Health Minister Dr Aaron Motsoaledi was upbeat when he addressed the media at the closing of a three-day national summit on nursing in Sandton, Johannesburg. He told journalists that the summit has produced a compact that will guide the improvement of the nursing profession and the standard of nursing care moving forward. But beneath his upbeat tempo, Motsoaledi was realistic enough to admit that the wheels of government move too slowly. He expressed nervousness that implementation might well prove to be the devil in the detail further down the line.
‘The main thing that worries me about the compact is implementation. Government is usually failed by implementation’¦ (we) come with very lofty ideals and good policies and implementation fails us. I’m anxious about that’, Motsoaledi said.
He went on to express dissatisfaction with parts of the compact. Recognising the fact that many nurses moonlight, that is, nurses often have two nursing jobs at the same time – which often leads to burn-out – Motsoaledi said he was not entirely happy with the way the compact is proposing that the issue be dealt with.
‘I thought it will appear like: ‘The Minister must ban moonlighting’. Now, it doesn’t read like that. And since I’m not a dictator, I will accept what is written. But I’m being given direction. It reads like: ‘Recognising the negative health system consequence of moonlighting, we urge the National Department of Health and private sector to implement measures to manage moonlighting’. I would have read it to say: ‘Ban’. Nurses are taking enough responsibility to show their distaste about moonlighting. They are leaving it to me that we are giving you power, Minister to do something about it. Though it’s not as strong as the word ‘ban’, it’s giving me direction of what they think about moonlighting’, said Motsoaledi.
But, taking into cognisance the fact that many nurses moonlight because they want better pay, Motsoaledi was not forthcoming about measures he will take to stop the practice from entrenching further. The compact also re-emphasises the re-opening of nursing colleges for the recruitment and training of more nurses. It also addresses the issue of nurses participating in strikes, but does not go into detail about how that should be addressed. The Health Minister could also not answer questions about the outstanding Minimum Level of Service Agreement. Labour unions have been asking government to engage with them to draft an agreement that, in the event of labour action, will ensure that crucial services such as nursing are not entirely disrupted. But, this is yet to happen.
What’s also important about the nursing compact are the time-frames within which to deliver on undertakings made.
‘We are putting together teams which will make sure about this implementation. Some of the issues raised are short-term; others can be immediate; some there’s already money in the budget, for instance, the issue of infrastructure. We do have money for general infrastructure. Health was very notorious on not spending the money. For instance, in the last financial year, with all these problems here, R813 million of infrastructure (money) was not spent. So, all we need to do is to sit and prioritise’, the Health Minister announced.
One resolution that seems to have stood out for the Health Minister is the issue of nurses’ uniforms. The summit has resolved that nurses will wear white.
‘I think the only thing that is left for me is the budget. I don’t know what it costs’¦ which means I’m ready any minute because it excites me. It’s not only about uniform. It has got a lot to do with infection control, which has been (a) problem in our hospitals. We’ll definitely put a budget for it and as soon as we’re ready, we’ll announce that we are ready. We never budgeted for it because it was not part of the budgetary items. But we are going to look into it ‘ whether it’s feasible, depending on the amount within the budget we have got now or whether we wait for next year’s budget’, he said.
Speaking on behalf of South Africa’s nurses, past leader of the International Council of Nurses, Professor Dudu Nzimande, reiterated the importance of the summit and how crucial it is for government to move quickly on delivering on resolutions contained in the nursing compact adopted this week.
‘For us as nurses in this country, this is the first of its kind that we have a summit like this where we all come together irrespective of what organisation you belong to, and so on, and we discuss matters that relate to us. This is very important for the health of our people. There might have been some problems here and there. This is going to try and correct some of those problems. On behalf of the nurses, we really would like to urge our government to make resources available so that whatever we have actually presented, we start working on it’, Prof Nzimande said.