INSTITUTING disciplinary action on striking doctors would only worsen an already fragile health system in Zimbabwe, health experts have warned.
By Michael Gwarisa
Junior doctors in Zimbabwe abandoned their workstations early September, 2019 citing incapacitation as a result of the meagre wages which they say can hardly sustain their daily needs.
Government has since declared the job action illegal through a Labour Court victory but this however, has not moved the striking doctors with the medical practitioners maintaining that they are still incapacitated and a court order was not useful to their plight. Government has since commenced Disciplinary hearings for the striking doctors amidst indications that some might be served with termination of employment papers while another batch will only be getting written warnings.
In an Interview with HealthTimes, Community Working Group on Health (CWGH) Executive Director, Mr Itai Rusike said dialogue was the only meaningful solution to the prevailing impasse between government and doctors.
The Community Working Group on Health is greatly worried by the prolonged impasse between the doctors and the government due to the Incapacitation Crisis that has resulted in untold suffering of patients and even deaths that could have been avoided under normal circumstances. Sadly, even the dead bodies are also not being accorded the quick and decent burial they deserve as dead bodies are taking a long time to be certified dead and post mortem procedures are being delayed in the absence of doctors at health institutions.
“While we acknowledge the genuine grievances of the doctors and the financial position of the government, we would like to urge the two parties to put patients first and at the centre of their discussions to save lives and untold suffering,” said Mr Rusike.
The CWGH is currently facilitating dialogue between the Zimbabwe Hospital Doctors Association (ZHDA) and their employer the Health Services Board (HSB).
“We believe that any problem has a solution and dialogue still remains the best option to resolve this long outstanding labour dispute. There’s need for the ongoing disciplinary hearings to be set aside, give dialogue a chance by opening dialogue doors.
“As the CWGH, we would like to encourage honest dialogue that delivers solutions to the problems facing the doctors while at the same time prioritising the lives of the majority poor that rely on the public health delivery system. We should bear in mind that the majority of our junior doctors do not even have medical Insurance cover themselves despite the fact that their work is all about saving other people’s lives.”
He further called on government to allocate adequate resources to the Health Services Board and give it the autonomy that it rightly deserves to enable it to determine the salaries and conditions of services of health workers as per regional standards.
“We would like to see both sides exercising restraint during the dialogue, respect each other, show some leadership to urgently resolve the dispute and for the doctors to eventually go back to work for the sake of their patients not empty handed and feeling that there are losers. The high mortality rates in our hospitals is unacceptably high, unfortunately the absence of doctors has also affected the health seeking behavior as some people sick people are just staying and dying at home.
“This will also have a huge impact on maternal health as mothers with complications that may need to be attended at central hospitals may die or complicate. As the Facilitator and neutral mediator, we initially met with the Executive Committee of the ZHDA on Monday, met with HSB on Tuesday and then jointly met both the ZHDA and the HSB on Wednesday for a Roundtable Discussion and the meetings are continuing even though progress is slow mainly due to the lack of trust and suspicion between the doctors and their employer but the good thing is that there is dialogue happening,” he said.
However, top Human Resources expert, Dr Fidelis Tsvangirai said even though dialogue was the best solution to the current deadlock, the striking doctors had shot themselves in the foot by not attending the disciplinary hearing.
“I believe in the code of conduct in discipline management. The notification of the person to attend the hearing is of paramount importance and such notification has a clause which stipulates that if one doesn’t attend the hearing, the hearing will be held in absentia to the possible detriment of the respondent’s interest.
“The hearing authority can proceed to hear the matter and make a binding decision whether the respondent is there or not. The respondent will have to appeal against the decision if it is not favourable to them. My thinking is that since the issue involves essential services, dialogue could be the best way forward to break the impasse. The challenge is that the whole issue is turning to be political regardless of the merit in the complaints being raised by the doctors.”
He added that the issue of striking Drs can no longer be resolved effectively by a legal route because it involves a number of issues among them economic, social, legal and political.
“As it is, both parties are incapacitated and both parties owe the citizens healthcare service delivery. The legal route will only help to prolong the matter and deny the citizens what they constitutionally deserve. A round table is the best way forward. What really worries me is that the Drs’ behavior does not resemble that of employees but that of shareholders and this is putting the government in a position not to continue with much needed negotiations as Drs are deemed to be negotiating in bad faith.
“The Drs request to have their salaries indexed to USD is ideal but unsustainable because it will lead to a wage price spiral leaving everyone in the same position but with a fantastic payslip. Sometimes its important to put the generality of people first because this whole issue is impacting negatively on the general populace and it’s also turning politically ugly.”
He also said under such circumstances, nobody wins because, although highly advised, it is not possible for government to dismiss all striking doctors and neither can Drs have all their concerns addressed considering government’s strained budget. Negotiations are the best foot forward and or arbitration.