Doctors unfazed as gov’t announces ‘no work, no pay”

Innocent Selatlhwa | Monday June 16, 2025 12:01

But BDU on the other hand is unmoved and continues to rally its members to take only one call per month. The two parties early March settled a matter in which DPSM had whisked BDU to court to compel doctors to attend emergency call duties beyond 24 hours in a month. Through a consent order, the two reached consensus and agreed to begin talks. They would start negotiations on May 10 and before the May 20, 2025 deadline, the parties had decided they could not find each other and the matter was thus referred for arbitration. It had also been agreed that whilst the negotiations are ongoing, all BDU members would be attending to emergency calls as rostered. However, once the talks failed, BDU advised its members to revert to doing one call per month.

However, government would not react to the communication by BDU until this week when the Permanent Secretary in the Ministry of Health, Professor Oatlhokwa Nkomazana wrote a letter to BDU informing it that their members who do only one call in a month would have their 15% commuted overtime and emergency call allowances deducted in loss. 'We refer to the ongoing discussions and the agreed-upon path to resolve the impasse concerning emergency call duties for essential service wokers, involving the Ministry of Health (MoH), the Directorate of Public Service Management (DPSM), and the Botswana Doctors Union (BDU). We appreciate the collective efforts made to date, including the mutual consensus to engage independent arbitrators to facilitate a resolution.'

In the letter, Nkomazana states that while they have ongoing discussions with BDU and had a mutual consensus to engage independent arbitrators to facilitate a resolution, there continues to be a directive for BDU members to undertake only one call per month and to disregard established On-Call rosters. Such a directive, she says, may constitute actions inconsistent with the provisions governing essential services. “In light of these developments, please be advised that the MoH and DPSM have, regrettably, resolved to implement the 'no work no pay' principle. This will entail the immediate halting of Emergency Call and Doctors Commuted Overtime Allowances for all doctors identified as having worked only one call per month and/or refused to work scheduled call, effective April 2025,” she stated. This measure, she says will remain in effect until further notice or until such time as the matter is satisfactorily resolved through the agreed channels. “We remain committed to the arbitration process and encourage all parties to uphold the integrity of this crucial mechanism for dispute resolution,” she stated. BDU would on the day (June 11, 2025) immediately respond, with a press statement dated June 6 digging their heels in. The union through its president, Dr Kefilwe Selema reaffirmed its commitment to ensuring that essential and emergency services continue uninterrupted, in line with their professional and ethical obligations during the arbitration process. However, Selema said they are deeply concerned about proposals that demand unlimited emergency call duties without appropriate compensation, rest, or negotiation. “We note the government's current intention to continue paying a 15% emergency call allowance, which - based on existing operational practice - translates one emergency call per doctor per month.

Any attempt to increase the workload beyond this, without a proportional increase in remuneration or rest time, would violate the principles of fair labour practice under Botswana's Employment Act; breach the spirit of good faith bargaining particularly during arbitration; and jeopardise patient safety due to fatigue and overwork,” he stated, adding that it could also result in the exploitation of public service doctors, whose rights deserve equal protection under law. Selema further highlighted that during facilitated negotiations, the government offered increases, which did not reflect the intensity or value of emergency call work. He said the current 15% structure must not be manipulated to extract disproportionately higher workloads from already stretched medical professionals. He further stated that BDU proposes that, during the period of arbitration, each doctor will perform one emergency call per month, including foreigners. “It is further expected that interns, residents and specialists be protected during this period. University of Botswana and Medical internship Training programme is clear on training and expectations on performance of emergency call. The government shall maintain the current 15% allowance, with no unilateral changes. Any further call demands must be negotiated and compensated fairly,” he stated.

Selema said the position ensures continuity of care while protecting both doctor welfare and patient safety. He said it balances national interest with lawful labour practice. “We urge the government to avoid actions that may erode public trust or undermine arbitration and pursue constructive dialogue. BDU remains open to solutions in the interest of both doctors and the nation,” he concluded. On April 6, BDU decided to embark on minimum service provision for emergency calls across the country. The union announced that they had, on April 3, 2025, given the government 72 hours to engage and finalise an emergency call to ensure non-disruption of health service provision across the public healthcare fraternity. But the employer did not heed the call, engage, or even respond, thus giving the impression of a non-caring partner. BDU would, as of April 7, 2025, in what they termed protecting its members against exploitation by the government by doing one emergency call per month that will equate to 24 hours. Doctors were also to ensure minimum staff availability per hospital per call, and where there is no coverage, the employer party would use the public-private partnership at their discretion. The government through DPSM then whisked BDU before the Industrial Court, accusing them of inciting a strike.

The impasse resulted in a good number of doctors across the country not showing up for work. The DPSM, acting on urgency, sought an order directing BDU to cease and desist from causing, procuring, counselling, or influencing its members, who are employed in the public service under essential services, from breaching their contracts of employment and/or committing an offence in terms of the Trade Disputes' Act, Cap. 48:02. They also wanted the court to direct and order BDU to intervene and/or take reasonable steps to ensure that their members who are employed in the public service under essential services and/or who render essential services do not otherwise conduct themselves in an unlawful manner.