Trying to plug the brain drain

A groundbreaking move by South Africa's health department could see nurses being paid at least 20 percent more, becoming the first beneficiaries of a plan to attract more healthcare students and keep homegrown skills home with higher salaries.

After the recent month-long strike by public servants, Health Minister Manto Tshabalala-Msimang announced an across-the-board increase of at least 20 percent for public nurses, as well as improved medical coverage and housing subsidies.

As part of this new "occupation specific dispensation" system, doctors, dentists, pharmacists and emergency care workers would move to a similar pay system next year, while all other public health professionals would see substantial increases by 2009.

The recent industrial action - South Africa's longest public service strike - ended on 28 June, but not before bringing the country to its knees: health workers, teachers and government employees took to the streets in protest; state hospitals were forced to transfer patients to private facilities and discharge all non-critical cases.

In South Africa it is illegal for members of essential services, such as the police and medical personnel, to strike. Tension mounted when government countered the unions' initial demand of a 12 percent hike with an offer of only 6 percent; a mutually agreed 7.5 percent increase brought the strike to an end.

A newly qualified professional nurse would now enter the public health sector at a salary of R96,750 per year (about US$13,900), which is R17,343 (about $2,500) more than that person would have received before July 2007," Tshabalala-Msimang said.

While all nurses will receive an increase of at least 20 percent, they will also have additional opportunities. "Nurses will now have an opportunity to progress to higher salary levels, based on performance, education and accumulation of skills," she said.

Pierre Uys, provincial health minister for the Western Cape Province said nurse educators had received special attention in the new system and would receive R159,000 (about $22,800) annually, in an effort to increase the country's capacity.

"Previously, nurse educators earned a salary parallel to that of professional nurses, which meant it was always very difficult to attract them to the field," Uys said. "We now hope to attract a small but qualified group of people."

According to the South African Nurses Council, the country produces approximately 2,500 nurses per year, but a 2006 study by the Centre for Global Development found that more than 4,844 were working overseas. At least 12,207 South African health workers in total - including an estimated 21 percent of doctors produced in the country - were practicing abroad in 2006.

The health department continues to identify "brain drain", or the emigration of skilled health workers, as a continuing trend.

While South African rands may still not compete with British pounds, Uys said the new increase would at least put public health salaries on a par with the private sector in South Africa.

Although the details were still being finalised in talks between the government and health worker unions, such as the National Education, Health and Allied Workers Union (NEHAWU), and the Health and Other Service Personnel Trade Union of SA (Hospersa), union officials were pleased.

"Negotiations are still continuing, we are still working out the translation keys between the new and old salary structures to determine where everyone will be but, so far, we're happy," said Rifos Mahlake, a Hospersa negotiator.

The talks are expected to conclude by 31 August - overshooting the original 31 July deadline by a month - said James Cornwall, chief negotiator for the public health and social development sectors, but nurses would still receive the increase retroactively from 1 July.

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