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The Eastern Cape is privatising the health and other sectors by stealth, and workers will be the victims


Mzikazi Nkata is a forensic pathology officer, member of the National Union of Public Sector and Allied Workers and local secretary of the South African Federation of Trade Unions, Saftu.

Service is being affected and patients are being turned away at some facilities in the Eastern Cape because there is no medication. This in a province with the highest unemployment rate in the country.

Last year I warned that the public sector wage freeze, coupled with cuts in government spending and the employment freeze, would not only result in greater levels of joblessness and inequality but would also result in a decline in the number of public sector workers. Not to mention the impact this would have on service delivery.

Following this, we saw an article by Dick Forslund that stated that in the South African Police Service “the number of personnel is expected to decrease from 181,344 in 2020/21 to 162,945 in 2023/24, due to natural attrition. Given the significant impact of the reductions on compensation of employees, non‐critical vacant posts will not be filled.” 

This is a reduction of the police force by 18,399 officers over two years, or by 10%. Forslund further states that in Correctional Services, “contracts for non-essential personnel will be terminated and natural attrition will be allowed to take place, leading to a projected decrease in the number of personnel from 37,836 in 2021/22 to 36,809 in 2023/24”. This is a reduction of 1,027.

As if this was not enough, on 16 January 2022, we as the South African Federation of Trade Unions (Saftu) in Gqeberha issued a statement in support of the rolling mass action by contract workers in the Department of Health. These followed after the health department took the decision not to renew the contracts for all essential Covid contract workers. The premise, as you can guess, is that there is no money to employ workers.

We as Saftu have shown and argued before that there is money and budget for this if you remove from the personnel salary system (Persal) workers who have long retired and those that have died. This is something we expected the MEC for finance to do when he bragged about embarking on a zero-based budgeting exercise. Instead, this was used as a tool to attack workers who are playing a very important role within our health system, while there are millions budgeted through the Persal ghost posts.

The majority of the staff in clinics are contract workers and because of this, we have seen some clinics in Nelson Mandela Bay being closed down, and many other clinics, like Wells Estate Clinic, face the threat of being closed if these contracts are not renewed. Emergency first-responder medical services will not have the capacity to service the whole of Gqeberha, its surroundings and other parts of the Eastern Cape as the majority of workers are contract workers. The same applies to community health workers, doctors, emergency service providers, nurses and other categories.

The cynics might say that this is a plot by government to privatise our health system, where private companies will take over our health services and make them a programme of the free market. And this deserves all the rejection it can get from each and every sector of society, as access to health is everything in a democracy.

The Eastern Cape Department of Health needs to consider making these posts permanent because there is money if you overhaul the Persal system. It is time to replace all the men and women who have left the department and redirect those millions into making all the Covid-19 health workers permanent. Health facilities are being destroyed by this privatisation and the use of NGOs instead of employing staff — this employment freeze in the public sector needs to stop.

This is something the country cannot afford. Not only will this mean bigger student-to-teacher ratios and a further understaffed public health sector leading to the further collapse of social services, it will also mean greater levels of unemployment. As we have said before, the budget cuts and the attack on the public sector will lead to greater levels of joblessness and deepening inequalities and the threat of completely putting the essential services provided by the public sector into private hands.

Already service is being affected, patients are being turned away at some facilities in the Eastern Cape because there is no medication, patients are encouraged by nurses to go and look for medicine in nearby clinics. This in a province with the highest unemployment rate in the country. And this does not look like it will be overhauled any time soon as the South African government has yet again borrowed about R11.4-billion from the World Bank — and we all know this means more cuts to government spend and increased levels of austerity.

This has happened despite the evidence that there is no need to go to the World Bank, government can borrow money from itself through the Government Employee Pension Fund (Gepf). The Gepf has just under R2-trillion in accumulated reserves. Every month workers contribute 6% of their salaries to the pension fund and the government contributes as well. Implementing a pension fund contribution holiday could be one measure to increase workers’ disposable income.

The government can use the Gepf further by borrowing from it at below-market interest rates. This will have several important advantages. Fundamentally, it will mean the government can consolidate its debt problem (the main argument behind the government’s austerity agenda), ensuring greater levels of resources for social spending and investment into infrastructure and job-creating programmes.

Communities of the working class and their allies really need to unite against the plot to privatise the public through austerity, as they are the ones who bear the ramifications of this — the signs of which we are already seeing. DM 

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  • David Bristow says:

    If your government does not build strong police, education and health sectors, they and you are stuffed. Methinks we are stuffed.

  • Gerrit Marais says:

    The only reason we still have anything worthwhile left in this country is through private ownership and initiatives. Why can Give of the Givers, Afriforum, etc. be so successful in areas where the government with all its resources, is failing so dismally. Nobody is obliged to create jobs. It is optional. Workers are there to fill jobs and if the economy can be relieved from this massive incompetent political interference and stupid rules, there will be more than enough employment and we shall all flourish. Just look around you – sort of beyond Africa though.

  • Sydney Kaye says:

    The situation you describe is the fault only of the incompetent and criminal ANC and the Trade Union support it enjoys . Instead of whining, wake up and vote against them.

  • Sam Shu says:

    I’m not sure you are correct on “privatization” as much as criminalization. These contracts with outsourced labour seem to land up with friends and family of officials. While health should be a govt function, at least outsourcing the clinics, as a whole, with goals and metrics, to medical groups in South Africa, would provide some competent health care

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