By Peter Sinkamba
The decision by Health Minister Dr. Chitalu Chilufya to ban medical staff from engagement in the private sector is further proof that the PF Government is out of touch with the background of health policy reforms and realities on the ground. It is also further proof that Dr. Chilufya is not only autocratic but also jealousy of achievements made by his colleagues who have benefitted from the moonlighting policy which was introduced post the1998 health sector crisis.
It is really a pity that autocracy and petty jealousies in the PF Government are driving policy agenda in the health sector.
Put simply, Dr. Chilufya is a national liability on medical services delivery. The earlier his autocracy is stopped from single-handedly reversing gains of medical policy reforms, the better for the nation.
As will be recalled, beginning in mid-1998, the public health sector was rocked by a series of work slowdowns, protests, and strikes organized by the Zambian National Union of Health and Allied Workers, which decried the deterioration of health facilities and supplies and demanded payment of delayed salaries and introduction of hardship allowances and other benefits including moonlighting. These upheavals climaxed with a nine-day strike at the University Teaching Hospital in Lusaka in June 1998, but soon became widespread throughout the country. A simultaneous crisis developed concerning district and hospital management boards, several of which were dismissed by the Minister of Health in the second half of 1998.
The dismissal of the boards occurred amidst allegations of financial mismanagement by the boards, and counter-allegations of discrimination and autocracy on the part of the minister. The ultimate outcome was a profound crisis in the functioning of board management, particularly as regard to human resources in the Zambian health sector, which threatened viability of the reforms. The outcome was massive exodus of medical staff to South Africa, England, and elsewhere in the world. The autocracy of the minister is repeating itself in Dr. Chilufya.
By now just about everyone in and out of the workforce is feeling the pinch of the current economic downturn. Everyone who drives is feeling the pain of higher petrol prices, but those higher oil prices are trickling down to every aspect of the consumer economy, affecting even those lucky enough to have adequate public transportation at their disposal. The resulting spikes in the cost of everything from food to transport and education has led many workers to take on second jobs to make ends meet and help maintain their standard of living.
If there is any good news in the current economic climate, the job picture may be the place. Many times in the past jobs were the first thing to go when the economy began to turn down, but at least so far the job outlook has held up fairly well. What has not held up as well have been salaries, and the stagnation of wages through wage-free freezes. This has also forced many people to seek additional income. In essence, while the permanent pensionable health care jobs in government is estimated at 12,000, in practice, the jobs are around 18,000 due to moonlighting.
With Government struggling to meet revenue goals, and margins continuing to shrink, the outlook remains extremely bleak.
The decision by Dr. Chilufya is not only bad news for health care workers across the country but Zambia Revenue Authority as well. No doubt about it, the moonlighting policy has helped cushioning the impact of economic downturn not only to health care workers but ZRA as well.
Inevitably, a number of insights and lessons have been gained on the subject matter. A number of lessons have been learnt which should guide policy-makers to improve health sector reforms. The PF government should know that Health Sector Reforms take time to bear fruit. Petty jealousies and corruption have hindered these reforms in Africa.
There is a need to revisit the role of the minister in the reform agenda. First things first – let us create a credible health sector before we lose gains. Ownership of reform programmes by the health workers themselves, and other stakeholders is necessary. Otherwise, we will remain a sickly unproductive, underdeveloped nation.
How I wish President Edgar Lungu could make sense of this sooner rather later before the nation reverts to 1998 upheavals in the health sector.
Well said baba Sinkamba well said! We should not imprison our health workers to the confines of public service when theirs is a profession that is needed 24hours 7 days 12months of the year. If a medical professional be they a nurse, lab technician, medical doctor even ambulance driver is on legal leave what should prevent them from using their free time to help others in the private sector whilst give them an opportunity to earn a little more to support themselves and their families? Let’s be pragmatic on this subject.
Meanwhile the crook Chilufya has proxy companies supplying MOH and Medical Stores with medicines yet he is a Minister…these morons need to go!!!
Thats role of opposition. Why cant upendi learn something
Talk sense and we shall surpot you
Lungu will see 2021 is near . We wont recognise lungu . They gassed me like a rat in my bank ers.
Is that checks and balance
How well did this good talker do in the last election?
You everyone else to play clean while you play dirty?
Who said, “Umwaice bala mubala no kumuma ba muma?”
Chamba man Sinkamba times have changed.Imagine if Police Officers,& Soldiers start guarding private institutions in the name of PJs after knocking? ZAF pilots start flying Proflights or Mahogany planes after knocking off?Teachers, GRZ lawyers and so forth.there will be no efficiency in the civil service bcoz everyone will be interested in serving the “stomach” .If Doctors wants to earn extra money there are so many businesses they can do (bar, boutique, supplying, farming, mini-marts etc). If you feel for doctors fee,l for other civil servants who are restricted to work in private institutions (PJs).Mulimbe ba mambala elo your professional is becoming saturated with an influx of medicine schools like Apex, Cavendish & all those students doing medicine in Russia, China & India in less…
CONT”D..
Mulimbe ba mambala elo your professional is becoming saturated with an influx of medicine schools like Apex, Cavendish & all those students doing medicine in Russia, China & India in less than 5 yrs.Its no longer an elite professional where people used to treat a dokota like a chief or priest..
Useless contribution my FRIEND. Is running a boutique not a secondary source of income????
LET DRS AND ALL IMPROVE their lives by continuing working in private Hospital too.
@******* ****: HAVE YOU EVER BEEN SICK BEFORE? I DO NOT WISH YOU ILL. BUT YOU MUST LEARN THAT IT CAN BE VERY BAD TO BE TREATED BY A FRUSTRATED HEALTH WORKER.
Its not about sickness @ Chisenga…Every job counts as life is dynamic .
@******* we are talking about when one is one leave here. What is the problem if someone is on legal and approved leave? And if they further inform the relevant authorities? Why shouldn’t they be allowed?This is not to say that they cannot be called back and when they are needed by the govt during their leave- all we are saying is give these guys a chance to earn a little during their leave. Other branches of govt such as defence and security are sensitive and these are no go areas and should not be compared to health, education and other areas. There are so many govt vet doctors who offer private consultation, same with govt engineers, govt agriculturalists, govt teachers etc etc
@ No 2020VISION ..
Terms and conditions of service of the civil service are clear. One is not allowed to hold two jobs or draw two salaries. Its not only for Doctors but it’s for the entire civil service. If you don’t like it engage the Unions to change the conditions or Parliament to change the Gazette .Whats so special about docs? Let them learn some basic entrepreneurship skills not lyonse ni nyereti or Stethoscope ,bedpan, kidney dish nangu chi rectoscope looking into other peoples’ anuses by inserting things in the rectum…
Give them grants to conduct research! It’s that simple. Besides, the befits will be enormous.
My Dear Vanduu, life is unbearable without sufficient income.
It is happening in America and all civilized nations. People make progress depending on how much tbey work.
Government is already not paying a good number of Civil servants who also need a life.
Peter Sinkamba has lost it. This guy is a lunatic who thinks his opinion matters. I used to like his idea of marijuana but it seems this guy wants to think that politics of appeasement still have credibility in this era. This is why Africa still lags behind in terms development.
Madam Maureen I think the guy has a point. I remember vividly the crisis of 1998. However let us not forget that every extra job by a Doctor whether at home or in a private hospital is saving another life. Forget about the extra income they are getting briefly and look at the bigger picture.
Green party didn’t participate in the just ended local by-election, did they??? Amazing. Instead of building their grassroots, he wants to concentrate on engaging the executive and appear like he is on that level. dobo ba guy, nasheniko!!!
@Zambian Citizen Green Party is in the process of building its base give us time and you will see miracles!
Doctors and Nurses are the ones stealing government medicines for their private practices!
Ban them from anything related to the medical profession!
Sinkamba go smoke weed!
“…the moonlighting policy has helped cushioning the impact of economic downturn not only to health care workers but ZRA as well”
Give us statistical figures! You are just halucinating!
Sir i dont agree with you based on the following:
1. GRZ has not stopped any person to create a hospital or clinic since we are in a libralised economy.
2. GRZ does not force any Medical Doctor to work for it, a Doctors has free choice between GRZ and Private Sector.
3. All employers do not allow their employees who are employed 100% to be also employed by their competitors.
Thus, let the Medical doctors choose one job. If the private sector is better than GRZ …let that doctor be employed by the Private Sector. If he she has a clinic , let them resign and concentrate on their business so that they can employ graduates who are not yet employed. It is a free choice to make Sir.
My understanding, according to news clip, is that the scourge was getting out of control with Doctors even missing their surgical engagements to go and moonlight. I believe this because what I know of Government workers is that anything – Mr “Kupe’ of the 70’s is still very much around.
what peeves me is how come disciplinary controls are so lapse in Govt. This shows that their bosses ( Chief Permanent Secretary Mr. Ronald and his PS’s are not on top of it or the system is incapable – which is dangerous because the country needs a lean and efficient administration.
Police should stop guardibg the banks, they are not GRZ entities. Ministers like Chilufya should also stop those companies supplying Government with whatever service as they are civil servants too. They are compromising pricing of projects and let them concetrate on looking for developmental projects, not personal.
Mr.Sikamba is right about Dr.Chitalu Chilufya’s one man driven health reforms.They are driven by personal ambition,jealousy of his friends who are specialists and an attempt to impress voters in readiness to take over from President Lungu given the rumours that he is a front runner to take over from ECL.Here are some of the reforms that he is spearheading which are not in the best interests of the country but personal 1.He attempted to ban high cost services in hospitals forgetting they are income generating but decision was reversed 2.He transfered specialists to rural areas and Clinics where there no equipment/facilities for them to fully use their skills 3.He has discontinued the masters degree for…
Moonlighting exists world over ! It’s been existing in Zambia all along
Mr.Sikamba is right about Dr.Chitalu Chilufya’s one man driven health reforms.They are driven by personal ambition,jealousy of his friends who are specialists and an attempt to impress voters in readiness to take over from President Lungu given the rumours that he is a front runner to take over from ECL. Here are some of the reforms he has spearheade(contd) 3.He has discontinued the masters degree for doctors with Unza and to specialise doctors will be trained on the job in hospitals like apprentices and gvt will issue them with certificates as specialists 4.He rushed the National Health Insurance Scheme without important stakeholders like employers and Unions represented by ZCTU 5.He has banned health workers…
Imagine you are a doctor at a public medical facility and at the same time you either moonlight or are a partner at a private medical facility. Most likely you see clients with similar conditions in both cases facilities, based on your specialization. At a private facility you are paid a huge sum for one surgical operation and almost nothing for a similar undertaking at a public facility since you earn a salary and perhaps an on-call allowance that is unconditional. Does this scenario predispose staff to temptations of for instance referring clients to the private facilities so they would be paid on top of the regular pay from GRZ? Is there potential for conflict of interest? I think other businesses could be better to avoid conflict of interest. But anyway the viewpoint may also depend…
I don’t like the minister of health but on this one I support him. Let doctors choose whether they want to work in government or private. No one is forcing them, they are also free to leave government and join the private sector if indeed they are after more money. Remember you can’t have your cake and eat it too!
Those calling on doctors to choose between public and private employment simply lack understanding of the health care system in country. If specialists leave GRZ, there will be no one to attend to difficult cases in public facilities. This scenario is against everything that our health system stands for. We have to try to maximise on the few specialist doctors that we have by allowing them to be present in more than one workplace. The ministry of health should be talking about work ethics and adherence to employment conditions instead of rushing to ban moonlighting. It’s not easy to train a specialist and it takes years to do so. If push comes to shove, doctors will leave the public sector to seek better conditions of service elsewhere. It has happened before and will happen again.