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BONU, MoH trade threats over 'call to duty'

Nurses.
Nurses.

As complaints in the form of petitions and other means continue to pile up before the new government, nurses and midwives don't want to be left out.

Having had several court battles under the previous regime, they are now hoping the new one would hear their lamentations. Botswana Nurses Union (BONU) has accused the Directorate of Public Service Management (DPSM), the Ministry of Health, and the District Health Management Team (DHMT) of adopting an approach that exploits nurses and midwives. The union said the said health workers have been subjecting to prolonged working hours without compensation, against the Employment Act and international labour best practices.

To that end, BONU has resolved that it is in the best interest of its members to adopt a strict adherence to the judgment of the Court of Appeal (CoA) on the ‘Call to Duty’ policy until such a time that the ministry agrees to negotiate over the development of a framework and guidelines and to compensate the members accordingly. DPSM in late 2023 partly succeeded in their pursuit to quash an Industrial Court order that would spell the discontinuation of the ‘Call to Duty’ for nurses or pay overtime as per a prior Industrial Court judgment by Justice Galesite Baruti. A panel of three CoA justices Modiri Letsididi, Goemekgabo Tebogo-Maruping, and Tshegofatso Mogomotsi, concurred in a ruling that the employer’s appeal succeeds in part in respect of two parts of the Industrial Court order, which must reflect that the time spent on call by the nurses and midwives be regarded as working time and where appropriate as overtime if they are required to be physically present at the health facility. The government, through the DPSM, lost the case against the nurses and decided to lodge an appeal in an attempt to cling to the long-standing ‘Call to Duty’ practice, which the nurses have argued is an abuse they have endured for a long time.

The CoA made the determination that there is a distinction between active and non-active on-call duty and by virtue of this distinction, nurses and midwives who are rostered to be on-call, are only considered to be working when they are physically present at their workstations. Essentially, the time that nurses and midwives spend away from the workstation whilst waiting to be called for duty is not deemed to work and as such, they are not remunerated or compensated for such time.

According to BONU Publicity Secretary, Kenosi Mogorosi, other employees in the public service who render the same essential services as nurses and midwives, are paid both overtime allowances as well as standby allowances as compensation for the time they work beyond their stipulated work hours and whilst awaiting to be called for duty (standby). “To wit, this approach seeks to justify the failure to compensate nurses and midwives for the time spent on stand-by through alleging that such time is provided for by the 30% commuted allowance. This approach ignores the practical reality that, when nurses and midwives are rostered to be on-call, they are unable to commit their time (which has been ruled to be time off duty or free time) to any other personal or private activity,” he said. Mogorosi bemoans that nurses and midwives are compelled to remain posted in the vicinity of their workstations to ensure that they can attend to patients when called upon to do so. He said it is on this basis that the CoA observed and commented that there must be negotiation over compensation for this personal time that is unduly taken away from them without compensation whatsoever. He further decries that despite their numerous and persistent calls for dialogue and negotiation, the ministry has blatantly refused to negotiate these serious terms and conditions of service. “The ministry has, without any reasonable cause or basis, failed and/or refused to bargain over the development of a framework or guidelines for the on-call duty to ensure that there is a reference point for nurses and midwives when performing such duty,” he said.

This has called for BONU to encourage strict adherence to the court judgment, something which could cripple the health system. The union advised that nurses and midwives who are rostered to be on call that there is no legal requirement for them to remain within the vicinity or radius of their workstations whilst on call as this is their free time. As such, they are at liberty to travel or use their time as they please. “The only duty imposed by being rostered on call is to answer the call and avail their services when called upon to do so. To that end, nurses and midwives are advised to answer such calls and communicate their location for the ministry and DHMT to transport them to attend to the duty,” he said. Mogorosi said there is no requirement for nurses and midwives to use their personal resources or transportation to travel to workstations when rostered on call, as such, the ministry and DHMT shall consequently have to make arrangements for them to attend to their duties. “BONU is fully aware of the prejudice that the public at large will suffer as a result of this strict adherence to the current terms and conditions of service, however, it is a necessary step aimed at ensuring that the ministry and DHMT act accordingly to ensure that nurses and midwives are not subjected to cruel, exploitative, and unfair labour practices,” he said. In response, the Ministry of Health says it was aware of the divergent views on the call to duty matter, between itself and the employer (DPSM) on one hand, and BONU, on the other.

However, the ministry didn't expect that BONU would advise its members not to perform their call-to-duty functions at this point. “This is because the December 2024 meetings held between the three parties resolved that this issue be referred for negotiations and final determination by all the parties,” Chief Public Relations Officer in the ministry Dr Christopher Nyanga wrote. Nyanga said the ministry wrote to BONU, advising them to withdraw the statement, because it was ill-advised and was bound to cause confusion within the nursing fraternity and panic within the communities that they serve. The ministry, therefore, advised nurses to continue performing all call-to-duty functions as before. “Not doing so, will be in violation of not only their conditions of service but also their professional conduct and ethical obligations to the patient. Should there be any developments in this matter, all the concerned parties, not just one, will make an official announcement as to the way forward,” he said.

BONU in response to the ministry has since said until such a time that the ministry gives the welfare of nurses and midwives the serious attention they deserve, all members should continue using their free time, however, they desire. “If the ministry wishes to benefit from the time and resources of our members, they must negotiate an appropriate set of rules and a framework that will deal away with all forms of exploitation. BONU isn't shocked by the ministry’s ill-advice statement, it's a desperate attempt to salvage a situation they have failed and/or refused to resolve through the relevant forum,” Mogorosi, the BONU publicity secretary wrote.

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