Batswana's health in limbo

The standoff between the Botswana Doctors' Union (BDU) and the Government of Botswana took a new turn this week when the union issued a press statement advising doctors to fulfil only their prescribed emergency calls before taking their holidays.Tensions have escalated in recent weeks, with BDU accusing the government of failing to engage meaningfully on their grievances regarding emergency call duties.BDU President Dr Kefilwe Selema acknowledged that while discussions have occurred with senior government officials, no clear solution has been reached.Speaking to this publication, Dr. Selema stated that the government—through the Directorate of Public Service Management (DPSM)—has yet to take a definitive stance, insisting that the issue must be addressed through formal bargaining structures rather than direct negotiations.He explained that the government appears unwilling to engage at this stage, arguing that doctors’ concerns should be resolved holistically. Selema recalled that in 2023, the issue was referred to a labour mediator for four months before returning to negotiations after the government declined arbitration. Despite repeated attempts through 2024, BDU still remains open to dialogue, he said.“The government is responsible for both citizens’ safety and the welfare of doctors,” Selema stated, emphasising that excessive, uncapped work hours endanger both patients and doctors alike. Last week, BDU announced a drastic measure: limiting emergency call duties to one 24-hour shift per doctor per month, effective April 7, 2025.This decision follows the government’s failure to respond to BDU’s 72-hour ultimatum on long-standing concerns over emergency call compensation.Selema highlighted that while a 15 percent compensation rate was agreed upon, it only covers a single shift, leaving doctors owed an estimated P250 million for unremunerated hours.In response, DPSM warned that BDU’s directive may violate the Trade Disputes Act, which prohibits essential service providers from striking or taking strike-like actions. DPSM reaffirmed the critical role of emergency medical duties, citing a 2023 Industrial Court ruling that blocked a similar move by BDU.Government officials, including those from the Ministries of Health and Local Government, have urged resolution through formal negotiation channels. However, BDU has advocated for an alternative framework. The Minister of Health and his assistant were unavailable for comment at press time.However, the Union met with Minister of Local Government and Traditional Affairs, Ketlhalefile Motshegwa, this week to discuss the impasse. Having assumed oversight of Primary Health Care Services on April 1, 2025, the Ministry pledged to strengthen the public health system at the primary level.During the meeting, BDU urged the Minister to expedite resolution of their grievances, fearing that the issue may escalate into a public health crisis.Motshegwa assured the union of the government’s commitment to respecting trade union and worker rights, vowing to prioritise employee morale and motivation.He emphasised that productivity should not come at the expense of worker welfare and called for a balanced approach to service delivery and healthcare professionals' well-being.During discussions, Motshegwa requested time for the government to reconsider its negotiation mandate, allowing key ministries to align their position before DPSM engages BDU in finding a sustainable resolution.The Minister acknowledged the budgetary implications of the dispute but stressed the urgency of ensuring quality healthcare delivery.Selema reiterated the union’s concerns over excessive on-call hours and noted that, despite exhausting formal channels—including negotiations, labour mediation, and arbitration—the issue remains unresolved and is now before the Industrial Court. He pointed out that BDU has consistently proposed hiring more doctors to ease workloads and standardize emergency call duty structures and compensation.Selema assured that BDU remains open to dialogue and is ready to negotiate once the government presents a meaningful proposal. However, the latest press statement has thrown a spanner in the works!

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Batswana's health in limbo