Mixed reactions over Gauteng jobs campaign and what it may mean for health

Mixed reactions over Gauteng jobs campaign and what it may mean for healthIn June, the Gauteng government launched a major employment drive called Nasi iSpani that is also punted to address some staffing gaps in the health sector. PHOTO: GCIS
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In June this year, the Gauteng government launched a major recruitment drive called Nasi iSpani. As explained on Business Live by Gauteng Premier Panyaza Lesufi, the Nasi iSpani programme is part of “Growing Gauteng Together 2030”, a strategy adopted in 2019 to create an economically inclusive Gauteng city region. “We want to position the province as a place of opportunities and grow its economy from R1.7 trillion to R3 trillion, halving unemployment to reach 15% by the end of the decade,” wrote Lesufi.

According to Statistics South Africa, in the second quarter of 2023, the unemployment rate in the country stood at 32.6%. In Gauteng, it was 34.4%.

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The Gauteng government says that through the campaign thousands of jobs will be offered, ranging from drivers, receptionists, cleaners, artisans, construction managers, communication officers, health practitioners, agricultural advisors, and engineers, to chief financial officers.

A political ploy?

Some, however, have labelled Nasi iSpani as nothing more than a political stunt before next year’s national and provincial elections. Opposition parties the Economic Freedom Fighters and Action SA have both asked questions and leading political commentator Justice Malala has referred to the initiative as a “jobs scam”. Lesufi has rejected such suggestions.

Rich Sicina, President of the Health and Allied Workers Indaba Trade Union says that the programme is not addressing the staffing gaps in Gauteng’s public health sector.

“This Nasi iSpani programme is not a genuine job creation programme. It’s a political stunt. It’s electioneering by the ANC because they see that they have lost the plot. And that 2024 is around the corner,” he says. “Why is this programme now and not there four years ago?”

“Nurses are sitting at home as we speak,” he says, “doctors are sitting at home as we speak. We need general workers in our system. We need allied workers, radiographers, and kitchen staff. We need a lot hence we are still complaining, even today, about the gross shortage of staff as far as health is concerned.”

Sicina tells Spotlight that it also worries him that National Treasury has announced cost containment measures that include, among others, the freezing of posts. “But all of a sudden, the Gauteng government has money to employ thousands of people every month, which raises a question of where does the money come from? Where will they get money to employ the people they are talking about?”

Jack Bloom, DA MPL in the Gauteng Provincial Legislature. PHOTO: Thom Pierce/Spotlight

Jack Bloom, health spokesperson for the Democratic Alliance in the province, stresses that there is a real need to fill skilled medical positions in the Gauteng Health Department, including nurses, doctors, and specialists. However, he tells Spotlight that community health workers have already been made permanent workers, so there is little scope to expand employment there.

“Some of those on the special COVID contracts were retained, but not all. The Nasi iSpani programme is largely an ANC election ploy that diverts attention from ANC mismanagement and corruption that ruins our health system,” Bloom says.

Prof Judith Bruce, Visiting Professor at the School of Therapeutic Sciences in the Faculty of Health Sciences at the University of the Witwatersrand (Wits), is also not happy with this kind of recruitment “As far as I know, this is not the way nurses are recruited into the health system, and actually, nursing should not be considered as a way to ‘alleviate poverty and unemployment’ in our country, which is what I believe the Nasi iSpani programme is all about. It spells very bad news for the profession, patients, and the community,” she says.

nusre walking in a hospital corridor
According to Statistics South Africa, in the second quarter of 2023, the unemployment rate in the country stood at 32.6%. In Gauteng, it was 34.4%. PHOTO: Rosetta Msimango/Spotlight

Others were more optimistic.

Bongani Mazibuko, the Gauteng Regional Chairperson of nursing union DENOSA, says, the programme mitigated what was a dire shortage, although there are still gaps.

“The gaps in the health care system will not be corrected until they address the issues of the staff complement and how [many] personnel are needed to offer services at the different institutions,” says Mazibuko. “ We have received reports of newly appointed nurses who have since joined DENOSA, and we know that not all posts have been filled yet.”

According to Mazibuko, the programme has done what the union has always advocated for – for all vacant funded posts to be filled. “The premier [started] a good initiative. Now the department must address the problem of the organogram.” According to him the department must update the organogram and be specific about how many nurses are needed in which hospitals and also be specific in terms of the categories of nurses – for example, how many specialist nurses, how many enrolled nurses – are needed.

He further says that services have been extended in most hospitals but staff has not been augmented. “You have fewer people trying to do a lot more than they can manage,” he says.

According to Dr Sue Armstrong, a lecturer at the Department of Nursing Education at Wits and Chairperson of the Nursing Education Association, there are certainly newly trained nurses who have not been employed after their community service year, which is a tragedy as we have an acute shortage of nurses.

“The reason given by the government is that they do not have the finances to employ them and now the German government is employing our nurses when we really do need them. So, I guess if there is funding available through this project, it does have the potential to assist, but if the government does not have the money and the Premier is part of the government, why does he have the money[for all these employments]?” she asks.

“We are not training sufficient nurses at present – have not for some time now – and the situation is worse since the change in nursing curricula, which in turn required accreditation from the SA Nursing Council, which is happening at a very slow rate for a multiplicity of reasons, she says. “We need a longer-term funding plan for nursing together with a concerted joint effort by all stakeholders to resolve the problem, but if there is a short-term injection of cash, it may be useful in the short term to get some nurses back into the system.”

Russell Rensburg, Director of the Rural Health Advocacy Project. PHOTO: Spotlight

But Russell Rensburg, Director of the Rural Health for Advocacy Project says, “To date, I haven’t seen any evidence that previous initiatives have led to more employment within the health sector.” According to Rensburg, it needs to be clear where the budget line is and what process the Gauteng government is using to appoint all these health workers and those who were employed during COVID-19.

Gauteng health responds

According to Motalatale Modiba, spokesperson for the Gauteng Health Department, the kind of health-related jobs being filled through Nasi iSpani range from categories such as clinical and clinical support, nursing, administration, and administration support. He says the jobs range from entry-level posts to highly technical ones.

“All departments are an extension of the Office of the Premier as they implement the programme of action agreed to by the Premier and his Members of the Executive Committee (MECs). The Department of Gauteng Health and Wellness and the Office of the Premier are working together to identify funded vacancies that must be filled to enhance service delivery in the health facilities around Gauteng province,” says Modiba.

Currently, according to Modiba, as a result of Nasi iSpani, “there are as many as 8 000 Community Health Care Workers that were appointed permanently by the department. The estimated budget for the said posts is R22 550 108 [and these] posts are budgeted under the Cost of Employment budget.”

He tells Spotlight that of the healthcare workers who were employed during COVID-19, over half of them were given new contracts earlier this year in line with the grant funding that the department received from the Treasury. “The plan by the department is to fill all the vacant funded posts,” he says. “All former COVID-19 employees, including those that were given contracts from the grant fund, were encouraged to apply for the Nasi iSpani advertised vacancies.”