In a desperate attempt to stem growing strike action among public sector doctors, health minister Dr Aaron Motsoaledi yesterday (Wednesday) made public the offer government would be taking to the bargaining chamber.
Motsoaledi's media briefing came as reports confirmed that the strike action was widespread in KwaZulu-Natal and rapidly spreading to all corners of the country with many doctors only attending to emergency cases as they waited for details of government's final offer.
Doctors are demanding a 50% increase while Motsoaledi's offer included increases of up to 60% depending on individual salary packages which could differ massively. However, doctors warned that government's latest offer merely lumped extras such as overtime, pension and scarce skills allowances into the package, creating the impression that they were offering much bigger increases.
Motsoaledi said that one of the major challenges they faced were the major discrepancies in salaries.
He said that in an attempt to retain skills, provinces and institutions ended up paying medical professionals different salaries in a desperate bid to retain and recruit doctors, especially in rural areas. He said some provinces advertised positions at higher levels and ended up appointing junior doctors in those positions.
Dr Mark Sonderup of the South African Medical Association's Western Cape branch said it was a pity that the minister had announced something that was not yet tabled in the bargaining chamber.
"Only once it has been tabled in the chamber does it become a reality and can we interrogate it," he said, adding that Western Cape SAMA members would go ahead with their lunchtime meeting today (Thursday) to decide on the way forward.
Motsoaledi acknowledged in the media briefing yesterday (Wed) that they did not normally announce a package which was being negotiated in the bargaining council, but they believed that some of the figures in the media were totally incorrect and misleading and needed to be clarified to avoid further confusion.
He agreed that public sector doctors had been underpaid for a long time and committed himself to improving the working conditions of medical professionals.
The health department said the salary package in the public sector included the basic salary, a 13th Cheque, medical aid, pension, scarce skills allowance, commuted overtime and in some instances a rural allowance.
The minister said each employee has the prerogative to structure their package according to their needs, but that "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," Motsoaledi claimed.
Motsoaledi said that in the proposed salary package, government intended to collapse all the ranges into one.
He said this would translate into a package of R314 023 for interns, representing an increase ranging from 31% to 53% - this meant that those being paid more at present would receive a smaller increase as opposed to those being paid much less.
"This differentiated increase will enable us to address the gross inequalities that existed across the health system," said Motsoaledi.
The proposed salary package for Medical Officers (Community Service) who are contracted for a year, will move from a range between R330 226 to R357 524 to a total salary package of R392 599.
According to the health department statement this represented an increase ranging from 9.8% to 18.9%.
"Principal and Chief Specialists (Professors) have been very difficult to retain in the system due to their high level skill and high demand locally and abroad," said Motsoaledi.
This group will be offered the following salary packages:
Principal specialists- the package moves from R769 271 to R962 174, which represents a 25.1% increase
Chief specialists (Professors) from R932 399 to R1.2 million, which represents a 29 % increase
Motsoaledi said that one of the most problematic areas of the present salary structure was that those who decided to study further took a major drop in salary. Government has offered to increase registrar salaries by between 18.3% and 60.1% to arrive at a salary package of R528 770 (from a range of between R330 226 and R446 853).
Motsoaledi said that no dispute had been declared and urged every doctor to return to their work station while negotiations continued.
"We would like to thank the union for their patience and understanding. We have no place for people who engage in illegal and wild strike. We condemn mavericks who have sought to undermine the negotiations and hope that the union will bring all their members into line," he said.
Dr Bandile Hadebe, Chairperson of the Junior Doctors Association of South Africa said that the minister's statement meant little at the moment and that they would be waiting for the bargaining council outcome.
"The decision to strike was not only motivated by salary increases and that is all he has focused on," said Hadebe.
Dr Bongiwe Ndebele, Senior Medical officer at Port Shepstone Hospital said they demanded a 50% increase across board or nothing while Dr Themba Mtshali, a Community Service doctor at KwaMhlanga Hospital, said they were waiting for a resolution from the bargaining chamber before they decide the way forward.
Round up of the latest developments across the country:
Strike meetings on Thursday at Helen Joseph and Rahima Moosa hospitals.
Mthatha hospital meeting daily to decide if strike action needs to be stepped up.
Western Cape doctors meeting on Thursday at Groote Schuur Hospital.
Steve Biko hospital meeting on Wednesday afternoon to decide if they will join strike action on Thursday morning.
Striking Stanger Hospital staff threatens to suspend emergency services as well if they continue to be intimidated.
Between 400 and 500 doctors at King Edward hospital join the strike.
Over 200 doctors at Northdale hospital join in.
Doctors at Shongwe hospital decide to offer only emergency treatment until they have more clarity on the bargaining chamber outcome.
Tonga, Rob Ferreira and Themba hospitals in Mpumalanga join the strike.
Chris Hani Baragwanath and Charlotte Maxeke hospitals decide to wait and see what the bargaining chamber delivers.