It appears our legislators have no interest in either probing a bit deeper into the workings of the health system or debating the sector from policy perspectives and offering alternatives. The Minister of Health must be one frustrated individual, if all the legislators could say to her was to increase the salaries of the doctors and nurses and improve their conditions to prevent them from going to greener pastures, and stop workers from stealing drugs, especially expatriates. Surely if our MPs think the problem of international migration of health professionals can simply be solved by raising salaries, then we are in trouble.
Why am I saying this? The question of inadequate salaries has been brought up by MPs from as far back as I can remember- 1970s, 1980s, 1990s up to now. It is almost like the current ones simply read what their predecessors said and repeat it. Two things puzzle me; firstly, there seems to be no attempt on the part of our legislators to analyse the evolution of salaries, absolute and relative, of health workers from a historical point of view, so that they can back up their statements with some kind of figures and time series. Secondly, they also do not try to do some comparative analysis and offer alternatives- what is the wage bill in the health sector, how does it relate to the per capita expenditure by Government on the sector for example what percentage of the health expenditure goes into personal emoluments, how does that compare internationally and so on, and lastly if the expenditure on the health sector were to be increased, for example to 10 percent or 15 percent of the Government budget, would they want to see the bulk of that going to salaries? Botswana actually on a per capita basis is among the top two spenders on health care in SubSaharan Africa; would the MPs want this money spent in a particular way to strengthen institutions in the sector and improve efficiency or would it just be enough as far as they are concerned, to simply increase the salaries of nurses and doctors and everything will be okay.
