Opinion Piece: Debunking myths about labour broking in South Africa’s healthcare sector

PUBLISHED: Tue, 26 Jul 2022 09:07:24 GMT
Donald McMillan, MD at Allmed Healthcare Professionals
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For many in South Africa, the term ‘labour broker’ often recalls negative thoughts. The practice of labour broking has a chequered past which has left a bad aftertaste for most. However, much of the opposition to the practice of labour broking comes from misunderstanding as to what it really entails. The practice has evolved from providing casual unskilled and semi-skilled labour on an exploitative basis into a fully-fledged service offering that provides temporary placement opportunities for skilled workers, along with many of the benefits of employment. Now a highly regulated industry, many reputable Temporary Employment Services (TES) providers have found their niche in supplying skilled workers on a temporary basis, particularly where such skills are sought-after or hard to find. An example of this is the placement of skilled workers, such as healthcare professionals in hospitals and clinics to meet their fluctuating demands.

Rooted in misunderstanding

Generally, there is the mistaken perception that the only way for workers to achieve job security is through permanent employment. There is also a misbelief that the point of the temporary employment sector is to keep people out of permanent jobs and prevent them from achieving job security. This is not the case. In the healthcare TES space particularly, most nurses seeking temporary placements are already permanently employed. Here, nursing professionals are using TES placements to take advantage of the skills shortage to pick up additional shifts to supplement their income and address their rising costs of living. In addition, they are ensuring hospitals have the necessary staff at short notice to ensure patient care is maintained.

Balancing cost and quality

Healthcare institutions also need to address the rising costs of providing medical care without compromising on quality of care, and one of the most effective ways to do that is to achieve flexibility through a TES provider. Given the environment in which they operate, there is no predictability and there is no fixed permanent formula when it comes to ensuring the correct number of nurses are on duty at any given time, to avoid being over-staffed (wasted costs) or under-staffed (compromised quality of care).

Having a labour model that is quickly adjustable is the only viable way to handle staff facilities according to the demand. Consequently, hospitals now work on a model of permanent staff, and flexible, outsourced staff. This helps hospitals to fill the gaps due to fluctuating demands, absenteeism, or annual leave. It also gives permanent staff the opportunity to take sick or family responsibility leave, knowing that their shift will be adequately covered. This helps healthcare workers to avoid burnout and gives them the flexibility to tend to their family needs.

Finding common ground

Another misconception about TES providers is that they work against labour unions. Perhaps this is because temporary placements do not fit in with their business model of a monthly union membership fee associated with permanent employment. Regardless, it is worth pointing out that when it comes to helping healthcare professionals avoid unemployment and giving them an opportunity to fairly earn a living, TES providers and unions should be on the same page.

Healthcare TES providers welcome engagement with unions. In fact, there are tangible benefits for workers in doing so. There is a unique offering in this industry called a ministerial determination. This gives amnesty to employers by allowing the workers to choose whether the TES provider adds the annual leave provision Rand amount to the worker’s salary or the TES provider makes provision for the leave to accumulate for when the worker takes leave. The ministerial determination allows the worker flexibility of choice in making provision for annual leave which is part of the basic conditions of employment, and this is done through consultation with unions who provide their sign-off before it goes to the Department of Labour. Workers take annual leave through their primary employer, and therefore have the benefit that when they take leave, they are compensated.

Choosing freedom and flexibility

Along with this industry-unique benefit, many healthcare professionals choose TES as a career path, because it gives them flexibility. Not everyone is as concerned with job security, some prefer to prioritise their home or family life, and TES placements give them the ability to work when and where they choose. They also get the freedom of gaining experience in other hospitals, in other facets of the medical field, which helps prevent boredom and complacency and adds to their skill sets. With the current skills shortage in the medical sector in South Africa, specialist TES providers can only continue to play a critical role in covering the gaps, ensuring continued quality of care for healthcare institutions and flexible earning opportunities for healthcare workers.

Donald McMillan, MD at Allmed Healthcare Professionals

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