Community health workers campaigning for permanent government employment face an ongoing battle, with the Western Cape Department of Health and Wellness (WCDHW) confirming that there is currently no policy decision to employ them directly as permanent public servants.
The department’s response comes as members of the National Union of Public Service and Allied Workers (NUPSAW) prepare to continue their campaign for better employment conditions and greater job security through demonstrations across Cape Town.
The workers want the department to employ them directly rather than through non-profit organisations (NPOs), arguing that their current arrangements leave them financially vulnerable, without benefits such as medical aid and pension contributions.
Department maintains current employment model
Responding to questions from TygerBurger, the WCDHW said it recognised the contribution community health workers (CHWs) make to healthcare services and acknowledged the importance of employment security, working conditions and personal safety.
“WCDHW also recognises that employment security, working conditions and personal safety are important concerns for CHWs and their families, and remains committed to constructive engagement on these matters,” the department said.
However, the department confirmed that its current model, under which CHWs are employed by contracted NPOs providing community-based health services, remains in place.
“There is currently no policy decision to employ CHWs directly as permanent employees of the Western Cape Government,” it said.
The department added that it remained committed to strengthening community-based healthcare services within the existing framework.
Union continues to push for permanent jobs
The employment dispute has seen community health workers and NUPSAW members stage demonstrations in recent months, including a picket outside the Bishop Lavis Police Station, where about 50 union members and workers employed by The Caring Network gathered to highlight their demands.
The campaign has also included earlier demonstrations in Bonteheuwel and a march to the Western Cape Provincial Legislature in April.
NUPSAW provincial organiser Jabu Khanyile previously said: “We are demanding to be permanently employed by the department of health.”
Community health workers provide frontline support in communities, assisting residents in accessing healthcare, promoting disease prevention and helping link households to health services.
Workers argue that their contribution should be matched by more secure employment arrangements and access to benefits. They have also raised concerns about the risks involved in delivering services in areas affected by gang violence.
Department confirms engagement with union
Asked whether it had met with NUPSAW to discuss the workers’ demands, the department said it had engaged organised labour on matters relating to community health workers.
“WCDHW has engaged organised labour, including NUPSAW, on matters relating to CHWs and has provided feedback through the relevant labour relations structures,” it said.
The broader issues surrounding community health workers’ employment had also been discussed through provincial and national collective bargaining structures, according to the department.
Although the department acknowledged the concerns raised by workers and organised labour, it reiterated that its existing NPO-based service delivery model remained its approved approach.
Safety concerns in gang-affected areas
The safety of community health workers remains another concern, particularly for those delivering services in communities affected by gang violence.
The department said the safety of people providing healthcare in communities was a serious concern. However, it explained that community health workers were employed and managed by contracted NPOs, with operational supervision and coordination provided through those structures.
“WCDHW provides oversight of the contracted community-based services,” the department said. It added that specific operational safety arrangements could differ according to local circumstances and should be addressed with the relevant employing NPO.
Where safety concerns affect the delivery of contracted health services, these can also be raised through the department’s contract management and oversight structures.
Protests amid ongoing employment dispute
The department said it acknowledged the concerns being raised by community health workers and organised labour and remained committed to engagement through the appropriate structures.
It also stressed that its current employment model remained in place while it continued engaging stakeholders on the sustainability of community-based healthcare services.
The latest response comes as workers continue their campaign for permanent public sector employment. Dates and locations for all planned October demonstrations have not yet been confirmed.
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