The Public Servants Association (PSA) has urged KwaZulu-Natal (KZN) MEC for Health, Nomagugu Simelane, to immediately start the process of confirming the permanent appointment of Community Health Workers (CHWs), in line with a recent Labour Court ruling.

The ruling dictates that these workers be afforded permanent status. This critical step will ensure that CHWs will receive benefits such as medical aid, pension, and other social protections that come with permanent employment.

“For over a decade, CHWs have worked under recurring fixed-term contracts with no job security or benefits. They have played an essential role in the healthcare system, especially in under-served communities, where they deliver critical services such as health education, maternal and child health, and chronic-disease management. Despite their immense contributions, CHWs have been deprived of basic worker rights, including the ability to access financing and healthcare owing to their short-term contract status. Many have been unable to afford medical aid, pensions, or insurance, leaving them vulnerable,” said PSA representative, Mlungisi Ndlovu.

Last week, Minister of Health Aaron Motsoaledi said crippling budget cuts affected the government’s capacity to hire, as well as perform a large number of functions. Last year 800 unemployed doctors petitioned the Department of Health for vacancies, with only 270 having been appointed across the country.

“The government is only allowed to absorb students just out of university doing internships and community services, and not to absorb unemployed doctors. If the state advertises posts, you can apply. If the post is in the private sector, you can apply. If you want to open a private practice, you can do so,” said Mr Motsoaledi.

The PSA said the judgement was a significant victory for CHWs and the public health system, recognising their importance and ensuring that they can enjoy the benefits and protection that are essential to a dignified working life. The ruling underscores the need for fair treatment and decent work, as supported by International Labour Organisation principles.

The PSA reiterated that the MEC should immediately start the process of ensuring that all eligible CHWs are permanently appointed.

“This includes providing a clear timeline for the transition, making budgetary provisions, and ensuring that all CHWs are integrated into the Department of Health’s permanent staff structure,” Mr Ndlovu said.

He said the PSA is committed to supporting this process and will monitor and address any delays or attempts to obstruct the implementation of the ruling. The Union is also engaging with CHWs at clinics and healthcare facilities across the province to explain their rights and outline the steps in the transition to permanent status. Workshops and information sessions are being held to ensure that affected workers understand the process and are prepared.

“The PSA further calls on the Department of Health to engage in dialogue with the Union and CHWs to ensure a smooth and efficient transition. These workers should not be affected whilst bureaucratic processes drag on. Immediate action is required given the critical role CHWs play in healthcare, particularly as the country moves forward with the National Health Insurance (NHI) initiative,” said Mr Ndlovu.

The PSA expressed their concern about potential delays and reviews by the Department of Health that could derail the progress made by the ruling.

“Government departments often use perceived vast resources of the state to frustrate such processes to the detriment of workers. The PSA will not stand by whilst the rights of workers are undermined, and will explore all avenues, including legal recourse, to ensure that CHWs receive their rightful permanent status without delay,” Mr Ndlovu said.

As South Africa prepares for the full implementation of the NHI, it is essential that CHWs are adequately supported, properly compensated, and equipped to continue their vital work, Mr Ndlovu added.

He said their permanent appointment was a critical step towards building a strong, capable, and well-compensated healthcare workforce, which is necessary for the success of the NHI and the delivery of quality healthcare to all South Africans. The PSA is committed to upholding the rights of all public servants, especially those who are most vulnerable, and will continue to advocate for fair treatment, dignity, and respect in the workplace, said Mr Ndlovu.

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