16 Mar 2015

Parliament has rejected a motion by Selebi Phikwe West MP, Mr Dithapelo Keorapetse requesting government to delink health workers from the civil service.

Presenting his motion on March 13, the MP said given the numerous challenges of the country’s health care system, there was a consensus on the need to reform the system.

“To a large extent it can be argued that by being part of the civil service, the specific needs of health workers and the efficient delivery of health service functions in Botswana have been lost in the general public service machinery. This calls for consideration of delinking health workers from civil service and setting up an independent Health Commission to run the health sector,” he said.

Mr Keorapetse argued that the de-linking of health workers from the public service would offer more flexibility, addressing key issues that were usually associated with a centralised civil service.

 He said it would provide the Ministry of Health with autonomy to control the size and use of its budgetary provision, and enable the health workforce to be directly employed by a decentralised body with some level of independence from government. 

However, the Minister for Presidential Affairs and Public Administration, Mr Eric Molale said the Bargaining Council was better placed to deal with part of the gist of the matter in the mover’s motion. 

“The Bargaining Council is a product of our efforts here as Parliament.  We must give them the opportunity to look at the matter and discuss it and make recommendations as is the norm,” he explained. 

Mr Molale admitted that autonomy in management was important, but he reminded MPs that heath service was a “public good” and it could not be left to a autonomous body not directly accountable to the public.

“I do not think that having a separate act will in any way make the system more efficient than it is now. I must hasten to also say that the new Public Service Act that commenced in May 2010 came about as a result of extensive consultation amongst various services that existed at that time,” he added.

The minister said the associations and unions, including the Nurses Union were saying that fragmentation of the public service creates an unfair sector where there were lots of inconsistencies. Mr Molale said they agreed and accepted that the inconsistencies forced government to come up with unaffordable interventions.

For his part, the Minister of Youth, Sport and Culture, Mr Thapelo Olopeng said delinking would not solve existing challenges such as salary structures amongst others. The MP for Mochudi West, Mr Gilbert Mangole said the health sector was a specialised department that needed attention. 

He said the current system led to many health professionals being lost to other countries. Goodhope-Mabule MP, Mr James Mathokgwane said ruling party MPs were against the idea of beneficiation when it started but later realised it was a good idea. 

He said the working conditions of health workers were demoralising and compromised the system.  Gaborone Bonnington South MP, Mr Ndaba Gaolathe said delinking was part of a much broader solution to reform the health system.

“The need to reform is inspired by the need to move into the future. We must set up an affordable framework and we look at three things, configuration of health structure, management practice and regulation of the environment. He said an autonomous regulator was needed. ENDS