An expert in ethics of the health profession has criticized government over its handling of the current public sector strike. As the strike includes nurses, the lives of many patients seeking attention in hospitals and clinics have been dangerously compromised. According to the law, nurses are prohibited from striking because of the essential service that they provide in restoring the health of the nation. However, nurses have rights, too, and they are withholding their service to make their demands heard. After three weeks of workers striking, the government has failed to accede to their demands. But it has bettered its offer and says it will have to borrow money to pay even this new offer. Professor in the Faculty of Health Sciences at Wits University and Director of the Steve Biko Centre for Bioethics, Ames Dhai, has described the government’s conduct in how it has handled the strike as ‘holding health care workers to ransom’.
‘I think it would be important to realize the rights of workers from the perspective of respecting the capacities of workers, their competencies and, therefore, compensating them accordingly. The issue that I see here is we have a situation where striking is legally not acceptable in terms of the Labour Relations Act. There is no Minimum (Level) Service Agreement at the moment, and based on the fact that the Labour Relations Act will not allow for striking in these essential services, I think what’s happening is the government is actually holding health care workers ransom, not only to the oaths that they have taken with regard to servicing those that are ill, but also to the laws of the land’, said Prof Dhai.
The South African Human Rights Commission agreed that government needs to come up with a Minimum Level Service Agreement.
‘There is still a need for government to sign (the) Minimum Level Service Agreement with unions so that those state employees that are involved in the delivery of essential services can have adequate protection and so that in the event of such circumstances government is able to make the necessary contingency plans as speedily as possible. Government should have foreseen that this was coming. It has become a regular occurrence whenever there are salary negotiations and, therefore, government should have adequately planned for this’, said Commission spokesperson, Vincent Moaga.
‘We are also of the view that had the Minimum Level Service Agreement been put in place, as provided for in the Labour Relations Act, we would have been in a position to protect the delivery of social services to the public. Had this been signed, then all those who are providing the necessary service would have remained in their posts and we wouldn’t be seeing the kind of pain that we’re seeing coming out of hospitals and clinics where pregnant women, elderly people and children are being turned away from hospitals’, he continued.
The Minimum Level Service Agreement is a document that can potentially ensure that there is no loss of limb or life in the event of strike action by health care workers. Both government and unions are responsible for coming up with this important document.
‘They would have to sit and agree on basic health care services that would be so delivered to ensure that patients are not harmed by anyone going on strike. They would have to come up with appropriate patient care at the time that health care workers decided to embark on industrial action. Employer and employee would have to agree on this’, said Prof Ames Dhai.
Dhai said the government was dragging its feet in drawing up the document. Because of this, she said the government should take responsibility for the collapse of health services in the wake of the current strike. She was also scathing on the striking nurses.
‘I think it’s time that government actually accepted most of the responsibility. I’m not sympathetic with people striking irresponsibly and neither am I sympathetic with the government. While we cannot condone the strikes, we cannot condone patients dying and patients suffering. That is not acceptable. At the same time we cannot accept what government is doing. We need to actually ask: Is it acceptable for government to be holding people to ransom? Every time there is an issue with regard to public sector strikes, when it comes to the health care situation, the government very, very quickly will remind people of oaths that they have taken, but the government forgets that it’s got to make the situation on the ground conducive to ensure that the health care workers are in an enabling environment ‘ an environment that enables them to take forward those oaths’, she said.
‘People that have been on strike have actually conducted themselves very unprofessionally. If one wants to go on strike and one wants to achieve the objectives of the strike, then stay away from being violent and intimidating people. I think if the strikers want the sympathy of the man on the ground, then the strikers will have to change the way they have actually been conducting themselves. What we’ve witnessed is highly unprofessional behaviour – behaviour that portrays that while we call ourselves health care workers, we really don’t care in terms of what happens to patients. So, the oaths that have been taken have been oaths that they’ve paid lip service to’, Dhai concluded.