The National Education, Health and Allied Workers’ Union [NEHAWU] calls on notes the tabling of the Health Budget Vote for the financial year 2023/24 by the Minister of Health, Dr. Joe Phaahla in the National Assembly.

The budget vote is underwhelming and reflects the overall health crisis that confronts our country’s healthcare system. Most importantly, the budget vote thoroughly confirms our long-held assertion that the government is hell-bent on intensifying its austerity programme. This has directly hindered the capacity of the state to provide quality healthcare services to our people and this is evident with the Health Budget for the financial year 2023/24. 

The Minister indicated that the 2023/24 budget allocation for National Department of Health shows a decline of R4.4 Billion from R64.5 Billion in 22/23 to R60.1 Billion in 2023/24, these cuts are occurring amidst crisis levels of challenges facing the healthcare service. The decline in budget allocation for health has an impact on improving our health system. We therefore strongly condemn the cut and reduction of the health budget by government.

The budget does not reflect the strategic deployment of resources for the implementation of the National Health Insurance (NHI) to guarantee universal access to healthcare for all citizens of this country. In fact, this budget confirms the wholly false position of the National Treasury that the National Health Insurance (NHI) is a risk to its fiscal framework.

On the Human Resources for Health [HRH], we are deeply concerned with the impact that this budget will have on the implementation of the HRH policy and strategy. Currently, there are about 39 000 vacant posts in public healthcare. In terms of the Human Resources Strategy for the Health Sector: 2030, “an additional 97 000-health workers, with Community Healthcare Workers [CHWs] comprising around one third would be required by 2025”. This budget is completely contradictory to the National Department of Health’s (NDoH) own policy and directly undermines the objectives of the HRH Strategy.

We firmly reject and dismiss the notion by the Minister, Dr. Phaahla that government is currently working through long-lasting solutions to appoint Community Health Workers (CHWs) permanently. This Minister has lied to the public, in fact, the NDoH and the National Minimum Wage Commission are planning to establish a sectoral determination for CHWs, going against Section 55 (7) (a) of the BCEA, which provides that the Minister may not publish a sectoral determination – covering employees and employers who are bound by a collective agreement concluded at a bargaining council. If the Minister is serious about the PHSDSBC processes, he must denounce all processes aimed at establishing a Sectoral determination. Whilst Minister Phaahla praises frontline workers during the battle against COVID-19, he also prescribes further uncertainty and insecurity to CHWs.  

As NEHAWU, we once again reiterate our position for the permanent employment of CHWs who must be integrated into the public health system. Currently, the integration of these workers into the public health system has not been achieved. Their employment is still fragmented which makes them vulnerable to exploitation.

The Minister made mentioned of the fact that National Treasury acknowledges that the NDoH is underfunded by R11bn, but fails to mention the context of this underfunding, more particularly as it relates to the National Treasury’s unilateralism over the public sector wage agreements. This shows a clear de-link in policy planning and action between national departments.

We call on the government to prioritise the rebuilding of the deteriorating public health infrastructure. In this regard, government should implement the National Health Infrastructure Plan in order to respond to the changing population, epidemiology and clinical dynamics.

As NEHAWU, we wish to invite the public to join us in pursuit of our Public Service Delivery campaign aimed at exposing the negative impact of austerity measures to the health of citizenry, while at the same time aimed at improving the healthcare system to deliver quality health service to the sick and communities as recipients. 

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Issued by NEHAWU Secretariat

Zola Saphetha (General Secretary) at 082 558 5968; December Mavuso (Deputy General Secretary) at 082 558 5969; Lwazi Nkolonzi (NEHAWU National Spokesperson) at 081 558 2335 or email: lwazin@nehawu.org.za