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Salary review for health workers
Tamar Kahn, Science and Health Editor
2006-06-20

CAPE TOWN As a three-year agreement granting special allowances to health- care professionals with scarce skills and those placed in rural areas draws to a close, the health department has embarked on an overhaul of the remuneration packages of the entire sector.

The agreement has seen approximately R1bn allocated to scarce skills and rural allowances for more than 50000 health-care professionals since July 2003 as part of governments efforts to retain staff in public hospitals and in clinics.

Research published by the Health Systems Trust last year showed 27% of public sector posts for health-care professionals stood empty, amounting to about 46000 jobs.

Doctors and nurses frequently quit for better pay and working conditions in the private sector or overseas. A 2003 study by the Organisation for Economic Co-operation and Development found there were 23407 medical professionals from SA working in Australia, New Zealand, Canada, the US and Britain, while a third of the countrys hospital posts for doctors stood empty.

The health departments head of human resources, Percy Mahlati, said the allowances would remain in place at least until a new remuneration system for health-care professionals had been finalised with trade unions and the department of public service and administration. The national treasury had assured the department that there was further funding for the allowances provided to the provinces as part of their share of the budget.

Critics of the allowances say they have failed to retain significant numbers of doctors and nurses in the public sector, and had sown division among staff.

KwaZulu-Natals former head of health, Ronald Green- Thomson, told Parliament in April that while the extra money was welcome, it had neither attracted nor retained health-care personnel in significant numbers.

Mahlati conceded that the scarce-skills allowances had experienced mixed success, noting that they had been most effective with doctors.

But not everyone is covered the bulk of nurses are excluded, he said.

The rural allowances range from 8%-22% of annual salary, depending on area and occupational category. The scarce-skills allowances range from 10%-15%. This is equivalent to rural allowances for doctors of between R22572 and R27588 a year, depending on location, and scarce-skills allowances of R18810 a year. Employees can get both allowances if they qualify.

Health-care professionals were unhappy that the allowances were not pensionable, said Mack Lukhele, of SAs largest doctors organisation, the South African Medical Association.

We want the money included in basic salaries he said. Western Capes head of health, Prof Craig Househam, agreed:We believe a consolidated package that does away with commuted overtime and rural and skills allowances, would be better. Special attention needed to be paid to nurses remuneration, he said.

Even here in the Western Cape we struggle to maintain our numbers, he said.


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