South African Unions Claim Big Eskom Pay Victory!

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Nurses demanding decent pay. Now that the NHI has been passed, more people can be treated in public hospitals but will the funds be available for salaries, wonder some of the health professionals’ organisations

THE NATIONAL Union of Metalworkers, the National Union of Mineworkers and the Solidarity union have won a ‘a strategic victory for workers’ after South Africa’s state power utility Eskom signed a three-year pay deal.

Eskom Holdings SOC Ltd. agreed to pay its workers 7% annual increases under the accord, against an inflation rate of 6.8 per cent.

Africa’s most industrialised economy has been subjected to rolling blackouts since 2008, known locally as loadshedding, because the state-owned company’s old and poorly maintained plants can’t keep pace with electricity demand.

The protracted pay talks have aggravated that problem.

Irvin Jim, the general secretary of the metalworkers’ union, said: ‘All of us have got our backs against the wall in that there are crippling rolling blackouts in the country that are sabotaging the economy, that are sabotaging jobs. The deal is a strategic victory for workers.’

Employees will also get a 7% increase in housing allowances and a one-off 10,000 rand ($548) payment in the second year of the deal.

Jim said the departure of Andre de Ruyter as Eskom’s chief executive officer in  December helped smooth the path to reaching an agreement with the new management more open to settling the dispute.

The new deal will avoid wage negotiations for the next few years.

‘It will maintain stability in the organisation, so Eskom and its employees can focus on dealing with load shedding,’ a spokesperson said.

Meanwhile, last Tuesday 13th June, the National Assembly adopted the National Health Insurance (NHI) Bill and the Congress of South African Trade Unions (COSATU) has welcomed it.

The confederation said in its statement: ‘COSATU and the overwhelming majority of workers are in support of an NHI. The majority of South Africans, in particular the working class, lack access to quality and affordable health care. This is not due to lack of resources but to their blatantly skewed distribution.

‘South Africa spends 8.5% of its Gross Domestic Product on healthcare. This is higher than many industrialised and peer nations. However, half of this is spent on the 16% of society fortunate enough to have medical aid. The other half is spent on public health care for the 84% dependent upon the state.

‘As a result, we have 1st class but under-utilised private health care available for 16% but charged at exorbitant prices and public health care overwhelmed with long queues, critical post vacancies, aging infrastructure and shortages and thus battling to provide basic health care for the 84% of society.

‘Consequently, many workers and their families are infected and dying from easily preventable and manageable diseases. Even workers fortunate enough to have medical aid, battle to afford to pay the ever-increasing medical tariffs. Most workers’ medical aids are depleted halfway through the year, and they are saddled with unaffordable co-payments. They are often forced to forego necessary but unaffordable treatment.

‘The reality is that South Africa’s public and private health care systems are broken and unsustainable.

‘It is critical that the NHI Bill now be processed and passed by the National Council of Provinces.  Government needs to move with speed to resource and build a quality NHI that will guarantee quality, accessible and affordable universal health coverage for all South Africans. Internationally the equivalents of an NHI have worked well and provide positive models for South Africa.

‘We simply cannot afford to be a nation that 29 years into democracy still grapples with the blatantly unequal and racially skewed distribution of resources and access to health care.

‘The right to life and access to health care is a constitutional right. It is time that all South Africans are afforded this right.’

There were 205 members of Parliament (MPs) who voted in favour of the NHI Bill and 125 who voted against it in the National Assembly on Tuesday.

Only 16% of South Africans are covered by a medical aid scheme, while 84% depend on 49% of resources from the fiscus and services provided by the public health system only.

Healthcare labour unions Democratic Nursing Organisation of South Africa (Denosa) and the National Education, Health and Allied Workers’ (Nehawu) said they supported and welcomed the move to pass the bill.

Denosa KZN chairperson Sibonelo Cele said: ‘Days of the “poor schemes for the poor” and “rich schemes for the rich” are over. It’s been long awaited because more people depend on meagre resources with the current arrangement.

‘With the envisaged changes, the health system will be able to give better healthcare to more people, especially those who don’t or barely afford it as things stand,’ he said.

Echoing Denosa’s sentiments, Nehawu spokesperson Lwazi Nkolonzi said Nehawu supported the full implementation of the NHI as it seeks to transform historical injustices and structural inequalities caused by the former apartheid state.

‘We re-emphasise our position on the NHI, that if the South African health system is to overcome the challenges it is presently faced with, strengthened political support is needed so that financing can be restructured and the roles of both the public and private sector can be redefined.

‘Access to quality healthcare is a right not to be delayed any further by private sector interests, whose only concern is profiting from people. The NHI Bill has gone through extensive public consultations and scrutiny by the Portfolio Committee on Health,’ he said.

Health practitioners in KwaZulu-Natal agree that the bill had good intentions to ensure universal health coverage; however, they have also raised concerns on how it will be implemented ‘considering the poor level of state services’.

Head of the discipline of public health medicine at UKZN, Professor Saloshni Naidoo, said all South Africans, irrespective of status, were expected to have access to healthcare.

‘Ideally, it should mean better healthcare for all. However, our situation is not ideal. We have a struggling public healthcare system, under-resourced and with serious infrastructure problems.

‘There remain several questions around how NHI will be implemented. Details of processes are what government must provide for us to better understand how this will happen and for us to be able to say that we are moving in a positive direction,’ she said.

Health professional and deputy chairperson of human rights organisation Active Citizens Movement, Dr Kapil Narain, said there were many genuine concerns surrounding the passing of the NHI, especially considering the poor level of state services and inept leadership.

He said there was certainly the possibility of maladministration and corruption as witnessed with the Covid-19 pandemic.

‘However, I feel this bill is in principle a powerful step towards achieving universal health coverage, in realising that health is a human right, and in ensuring we “level the playing field”. It is a defining moment in South Africa’s health landscape.

‘Implementation is a grave challenge and may not yet be realised for years to come. Healthcare workers, fellow citizens and civil society must hold government to account.’

Meanwhile, the SA Institute of Race Relations (IRR) said South Africans should be deeply alarmed that the bill was approved without knowing how much it will cost.

According to IRR campaign manager, Mlondi Mdluli, there was no certainty that ‘NHI taxes’ will be reserved for NHI purposes, rather than used for general government spending.

The bill will now be submitted to the National Council of Provinces (NCOP), and SA could comply with Universal Health Coverage (UHC), which will give all people equal access to the full range of quality health services they need, when and where they need them, without financial hardship.

Health Minister Dr Joe Phaahla described the passing of the Bill as a ‘historic’ moment.

This in itself is a major milestone. We’ve been on this path over a long period, almost 12 to 14 years.

‘Starting with policy development, it was also delayed by the advent of the pandemic after it was submitted to Parliament.’

Phaahla said the NHI Bill, which was introduced in Parliament in 2019, laid a foundation for major reforms needed in the country.

‘It’s a major milestone in a sense that since the advent of democratic South Africa, in the health sector, we focused on improving access from the time of president Nelson Mandela.’

The urgency of the health bill is highlighted by the outbreak of cholera noted by COSATU in the Free State at its June 15th executive committee.

Its statement noted: ‘What we find unpalatable is the fact that this outbreak is linked to contaminated water that is being utilised by our communities.

‘We find it completely unacceptable that our communities are still struggling to access clean and running water from the taps.

‘We call on the Department of Water Affairs and municipalities to ensure that our people are supplied with clean and safe water. We call on the Department of Health to speed up the interventions to eradicate the outbreak!’