the NGOs were only paying them a stipend. This stipend could be as low as R1,500 – far below the present minimum wage agreed to by the government and the unions.
“The first province to try to solve this problem was KwaZulu-Natal. They placed the community health workers under one programme – KZN’s very successful Sukuma Sakhe Programme – and also put them on Persal (the civil service payment system) to guarantee the payment of stipends on a monthly basis so that none of them would go a month without payment. The National Department of Health then engaged the workers about the future of this service.
“As the issue was becoming a labour matter, the department entered into negotiations with labour organisations under the auspices of the Public Health and Social Development Sectoral Bargaining Council (PHSDSBC).
“The overriding principle in those negotiations was that community health workers must no longer be employed through third parties such as NGOs but must be part and parcel of the health-care system of the country.
“The following agreements were then made in the negotiating chamber: that as a first step, they will come into the department on a yearly contract which is renewable. (The spirit behind the contract was never to get rid of people, but was to comply with the current labour regime.); that they are all moved on to a minimum wage. This agreement was made because none of them was earning at the level of the present minimum wage. In fact, many of them were far below that; and that they must be paid through Persal, (and) no longer a stipend.
“The agreement on the standardisation of remuneration for community health workers was signed, in June last year by the Department of Health and five labour organisations. The five are: Nehawu, Denosa, PSA, Hospersa and Nupsaw.
“Part of the agreement states: ‘A non-service remuneration payment of three thousands and five hundred rand (R3,500.00) should be for those CHWs that have matric, or either experience, and those that can benefit from Recognition of Prior Learning (RPL) will be processed through the Persal payment system.”
“We are aware that presently there are some community health workers who are demanding that they be like any other public servant in the Republic, with benefits and perks that the public service can offer. So, we can confirm that the National Health, a statutory body in terms of the National Health Act 2003, has referred this matter to the PHSDSBC. We believe that legal process must be given a chance. It is the only way out.”Sunday Independent report Cape Argus report (subscription needed)