On 12 March 2018, members of five unions – Denosa, Nehawu, PSA, Hospersa and Nupsaw – held an overnight sit-in at the Gauteng health department’s Johannesburg offices. They wanted their outstanding performance bonuses for the last two years.

“Failure to see a solution to this two-year-old matter unfortunately leave the unions with no option other than embarking on a complete shut-down of services in the department by withdrawing our labour,” warned Denosa’s Simphiwe Gada back then.

A few days later they marched to the department. In April, workers followed through with their threats by protesting at Johannesburg’s Charlotte Maxeke Johannesburg Academic Hospital. On Thursday they escalated the protests.

They burnt tyres at the hospital, blocked entrances, and threw rubbish on the ground. Non-emergency operations were cancelled and only 19 of 50 operations scheduled for the day proceeded. Patients and non-striking workers were intimidated.

Health Minister Aaron Motsoaledi and Gauteng Health MEC Gwen Ramokgopa condemned those who sacrificed health services at one of the country’s largest hospital over a labour dispute.

They didn’t, however, take ownership for the cause of the strikes: the mismanagement of the provincial department and its financial crisis. They were warned and they didn’t act. Worse, Thursday’s Charlotte Maxeke protests were a result of the provincial department’s failures.

Arriving on the scene, Motsoaledi said: “This was a sheer act of hooliganism. I really believe that some people must be arrested. No matter how justifiable your grievance, you don’t do that to sick people.”

Gauteng Health MEC Gwen Ramokgopa was quoted: “For me, this is another Life Esidimeni unfolding and I hope that all of us as a society will stand up and say ‘not on our watch’.”

The Life Esidimeni example is apt, but not in the way Ramokgopa suggests.

At least 144 patients died after the department callously moved them from private psychiatric facilities into NGOs and home care in 2016. The Gauteng health department, and particularly its top officials, were to blame.

On Friday, Nehawu Gauteng Chairperson Lulamile Sibanda said unions had been in discussions, through meetings and sessions in the bargaining chamber, for two years over the department’s failure to pay performance bonuses.

In October 2017, the department made commitments to pay, he said, which it did not honour. That led to the sit-in and march earlier in 2018. Sibanda said the department didn’t arrive at a meeting on 18 May at the bargaining chamber nor did it attend a meeting to discuss picketing rules after workers declared a dispute.

The department got a court interdict to prevent further protests at Charlotte Maxeke, which meant little when workers decided they’d had enough.

Thembi Madonsela, a hospital cleaner who has been working at the hospital for 26 years, said on Thursday that workers want what is due to them. “I get to work on time every day and do my job despite the fact that I work a job that should have been worked by two people. It is frustrating because on the top of it we are not getting our performance money.”

Madonsela said that other government departments received their money and it is only Gauteng department of health workers that did not receive the performance bonuses.

“We want 2016/2017 and 2017/2018 performance bonuses. It is our money and we work hard for it. As it is, our salary is not enough. You get paid on the 15th and on the 16th it is already finished. The tax has increased, things have increased and the performance bonuses make a huge difference in our lives. That money assists us in things like paying school fees and paying off our debts,” said Madonsela.

She added that there are other grievances such as poor services, lack of resources, and workers not being promoted. “I have been working for 26 years standing at the same level. We do not have enough cleaning machines, washing liquid and we are short staffed,” explained Madonsela.

Unions and workers hadn’t been paid what was due to them. They engaged their employers for two years and felt their bosses were negotiating in bad faith. They warned they would go on strike. Then they did.

Gauteng health spokesperson Khutso Rabothata wouldn’t comment on Friday on why workers at the hospital had not been paid the money due to them for the last two years. He said he couldn’t comment while meetings continued with labour leaders.

Speaking in May, Ramokgopa condemned the protests the previous month and said discussions were ongoing on when workers would be paid their bonuses. She made it clear that the department didn’t have the money to cover what it owed from 2016/17.

The MEC has said she is working on improving the Gauteng department of health’s finances since she was appointed in 2017, but the situation remains dire and healthcare users, staff and service providers continue to bear the brunt of the unbalanced books.

“The department as it is, ironically, is in ICU. It is on the brink of financial collapse,” said Nehawu’s Sibanda. He said it was irresponsible for Motsoaledi and Ramokgopa to criticise the workers while not acknowledging the anger they had caused.

In March, the DA’s shadow health MEC Jack Bloom said Premier David Makhura had failed to improve the department’s finances. “Every year he has announced a ‘turn-around plan’ for the Gauteng health department, but the payment arrears keep growing and so do the medical negligence claims,” he said.

At that stage the department owed over R5-billion to service providers while medical negligence claims stood at R18-billion. The provincial government talks of cutting down on corruption but we’re still waiting to see the Special Investigating Unit’s completed report, launched in 2010, into corruption under former health MEC Brian Hlongwa.

Those who trashed Charlotte Maxeke hospital should be condemned and held accountable. But health services would never have been disrupted if the department was able to manage its finances and honour its commitments.

Advocate Adila Hassim, who represented the families of the patients who died as a result of the Life Esidimeni move, recently warned that a similar catastrophe could occur: “This is because, despite protestations, the Life Esidimeni story is not exceptional. It is an inevitable consequence of a system of public governance that is broken, a public service that does not serve.”

That goes for workers as well as patients.

Services had returned to normal at Charlotte Maxeke on Friday and Sibanda said the department had offered to pay workers’ 2016/17 bonuses by June and the 2017/18 bonuses within the next three financial years. DM