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posted 29 Oct 2015, 23:52 by Gerry Kangalee

Some of us might have forgotten that health sector reform is part of the total package of public sector reform, the intention of which is to phase out government's responsibility for the provision of health care, by gradually placing it in the hands of the private sector.

This has been happening before our eyes and we don't recognise it. That it is the reason for the back log of patients on various waiting lists for all kinds of surgical procedures. This situation and several others, such as health and safety issues, the unavailability of the necessary medical resources and so on, has created an environment of frustration for health workers in the Regional Health Authorities. When these institutions were established the stated intention was to bring about greater levels of efficiency in the public health system.                                                                                                               

When we read about the state of health care today, it does not appear to us that these stated objectives have been achieved. If you pay close attention, you will discover that the majority of health workers can no longer feel confident that there is security of tenure in any job in the public health system. This is because contract labour is the order of the day. In addition to which, the level of training once required in order to qualify for certain jobs has been watered down. The apparent reason for so doing is to place the holder of some of these jobs in a lower pay grade.

One does not have to utilise too much brain matter, to conclude that the reason is to create the conditions whereby, it would be easy to employ persons, with minimum qualifications, in these positions at a reduced cost.

There are many other problems facing health workers. Such as bed shortages, the breakdown of critical pieces of medical equipment and sometimes the overcrowding of Wards which makes it difficult for the wardsmaids to properly clean them. In the SWRHA for example, nobody wants to speak of the absence of a proper indexing system for the Stores Department. Then there is the alarming problem of staff shortages. As a result, many times you will hear Nurses saying, that they “crash” meaning that because of the excessive hours which they usually had to work; they suffered a physical and mental break down.

This situation is the result of the government’s decision to shift the responsibility to provide health care into the hands of the private sector. The public is now forced to spend large sums of money to access the services provided by the private medical institutions. In other words; the inefficiency of the public health system, is acting as a mobiliser of public support for the privatization of the public health system.

As a result, the task which is now facing the workers employed in the Regional Health Authorities is one which will challenge them to employ strategies with which to win back public confidence in the public health system. This is a task which must be carried out with the combined efforts of the workers, by simultaneously building the National Health Workers Union (NHWU), while demanding that the authorities abandon, immediately, their plans to privatize the public health system.

It must be understood that public confidence in the ability of the system to provide health care efficiently is critical  and is one of the yard sticks by which the system is measured. This is not a task to be carried out by a union with leaders who see themselves as the ones who make the world spin on its axis. It is a task which requires the active involvement of the workers to change the mindset of the management at all levels within the system.

That is what is meant by “building the union from the ground up.” It must be understood, that the concerns and desires of the public for efficiency in the public health system are identical to those of the workers. They both want the same thing.  An efficient health system guarantees job security for the workers and cheap health care for the public; especially the aged and differently-abled. When one examines what passes for trade union representation these days in the public sector one can say without fear of contradiction that a well organised and militant health workers union can certainly do a much better job.  And that is certainly the objective of health care workers who are involved in the task of building their own Union.

Of course, there are certain elements whose ego and selfish ambitions are causing them to believe that what is required is a leader who knows what is best for the workers. So that all you have to do as workers (as is the custom in certain unions) is to pay your union contribution and the leaders will take care of everything for you. What health care workers are building is a different type of union. It is one in which the members are expected to be actively involved on a day to day basis in the affairs of the union. It is a union in which it is expected that the branches will be the driving force. Therefore, it will be extremely necessary for the shop stewards and branch officers to be properly trained to carry out their functions and schooled in the true culture of trade unionism.

Health workers must not go back to the selfish trade union culture to which they once belonged. They must not allow persons who, by their recent actions, have demonstrated that they are hooked on that culture of selfishness to impose themselves upon the workers. What they need now, are persons who have years of experience in the job of representing workers and the selfless ambition to ensure that the health workers succeed in the task of building the union. 

There is no doubt in my mind that the National Health Workers Union is here to stay and that the impact it will have on the quality of health care in the country will be far reaching. It has to see itself as a partner of those non-governmental organisations (NGOs) that are the advocates in the cause of persons who are differently-abled as well as those who are suffering with lifestyle and life threatening diseases. It also has to take the lead in exposing all forms of dishonesty in the RHAs, because the holes in the system through which most of the badly needed supplies fall must be closed.

It is alleged, that some practitioners in the private health care sector with close links to the RHAs, subsidise their operations with those illegal items. It is alleged that these things have been happening for years and nothing is being done about it.

So as the NHWU strengthens its influence in the public health system, it must also become the voice of workers in the private health sector. That is a task in which workers in the Regional Health Authorities must become the leaders. This is not a job for individuals who use their positions to take time off to do everything else instead of using that time to build the union in their place of employment. Health workers can do without that kind of leadership.

What are needed now are leaders who can motivate the workers by building solidarity instead of division. There is an abundance of potential quality leaders within the heath sector waiting to come out and work in the cause of their brothers and sisters. The arrival of the NHWU on the trade union scene marks the beginning of a new era for health workers and for the improvement of public confidence in the system.