On November 16, 2023, the Court of Appeal for the Republic of Botswana delivered a landmark ruling in the case between the Director of Public Service Management (DPSM) and the Botswana Nurses Union (BONU), CACGB-085-22. The court clarified the distinction between active and non-active on-call duty for nurses and midwives. It determined that healthcare workers rostered for on-call duty are only considered to be working when physically present at their workstations. Time spent away from the workstation while awaiting a call does not qualify as work and is therefore not subject to compensation.

Despite this ruling, BONU has raised concerns over the perceived unequal treatment of nurses and midwives compared to other public service employees who render essential services. These employees reportedly receive both overtime and standby allowances for their additional hours and standby commitments, unlike nurses and midwives.

BONU has accused the Directorate of Public Service Management, the Ministry of Health (MoH), and District Health Management Teams (DHMT) of exploiting nurses and midwives by subjecting them to prolonged working hours without adequate compensation, contrary to the Employment Act and international labour standards. The union noted that the current system forces healthcare workers to remain near their workstations while on-call, effectively restricting their personal time without compensation.

The court emphasized the need for negotiation on the issue of compensation for the personal time taken from nurses and midwives. Despite repeated calls from BONU for dialogue, the Ministry of Health has reportedly refused to engage in discussions to develop a framework or guidelines for on-call duty.

In response to the lack of progress, BONU has announced its decision to adopt a strict adherence to the court's judgment until negotiations are initiated and fair compensation is implemented. The union has outlined the following measures:
  1. Nurses and midwives rostered for on-call duty are no longer required to remain within the vicinity of their workstations during their free time. They are free to travel or use their time as they see fit.
  2. Healthcare workers are obligated only to answer calls and communicate their location when called upon. The Ministry and DHMT will be responsible for arranging transportation to ensure they can attend to their duties.
  3. Nurses and midwives are not required to use personal resources or transportation to travel to workstations while on-call.
BONU acknowledges the potential inconvenience these measures may cause the public but views them as necessary to address what it describes as cruel, exploitative, and unfair labor practices. The union has reiterated its commitment to securing fair treatment and appropriate compensation for its members.