Z+Vavi+to+NEHAWU+Public+Service+Delivery+Summit+and+Campaign





=Input to NEHAWU Public Service Delivery Summit and Campaign=

//Zwelinzima Vavi, General Secretary, COSATU, April 2006//

 * Dear comrades and friends from the labour movement, the Alliance and the State.**

Let me start by expressing our gratitude for the opportunity to address this summit.

We are pleased that NEHAWU is once again on the move. It is through innovative initiatives of this sort that NEHAWU used to provide a well thought out way forward for the federation on so many issues. For a while, as we all know, the union was in turmoil and we missed their leadership.

Last year I proclaimed that NEHAWU is on its way to recovery. Today I want to say NEHAWU is right where it belongs - leading from the front row in the federation and providing a unique and strategic input on tactics and strategy, not only to be followed by the federation but by the entire working class. NEHAWU is back to its original place as the generator of new thinking for the federation. This is pleasing indeed for it means we are succeeding with our 2015 plan that centres around strengthening the working class.

We particularly welcome the chance for the Alliance to exchange views on such strategic issues as the transformation of the state, and in particular the health system. These are vital issues for all South Africans and all working people, and the Alliance must be able to set the broad direction.

If the Alliance had this type of discussion on other important issues, we would certainly make more progress in meeting the needs of our people. The Alliance should be a resource that lets us hear our people and work collectively to respond to their demands. We need to use it more for that purpose.


 * Comrades and friends,**

The objectives of the national democratic revolution (NDR) will not be realised if we fail in our attempts to transform the state and all its institutions. We inherited a state that was developed to serve the interest of a small minority. At the same time, it was an instrument to humiliate our people, to suppress the rights of workers and the majority of South Africans. We are seeking to create a new state that will help us realise our strategic role in building a better life to all.

In this context we have said in the past that public servants are the arms and legs of the RDP. Without well trained, well motivated, happy and well paid public servants we may as well kiss that NDR itself good bye.

Our glass is half empty and half full. Since 1994 the new government introduced a series of measurers to address pertinent issues relating to restructuring of the public service. Quite clearly we have gone a long way to ensure that we develop new ethos such as //batho pele// to gear the public service to serve all including the previously disadvantaged.

Yet the glass is half empty because despite the progress we made, many public servants are still under tremendous pressure, arising out of chronic staff shortages and under investment. This has led to many clashes with almost all unions the sectors of the public service. A few weeks ago we were celebrating the return of about 500 correctional services staffers dismissed for protesting against the chronic staff shortages.

The fact is that the main problems with service delivery lie outside the control of our public servants. They arise from the failure to transform inherited, oppressive and unaccountable management systems; the lack of resources in many sectors, including the main services like health; and understaffing especially in historically African institutions and areas.

A major problem remains the lack of career mobility for most public servants. Elementary workers in the public service have never had real career paths that would provide incentives for improving their competencies as well as hope for their own futures. Now, with the ending of rank and leg promotions, we have ended clear career paths for our professionals. Only education has remedied this problem, although we agreed to deal with it more than six years ago.

We cannot expect our public servants to balance these problems just by working harder and being more dedicated. Workers also suffer when public servants are not as dedicated to public service as they should be. But we cannot blame just individuals - we have to understand how the environment leads to disillusionment and poor service.

We must address both problems - the culture of lack of service, in particular to the poor, and the environment that leads to that, so that continuously, in a real partnership with our government, we can motivate all public servants to ensure that they change attitudes and serve our people. //Batho pele// is meaningless under the current circumstances in most of the cases. That’s how important this conference is.

That is why COSATU has long called for sector summits to look at the main public services – health, education, the justice system, welfare and housing. The problems differ from sector to sector. We can only come to grips with the fundamental causes of inadequate service delivery and democratisation if we look at what is happening at sectoral level.

This meeting is also important because of the on-going crisis in our healthcare system. That crisis has two critical aspects.

First, most South Africans still do not get adequate healthcare. Around our country, we have hospitals without medicine or clean linen, clinics without staff, and long queues for any form of public healthcare.

Second, the crisis of HIV and AIDS has added to the burden on the health system. In some hospitals, half of all patients have HIV as an underlying condition. Responding to the epidemic is a major challenge for the health sector, and it has not lived up to our expectations. In particular, the roll-out of anti-retrovirals and provision of training for health professionals to cover HIV has been far too slow. Meanwhile our people are dying when they could be saved, and infections continue to rise.

We cannot blame a lack of resourcing for the crisis in the health system. If we count both public and private health together, South Africa already spends more on healthcare than most comparable middle-income countries.

The problem lies rather in underspending in the public sector, which services 80% of our people, and overspending on private health care. The result is worse public health, appalling working conditions for most health workers, and unacceptable service for our people. The problems in the public health system reflect in an intense form the major difficulties blocking the transformation of the public service as a whole.

The public health system continues to struggle against the understaffing and underfunding that began under apartheid. Before 1994, it was covered up by discrimination, with first-class facilities for whites and, especially in the homelands, almost nothing for Africans. Now that the public service must serve all the public, not just a minority, the gaps are showing up. GEAR imposed terrible damage with its cuts, and the increases since then are not enough to put the system right.

Meanwhile, in the private sector, costs have been soaring for patients. Our unions negotiate for health insurance for our members, as a long-standing demand. But workers cannot afford the current rates.

The bottom line is that the private health system is far too concentrated, expensive and exclusive. Increasingly, it is a burden for our members and for the economy as a whole, as it pushes up health costs without ensuring improved healthcare for our people. It absorbs our health professionals to serve a minority, but contributes almost nothing to public health campaigns or human resource development. And naturally it does not serve the poor and unemployed, who cannot pay.

The Department of Health is exploring privatisation of health care for formal-sector workers in order to increase funds for the health system. It labels its proposals social health insurance, although they have little to do with social health insurance as it has long been known in the labour movement.

We as COSATU have serious problems with the government’s current proposals.

First, they rely on private health insurance rather than a national fund. By making ordinary workers joint private schemes, it would increase the cost of healthcare for workers and for society as a whole. Remember that almost half of all formal workers earn less than R2500 a month. They cannot afford to pay more for healthcare.

Second, the government’s current proposals would only improve funding for the public health system by forcing workers out of it. A central belief is that workers should be shut out of public health so that there is more money left for the unemployed and destitute.

That is hardly an acceptable solution. We want a public system that ensures that every South Africa has decent, adequate healthcare. We have long rejected privatisation of health care, because that inevitably means that healthcare – which is a right under our Constitution – would become dependent on income and wealth, rather than need.

For our part, we as COSATU have long proposed a National Health Insurance System (NHI). This would be a genuine social health insurance system, with contributions from all who can afford to pay and management through the state. The aim would be, not to increase total funding for health, but to use the existing funding more effectively. By combining the funds now spent in both the public and private sector and using them more equitably, we would achieve decent standards for all our people and be able greatly to improve public health outcomes.

The call for an NHI system informs COSATU’s demands for the proposed Health Sector Charter. In particular, we want to make private providers support service provision and public health efforts even for those who can’t pay. They should share underutilised resources and personnel at cost. That would begin to equalise resourcing across the health system.

Because health is so important for our people, we plan to table the Health Sector Charter at NEDLAC. These crucial issues cannot be negotiated behind closed doors, without stronger involvement from the key stakeholders – above all, the public who depend on the health system.

Still, self regulation like the Charter can only make limited progress. We still look to the state to direct the private health sector more effectively to ensure more affordable access for all our people. We support the principle of strong regulation of the private health sector, particularly to prevent duplication of equipment and control the costs of medical schemes and medication.

In the past, however, some government regulations have been poorly consulted and thought out. Future efforts should be discussed first within the Alliance, and should avoid putting unnecessary burdens on our health professionals.

Besides regulating the private sector, we need to explore qualitatively new, collective structures to provide healthcare. We have experience with union and bargaining council schemes that provide affordable, comprehensive primary healthcare for workers. Can we duplicate these experiences on a larger scale? Similarly, we need to explore community and co-operative health insurance schemes, which can ensure greater participation and more affordable services.

Finally, as this Summit demonstrates, inadequate funding is not the only problem in the public health system, although it certainly contributes to most of its weaknesses.

Other problems include the lack of a well-organised system for skills development for health professionals. We have seen downsizing in nursing schools at a time when we need thousands more, not less, nurses. The lack of an agreed on career path adds to the problem.

A related issue is the failure to ensure a hospitable environment for health workers. The public system cannot and should not compete with the private sector on the basis of salaries alone. But we can do more to ensure that our workers, including doctors and nurses, feel welcome and appreciated. That requires, in particular, adequate career mobility, time for professional and skills development and a reasonable burden of work.

Last but by no means least, management in the public sector remains largely hierarchical and oppressive. We need to develop more open and respectful systems, which value workers’ inputs and ensure a flexible, focused response to the needs of our nation. We need to ensure that supervisors and managers are trained in personnel management, not just their professional fields.


 * Comrades and friends,**

The challenges faced by the health sector are substantial. This type of meeting, bringing together the democratic movement to discuss strategic issues, must play a central role in addressing them.

We as COSATU are glad and proud that NEHAWU took the initiative to call this Summit. We are sure the work here will inform engagements with the state, in the Bargaining Council, and on the Health Sector Charter.

Congress of South African Trade Unions 1-5 Leyds Cnr Biccard Streets Braamfontein, 2017
 * Patrick Craven (Editor, Shopsteward Journal)

P.O.Box 1019 Johannesburg, 2000 South Africa

Tel: +27 11 339-4911/24 Fax: +27 11 339-5080/6940 E-Mail: patrick@cosatu.org.za**


 * April 21, 2006**


 * Media statement**


 * For immediate release**


 * __Nehawu Statement on the 1st Day of the Service Delivery Summit__**

The Nehawu Public Service Delivery Summit is proceeding well.

On this 1st day, the summit amongst others, received an executive summary of the research report prepared by the NALEDI (labour‘s the research institute) on the Chris Hani-Baragwanath Hospital project.

The project was initiated by Nehawu five years ago with a view to creating a model people’s hospital that will be service orientated. The presentation of the research findings is part of the case studies on the state of service delivery that are being considered by the summit. They will inform the campaign platform and the campaign demands that the union will be announcing on the last of the summit on Sunday. The NALEDI research report, amongst others, found that in the case of Chris Hani-Baragwanath hospital there is:

- Poor or dysfunctional management and management systems. - Lack of capacity in management, which has led to a paralysis. - Management by silos, where every occupational group has its own management and there is no one who takes overall responsibility for the management of the institution. - There is a critical shortage of staff across categories and most importantly amongst professionals such as nurses, doctors, pharmacists etc.

The study also found out the critical contributor to the staff shortages is the fact that the management of the hospital has prepared staff establishment based on a 1500 bed capacity, whilst the current bed capacity of the Chris-Hani Baragwanath hospital is actually 2800.

This is scandalous in the view of NEHAWU.

The findings of the research report will be factored into the campaign platform that we will be announcing on the last day of the summit. End


 * Issued by NEHAWU Communication Department**


 * For further information, please contact Tebello Mokoena at 082 332 1369**

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