MPs leave nurses feeling angry and undervalued again
November 4, 2005
 By Terry Bell
Nurses around the country who consider themselves undervalued are even angrier this week because of what many see as another illustration of how they are taken for granted.
This time it is parliamentarians who are in the firing line. On Tuesday, when the long-awaited and controversial Nursing Bill came before the national assembly, it could not be voted on because there were too few MPs to make up a quorum.
So a crucial piece of legislation, affecting the group of workers the World Bank has characterised as "the most cost-effective resource for delivering high quality health care", was placed on the back burner
"We really don't even know how many nurses are available" |
. Because, as many nurses see it, many MPs fail to recognise the importance of their profession.
Not that nurses and their unions are enthusiastic about the bill. In fact, they complain that several of their careful submissions have been ignored.
"Yet we were given such an attentive and prolonged hearing by the parliamentary portfolio committee when we made our submissions," says Thembeka Gwagwa, the general secretary of the Cosatu-affiliated Democratic Nursing Organisation of SA (Denosa).
The Denosa submission included arguments against placing the regulatory body, the Nursing Council, under ministerial control. It also pointed out that the ill-defined proposal for community service for nurses seemed illogical and impractical.
"However, both those provisions remain in the bill," says Gwagwa.
The nursing unions had hoped that the move towards a new Nursing Act would signal the start of a more efficient and effective approach to nursing in the country where there are, officially, 180 000 registered nurses.
"But we really don't even know how many nurses are available or working as nurses in the country," says a National Education Health and Allied Workers' Union (Nehawu) shop steward.
Just how far out the official estimates might be was illustrated at a Denosa executive meeting last weekend. The Western Cape region of the union carried out a survey of practising nurses in their province. The results were tabled at the meeting.
"We had always assumed, based on official estimates, that there were more than 17 000 nurses in the Western Cape. But the region found that there are little more than 9 000 actually working as nurses," says Gwagwa.
The reason for the discrepancy is simple: the official figure for nurses is of all qualified workers who maintain their registration. Most appear to remain on the register even after retirement, or moving on to other work.
An increasing number of South African registered nurses are also working abroad. They join the estimated 14 percent to 19 percent of South African doctors working in other countries.
"I heard recently about an entire intensive care unit in one of Saudi Arabia's top hospitals that was staffed entirely by our nurses," says Gwagwa.
Nehawu and Denosa point out that this brain drain is continuing, despite confident comments by health minister Manto Tshabalala-Msimang that many nurses who had left were heeding appeals to return.
They also maintain that their contact with nurses working abroad indicates that they would be happy to return, but only under certain conditions. Pay does not appear to be top of the list, although it certainly features.
This is scarcely surprising, since, in real terms, the starting salary for a qualified staff nurse after four years of training has fallen by more than 4.4 percent over the past four years.
The same decline in real wages applies across all levels. What this means is that, after a 4.6 percent pay award in July, the basic salary of a staff nurse is now R75 412 a year or R6 284 a month. A staff nurse with 10 years' experience may earn R82 482 a year or R6 873 a month.
According to the unions, an improvement in salaries alone would not see many nurses returning from overseas posts.
What most expatriate nurses demand are major improvements in working conditions in often severely understaffed public hospitals.
In Mpumalanga, for example, figures quoted at the Denosa executive meeting were that 46 percent of nursing posts are now vacant.
The consensus view is that the local nursing shortage is even more chronic than the official figures show. "To talk of our public hospitals being understaffed is a gross understatement," says Gwagwa.
But there seems little the nurses can do to force the issue since, as an essential service, they may not go on strike.
Adds Gwagwa: "However, I think this is a gender issue too. Nursing is still largely a profession of women and so it is undervalued in our society."
Strike prohibitions notwithstanding, she warns: "I think those in authority should remember an old slogan: 'Wathint'abafazi, wathint'imbokodo' - When you strike the women, you strike a rock."
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