Minister of Health on the revised salary offer for Medical Professionals

Q.  Do you have any plan to handle the doctors that were on strike, with regards to the fact that it is prohibited for doctors to strike?

A.  We have deviated from the norm where one took drastic measures against people who engage in illegal strikes. This is because of the fact that government had also committed some wrong in this case because of their delays. However there is no such thing as a legal strike when it came to doctors, the events that had occurred should not be taken as a norm, and must not occur again.

Q. Was the Finance Minister happy to give into your request?

A.  In all countries, Ministers of Finance are like treasurers, they can never be happy, but the Minister was happy. This is because health and education are important, so he was happy.

Q. One of the other things that the strike was about is working conditions. Under the salary issue how do you plan on looking at the working conditions? In some hospitals there are machines that are aging and not functioning properly.

A. In the Program of Action of government actually deals with the issue raised by the doctors. The demands that were made by the doctors were similar to those that exist in the government’s Program of Action.

Q.  Do you have a time line on the implementation of the issues that are being discussed in the bargaining council?

A.  The route that has been taken (the fact that a statement is being made while the bargaining process is still taking place) is extremely not normal. So I cannot give any time frames on this matter, I have to constrain myself.

Q.  At your last conference, you said that there would be no money to meet the demands raised by the doctors. What has happened now?

A. I still say that we don’t have the money that England and other first world countries have. Actually no country will say that they just have money, however we have provided what we can, and have made adjustments in our budget. It’s called prioritizing.

Q. Would the department review this offer if the unions do not accept?

A. I can’t preempt what is going to happen, but we have put the offer on the table.

Q. Is this a final offer, is government not going to go higher?

A. A statement like that can only be made in the chambers, so I have to confine myself and thus I can’t answer your question.

Q.  Who are negotiating here? We have seen in the past weeks the emergence of new unions, so who is the government recognizing?

A.  That is a very well thought of question, we are negotiating with SAMU, which is an affiliate of COSATU. I have been meeting most of their members .The other associations which have just emerged, we just them on TV. SAMA told us that they have never called a strike; they were also caught by surprise. So we hope that unions will whip their members into order.  Otherwise there would never be room for rules in this country.

Q. I have lost track of where we are with the Occupation Specific Dispensation (OSD), is this OSD?

A. OSD has many legs, what we did today was adjust people’s salaries and streamline them, so that when a doctor is looking at their salary would know that this is the package.

Q. Is the government not worried that the offer that it is making to doctors will encourage other unions to expect the same?

A.  I am sure that you are aware that over the past month everyone has been talking about what doctors are getting. If any other people wake up and say me too, I am sure we will cross that bridge when we come to it.

Q. Can you give us an indication of what led to the eleven-month delay?

A.  I once again apologize for the delay. There were many discrepancies, as in some cases a junior doctor would be employed in a senior position. Some provinces also paid doctors differently to other provinces. Everything thus had to be done manually, and thus this also made things difficult. 

Q. Can you tell us what the total amount of these packages is going to be? And will the increases be back dated?

A. The total cost to the state will be more than a billion and remember this is a package for nine months and this will be starting from the first of July.

Q. Will there still be a rural package on top of this basic package, and the juniors who are over paid will they remain on scale or will they be paid less?

A. We have not discussed in this package adjusting anyone’s salary down.

Q. One of the issues that arose during the strike was that doctors are over-worked, will there be measures taken to deal with this

A. This is something that members of the public will not understand. Over-time is part of the profession. There has to be a doctor on stand by for 24 hours, not all of them can knock off at 4:30. There is something called commitment over-time, which becomes inbuilt in the salary. Doctors who don’t do overtime are extra-ordinary. It would only be a doctor who is about to retire or an old lady who would not work overtime.

The issue of doctors being over-worked is not unique to South Africa. Many countries are dealing with shortages of doctors. It worse in some countries, in South Africa we had Bantu Education, and black people were not taught math and science, so it was difficult to be a doctor. Medical schools only produce 1200 doctors per year and that is not enough.

Q. The doctors who went on strike also demanded that they be back-paid since there was a delay with regards to this issue. Is this going to happen?

A. I am not aware of this issue. What I know is that there was an agreement that because of the delays there would be some monetary compensation.

Statement by the Minister of Health on the revised salary offer for Medical Professionals
24 June 2009

Ladies and Gentlemen
This is an extraordinary media briefing because we don't normally announce a package which is being negotiated in the Bargaining Council. We are forced to do this due to the events that have taken place during the past month, whereby there was a media frenzy and public debate about the payment of health professionals.  

I wish to reiterate the statement I made publicly that the medical profession is underpaid, and that is not up for debate because we know and accept it. I also wish to reiterate that health is one of our most important priorities,  and we  will do everything to make sure that our medical doctors and other health professionals are happy and remain in the system.

These medical professionals are providing an essential service to all South Africans and it is therefore important that their remuneration and working conditions are well taken care of.

One of the major challenges we face is the problem of major discrepancies in salaries of medical professionals. For instance in an attempt to attract and retain skills, provinces and institutions ended up paying medical professionals different salaries, especially in rural areas. Some provinces advertised positions at higher levels and ended up appointing junior doctors in those positions.

One of the main objectives of OSD, among others, is to have a single salary structure for all professionals according to their ranks, and not according to where they find themselves either in institutions or provinces. This does not mean rural allowances are being done away with.

The salary package in the public sector includes a Basic Salary, 13th Cheque, Medical Aid, Pension, Scarce Allowance, Commuted Overtime and in some instances Rural Allowance. Each employee has the prerogative to structure their package according to their needs. This whole package has been lost in the public debate. It is for this reason that we need to explain that it is not correct that there is an intern who earns R117 500 per annum. This amount is the basic salary package that excludes all other benefits. The minimum total package paid to any intern ranges from R205 604 to R239 744.

In the proposed salary package, we intend to collapse all the ranges into one. It is our pleasure to announce a salary package of R314 023 for an intern, which collapses the previous above range of packages into one, as we have said. This increment represents an increase ranging from 31% to 53%, with the lowest paid  receiving a 53 % increase and the highest paid  receiving 31%. This differentiated increase will enable us to address the gross inequalities that exist across the health system.

The proposed salary package for Medical Officers (Community Service) who are contracted for a year, will move from a range between R330 226 - R357 524 to a total salary package of R392 599. This represents a differentiated increment ranging from 9.8% to 18.9% to address the inequalities.

One of the most problematic areas of the present salary structure is that those who decide to study further, ( and therefore become registrars),  take a major drop in salary. This serves as a disincentive for further study among doctors. In order to address this , we are increasing registrar salaries by a percentage ranging from 18.3% to 60.1% to arrive at a salary package of R528 770, from a pervious package ranging  R330 226 to  R446 853.

Principal and Chief Specialists (Professors) have been very difficult to retain in the system due to their high level skill, and therefore high demand, locally and abroad. In our endeavour to retain them in the system, the proposed salary package is as follows:

Principal specialists- the package moves from R769 271 to R962 174, which represents 25.1% increase
Chief specialists (Professors) from R932 399 to R1.2 million, which represents 29 % increase

We wish to thank all the parties who have assisted us in developing these proposals, especially National treasury and the Department of Public Service and Administration.

While we acknowledge the delay in presenting this proposal for reasons beyond our control, the fact that we have now tabled these for negotiation, and therefore negotiations are now underway, without any declaration of a deadlock, means that we expect every individual to return to their work station.

We would like to thank the unions for their patience and understanding. However, we have no place for people who engage in illegal and wild strikes. We condemn mavericks who have sought to undermine negotiations, and hope that the Unions will bring all their members into line.