After a disruptive strike which cost four people their lives, healthcare workers are no better off as the chaos caused has not resulted in a salary increase and strikers are to have their pay cut for every day they were not at work during the protest.
And while unions agreed to call off the strike when the state agreed to continue wage talks, the National Health and Allied Workers Union (Nehawu) is among the minority unions which has refused to sign the amended 7.5% wage agreement for 2023-2024.
Nehawu refuses to consider signing until agreement is reached on 2022-23 wages, writes Liezl Human in GroundUp. It is adamant that the previous year’s deal be finalised first.
Nehawu spokesperson Lwazi Nkolonzi said the union’s “immediate priority” is to conclude 2022-2023 wage negotiations and then look into the issue of 2023-2024. “We cannot go on without having resolved the dispute that led us to strike,” he said.
In fact, if unions accept the latest pay deal, nurses, cleaners and porters will have less money to take home than last year, as was the case for the 2022 and 2020 financial years, according to analysis of data from the Department of Public Services & Administration, writes Jesse Copelyn for Bhekisisa.
In the state’s final offer these workers will get a 3.3% increase compared with what their salaries were in the 2022/2023 financial year (which ends on 31 March), says Oomang Parag, spokesperson for the Public Service Co-ordinating Bargaining Council.
Inflation was 7% in February, according to Statistics South Africa.
Public servants have also been getting a R1 000 cash allowance (after tax) from the government since 2021. Until now, this wasn’t added to the figure used by the state when it calculates how much to pay into people’s pension funds (usually 13% of the“pensionable” salary, on top of the 7.5% workers contribute each month themselves).
But the new deal says that from 1 April, this amount will be part of the math, which will translate into a bigger pension contribution from the state. It will also create a higher starting point for future negotiations, says the department.
On average, the cash payout represents 4.2% of public servants’ salaries. Since that’s now being added to the 3.3% increase to their baseline salary, the government says workers are getting a pay increase of 7.5% in total.
In the end, even the promise that ended the strike (that the state would keep talking to Nehawu about its demands) fell through, said Nkolonzi.
He says: “The government has reneged on the settlement agreement of the strike about 2022/2023 pay.”
Why the hesitancy over salary hikes?
South Africa just can’t afford the pay that the unions want. The government is working to rein in its massive public sector wage bill.
In relation to the size of its economy, South Africa spends more on paying public sector workers than most countries. In 2021, the combined cost of government worker salaries was equal to 14.8% of the value of all the goods and services produced in the country that year (GDP).
Other middle-income countries like Mexico, India and Russia had a public sector wage bill of less than 10% of GDP.
So what do nurses, porters and cleaners earn at state hospitals?
Nurses earn between R18 300 and R93 100 a month plus a R1 000 stipend.
Among full-time professional nurses working at government hospitals, those doing their year of community service are paid the least.
Professional nurses study for four years and then do a year’s compulsory community service after graduating. There are also three other categories of nurses working at government hospitals and clinics: specialist nurses, staff nurses and nursing assistants.
Specialist nurses are professional nurses who have a postgraduate degree in a particular specialty, like cancer treatment or psychiatric care. Staff nurses and nursing assistants work under the supervision of a professional nurse.
Staff nurses are qualified to do more complicated tasks than nursing assistants: they can treat fractures, for instance.
At the moment, the government pays professional nurses doing community service R220 347 a year (R18 362.25 a month), and nursing managers at tertiary hospitals, the best paid position, R1 117 236 a year (R93 103 a month).
Moses Mushi, spokesperson for the department said this includes benefits like medical aid and housing, so the basic salary they take home is less than this.
However, all workers also get a stipend of R1 000 per month (after tax), which is not included in the annual salary figures.
Salary ranges for staff nurses and nursing assistants are lower. A staff nurse, who studies towards a two-year diploma, earns between R179 172 and R311 361 annually from the government, while a nursing assistant, with a one-year qualification, gets between R138 549 and R240 777. These workers also get the R1 000 monthly allowance.
Although there is a wide gulf between the salaries of different nursing categories, what’s common is that when accounting for inflation, these workers will have earned less than the previous year for two out of the past three financial years. That will become three out of four if unions accept government’s current offer.
The broken promise
In 2018, the Treasury announced a three-year wage agreement for a large group of civil servants that included nurses, state lawyers and engineers.
The deal said that from April 2018, top-earning public service workers would get a 6% wage increase, while the lowest earners would receive 7%. This was above expected inflation of 5.5% and well above what inflation actually ended up being (4.5% that month).
For the next two years (2019 and 2020), more senior workers (like middle managers) would receive an annual salary increase in line with inflation, while less senior staff (such as nurses not in managerial positions) would get 1% above inflation, Treasury’s statement said.
Wages increased by the promised amounts in 2018, the first year of the agreement. For instance, community service nurses had a pre-tax annual income of R185 478 in 2017, which jumped by 7% to R198 462 in 2018.
Things continued smoothly in 2019. For example, community service nurses saw their annual salaries climb by 6.2% to R210 768 (other lower-paid nurses’ salaries increase by the same percentage).
Consumer price inflation had increased by 4.4% at that time compared with the previous year. It had been expected to increase by 5.3%, meaning the wage increase for this group was 1.8 percentage points higher than actual inflation for April.
But things took a sour turn in 2020, the agreement’s final year t.
Amid the financially crippling pandemic, government was unable to stick to its promises, and failed to raise wages at all (the government did say that workers would receive increased medical and housing allowances, though the state salary data doesn’t show this). This is despite the fact that inflation was 3%.
For some nurses, their salaries continued to buy them less every year.
In July 2021, they got a 1.5% wage hike, and a monthly stipend (not subject to pension deductions) of between R1 220 and R1 695, depending on salary level. The stipend equals R1 000 a month after tax.
Since community service nurses earned R210 768 a year in 2020, and received a monthly stipend of R1 220, the stipend represented a roughly 7% increase. Combined with the baseline increase, they received an 8.5% wage hike overall, far more than inflation at the time, which stood at 4.6%.
By contrast, higher-paid nurses such as nursing managers at tertiary hospitals got less than inflation that year.
They would have been earning at least R949 482 annually in 2020 and received a monthly allowance of R1 450 for 2021, meaning their stipend represented a 1.8% increase. With the pensionable 1.5% raise, they got a 3.3% wage hike – lower than inflation.
In October 2022, the government increased the pensionable wages by 3%, below the rate at which consumer prices had increased (7.6%). The state also extended the stipend (initially only planned for 2020/2021), which remained at R1 000 after tax.
Porters and cleaners have had a rough few years – but 2021 was great.
Government-employed porters and cleaners have had a similar experience. Job adverts usually class these positions as “salary level 2” roles in the category of “non-occupation specific dispensation (OSD) workers”.
The OSD was set up to keep skilled professionals in the government service by making sure they get salary increases aligning with their specific field of expertise and experience. This system is supposed to ensure people can plot a career path working for the state, and earn well, even if they don’t go into management.
Non-OSD workers, like porters and cleaners, qualify for annual increases to keep up with inflation and bonuses, but must work for a set amount of time (at least 12 years) before being promoted to the next salary bracket.
How much can people on level two non-OSD salaries earn?
Department data show that salaries at this level range between R107 196 and R126 270 before any tax is paid (supervisors and foremen are on a higher salary grade and earn more). They also get the R1 000 a month post-tax stipend.
Job adverts usually offer the minimum amount.
For instance, a vacancy for a porter at the Red Cross War Memorial Children’s Hospital in Cape Town is being advertised at R107 196 per year pre-tax.
Someone at the lowest pay level in this position would therefore get R8 933 a month plus the R1 000 cash payment, with their salary also including benefits like pension contribution, medical aid and housing allowance.
Over the past three years, job adverts show that porters and cleaners have experienced similar wage changes to nurses – they didn’t get a salary increase in 2020. (For instance, job announcements published by the government show that porters were earning the same amount in the 2020/2021 financial year as in 2019/2020 – namely, R102 534 per year before tax.)
But in 2021, they got a 1.5% increase, along with the additional non-pensionable allowance. Since their wages stood at R102 534 a year for 2020, a stipend of R1 220 a month increased their salaries by 14.3%. Combined with the baseline increase, they thus got a 15.8% increase overall.
Like other public sector workers, they then got a 3% increase in their pensionable wage in 2022, along with the continuation of the stipend.
In the 2021/2022 financial year, adverts showed their pensionable salaries bumped up to R104 073 (a 1.5% increase), though they would also have received an additional R1 220 stipend at this point.
The next year it went up by 3% to R107 196.
In short, just like nurses, people doing these jobs also saw cuts in their wage for two out of the past three years.
Meanwhile, the Western Cape Health Department has initiated disciplinary action against 192 employees who took part in the strike.
The department's spokesperson Mark van der Heever told News24 that information from its labour relations office indicated that only 20 nurses were involved in the protests across the province, all of whom were employed at Khayelitsha District Hospital.
“In all, a total of 192 staff, from all categories, took part, and we are currently facilitating disciplinary action against them,” he said.
Nehawu’s Western Cape secretary, Baxolise Mali, said it hadn't received information about 192 members being charged and could only comment once the action had been brought to its attention.
GroundUp article – NEHAWU won’t sign new 2023-24 public sector wage deal (Creative Commons Licence)
Bhekisisa article – How much do state nurses, porters and cleaners earn? (Creative Commons Licence)
See more from MedicalBrief archives:
Nehawu refuses to budge on wage demand after strike
Hospitals and patients bear the brunt of disruptive Nehawu strike
Court forbids Nehawu’s national strike on pain of SAPS intervention