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MINISTRY OF HEALTH AND CHILD CARE
Northern Region Workshop Report on the Alignment of
Legislation to the Constitution of Zimbabwe 2013:
Health Service Act [Chapter 15:16]
Holiday Inn, Harare
22 & 23 March 2017
Prepared By:
INTER-MINISTERIAL TASK-FORCE ON THE IMPLEMENTATION OF THE
CONSTITUTION (IMT) TECHNICAL COMMITTEE
Acronyms
AHFOZ Association of Healthcare Funders of Zimbabwe
CALR Centre for Applied Legal Research
CWGH Community Working Group on Health
HPAZ Health Professions Authority of Zimbabwe
HSB Health Services Board
IMT Inter-Ministerial Taskforce on Alignment of Legislation to the
Constitution
MoHCC Ministry of Health & Child Care
MoJLPA Ministry of Justice Legal and Parliamentary Affairs
MoPSLSW Ministry of Public Service, Labour and Social Welfare
ZINA Zimbabwe Nurses Association
ZHRC Zimbabwe Human Rights Commission
ZLHR Zimbabwe Lawyers for Human Rights
ZPCS Zimbabwe Prisons and Correctional Services
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Table of Contents 2. STAKEHOLDER PARTICIPATION ............................................................................................ 3
2.1 Programme of the Workshop ................................................................................................ 4
3. DAY 1 PROCEEDINGS ............................................................................................................... 4
3.1 ....................................................................................................................................................... 4
3.1 Opening Remarks ......................................................................................................................... 4
4. CLOSE OF DAY 1 .......................................................................................................................... 14
5. DAY 2 PROCEEDINGS ................................................................................................................. 14
5.1 Thematic Group Discussions & Report Back ........................................................................... 14
5.2 Plenary session ........................................................................................................................... 19
6. CONSOLIDATION OF SESSION PROCEEDINGS AND WAY FORWARD ....................... 22
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1. INTRODUCTION
In May 2013, Zimbabwe adopted a new Constitution. As a result of the enactment of the new
Constitution, existing legislative provisions which were founded in line with the old
Constitutional are unconstitutional, and are in need of being aligned with the provisions of
the Constitution of Zimbabwe. The Ministry of Justice, Legal and Parliamentary Affairs
(MoJLPA) has been tasked with the role of coordinating the process of alignment of
legislation with the new Constitution in terms of Section 324 which provides that ‘all
constitutional obligations must be performed diligently and without delay.’
In pursuit of this, the MoJLPA with the technical support of the Centre for Applied Legal
Research (CALR) established an Inter-Ministerial Task force on the Alignment of Legislation
to the Constitution (IMT) as an institutional platform to facilitate the implementation of the
Constitution of Zimbabwe to ensure that all legislation is consistent with the Constitution.
The overall objective of the IMT led project entitled ‘Implementation of the Constitution in
Zimbabwe: Supporting the Constitutional Legislative Alignment Process’ is therefore to
support the Constitutional Legislative Alignment Process in Zimbabwe.
The Ministry of Health and Child Care (MoHCC) submitted a request for support to the IMT
in aligning the Health Service Act [Ch. 15:16]. The Ministry had identified legislative gaps
therein that are inconsistent with the Constitution and International Conventions and Treaties
relating to the health service and had outlined these in a Discussion Paper, which was
submitted to the IMT Technical Committee. The project supported the holding of
stakeholder consultation workshops to obtain stakeholder input on the Discussion Paper. The
Northern Region stakeholder consultation workshop was held at Holiday Inn Hotel in Harare
on the 22nd and 23rd of March 2017.
2. STAKEHOLDER PARTICIPATION
Stakeholders that participated in the consultative workshop were composed of various
government Ministries (MoHCC, MoJLPA, MoPSLSW), Community Working Group on
Health, Health Service Board, Zimbabwe Nurses Association, Allied Health Professionals
Council of Zimbabwe, Citizens Health Watch, IMT, Office of the President and Cabinet
Health Advisor’s Office, Pharmacist Council of Zimbabwe, Medical Rehabilitation Council,
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Environmental Health Practitioners Council, Provincial Medical Directors (PMDs) and
District Medical Officers (DMOs) from the Northern region of Zimbabwe, representative of
various public hospitals, Zimbabwe Lawyers for Human Rights, Women and Aids Support
Network, Albinos Trust of Zimbabwe, Combined Harare Residents Association as well as
media representatives (Star FM, ZiFM, Newsday, Herald, New Ziana) Fig Multimedia and
CALR.
2.1 Programme of the Workshop
The workshop was held over a two-day period. The programme is attached hereto marked as
Annex 1.1
3. DAY 1 PROCEEDINGS
3.1 23.1 Opening Remarks
The Principal Director Policy and Planning of MoHCC gave the opening remarks on behalf
of the Permanent Secretary, MoHCC. Participants were welcomed to the Northern Region
consultative workshop on the alignment of the Health Service Act to the Constitution. He
outlined the background of the Commission Review into the Health Sector, which was
established in December 1997 by His Excellency the President..
Amongst their terms of reference, the Commission was expected to look into the human
resource health management systems in the public sector, including the review of the role of
the Public Service Commission in the recruitment, appointment, promotion and determination
of conditions of service for health professionals. Following extensive consultations
nationally, regionally and internationally, the Commission recommended the creation of the
Health Service Commission, which would consist of a chairperson and 9 – 12 members
drawn from professional associations and the private sector, all appointed by the President.
This had birthed the creation of the Health Service Board through the Health Service Act
(Chapter 15:16) in 2004.
1 The Workshop Programme
5
The Permanent Secretary further underscored the importance of involving citizens in the law
making process, particularly health workers in this instance since they were the backbone of
Zimbabwe’s healthcare system.
3.2 Update on the Constitutional Alignment Process The Principal Law Officer of Constitutional and Parliamentary Affairs from the MoJLPA
outlined the process of constitutional alignment, highlighting the stages that had to be
followed in aligning each Act and the role that the IMT played since its creation in October
2014. He noted the progress that had been made thus far and shared with participants a list of
Bills that were now at the consultative stage.
4. OBJECTIVES OF THE WORKSHOP The Legal Advisor of the Health Service Board (HSB) outlined the objectives of the
stakeholder consultative workshop, which primarily consisted of bringing together key
stakeholders with an interest or expertise in the area to converge to share ideas on how best to
align the Health Service Act with the Constitution of Zimbabwe and also giving them an
opportunity to participate in the law reform process. The workshop would also allow
participants to be made aware of the IMT’s work generally and to be updated on the ongoing
alignment of other pieces of legislation.
He noted that the current Health Service Act was promulgated in 2004 and so it was not
consistent with the new Constitution of 2013 in some respects. Thus, in the spirit of achieving
transformative constitutionalism in the health service sector, the resultant aligned Act should
be a legitimate product, owned by both internal and external stakeholders. He further
expressed the hope that these consultations would not be a once-off exercise but an ongoing
process.
5. OVERVIEW OF THE HEALTH SERVICE ACT A Legal Officer from the Health Service Board gave a brief background of the history of the
Health Service Act. He noted that the recommendation to the President in 1999 had been for
the formation of a Health Service Commission not a Board so structurally and operationally,
there was a need to interrogate why it was not created as a commission in 2004 as
recommended in the report. Emphasising the differences in the two types of entities, he also
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noted that there was widespread confusion regarding the Board’s status and also the corporate
status of hospital management boards and whether they should be regarded as a government
entity or a private/independent institution, hence there is need for clarity in that regard. For
example, whereas commissions reported to Parliament directly, the HSB has to report
through the Minister. The unfortunate result had been that the HSB could not independently
move quickly to address issues that were arising in the Health Service and they would get tied
up in the red tape and bureaucracy of the Ministry of Health and Child Care.
5.1 Constitutional provisions relating to the alignment of the Health Service Act The Director of Pathology Services from the MoHCC went through the relevant
Constitutional provisions in detail in order to assist participants to see which areas needed to
be captured in the new Health Service Act.
He advised the meeting that Commissions are generally constitutional bodies, but not always
(like the Sports & Recreation Commission), so there are different types: independent (such a
as the Human Rights Commission, Media Commission, Gender Commission) and executive
(such as the Civil Service Commission, Defence Commission, Police Commission and Land
Commission). The question that needed to be answered therefore was where the HSB
belonged in terms of being a Commission.
He looked at the Civil Service in terms of section 199 of the Constitution and highlighted the
fact that health workers did not fall under the Public/Civil Service any longer but had been
transferred to the Health Service, which means that technically they were not civil servants
but health servants. The anomaly however was that the Minister and the Permanent Secretary,
who were the responsible officers for the Ministry and also the HSB, even for accounting
purposes, were not themselves members of the Health Service but were civil servants. It was
therefore imperative to clarify the relationship between the Ministry and the Board.
The presenter also extracted principles of public administration, public finance management,
labour rights, as well as the composition and governance of other boards and commissions (as
comparisons with the Health Service Board). He emphasised the importance of aligning
every provision in the current Act with the Constitution to avoid gaps in the law.
7
5.2 Plenary session In the ensuing discussions, participants made the following comments:
Issue/Comment Responses
Participants raised concerns over why health
workers were moved away from
Civil/Public Service.
Health workers would go on strike &
negotiate with the Ministry of Public
Service and agree, but they could not
implement an increase for health workers
alone as it would mean an increase of all
civil service salaries, for which there were
insufficient resources. Public Service
resorted to using allowances as a
workaround but they were piling up plus
they were not pensionable, whereas the
salary was. So this was a technical
impediment. So it was recommended that
they have their own Health Service to get
around this technicality.
The participants agreed with the sentiments
expressed but expressed that it was not
purely about workers and their money.
There were issues that relate to operations &
decisions peculiar to the health sector. As
early as 1985, some decisions had been
made then that the health sector should
stand alone. The urgency to deal with
health-related issues was not present in the
overall Public Service Commission, eg re-
training another cadre of nurses &
pharmacists after they had been taken to UK
by the planeloads. PSC would want long
explanations as they were not aware of the
critical issues, or at least pretended that they
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were not aware. They wanted to be
convinced as Commissioners. This can be
too long a process when people are dying
due to lack of medical staff.
The Board also came up with a
remuneration grading system once which
was approved but was never implemented or
funded, such that funding issues remain
problematic. This should be incorporated in
this alignment process.
Emphasis was placed on concentrating on
substance and not just the name. For all
practical & functional purposes, the Health
Service Board is an executive Commission.
Are all Commissions not chaired by the
same people at the end of the day (Civil
Service Commission)? It appears to be that
way from the previous executive
commissions.
It was submitted that there is a Chairperson
on the Board.
The presenter submitted that there is need to
distinguish between powers exercised by the
HSB and those that a Commission can
exercise. It is on this basis that the
participants would determine what to
include in the Amendment Bill. The idea
was to focus on the function more than on
the name. .
Some participants submitted that they would
have liked to see the HSB appear in the
Constitution.
The HSB is already included in the
Constitution, under section 199(e). A
Constitutional amendment would have to be
made to specifically mention HSB, which
itself is an uphill task and must be justified.
In reality, it may not be necessary.
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Participants raised concerns over the
different meanings attached to the words
“restrict” & “forbid” (under labour rights).
“Essential service” doesn’t seem to mean
much compared to other public workers, so
why can they not strike? Participants
submitted that their pay dates are always
moved just like everyone else. Let the
essential nature of health workers be seen
by improvement of conditions of service.
Drafting is a complex process and not every
single word cannot be defined. That is
where the courts come in, to provide such
interpretations of the law, especially
constitutional issues.
Lit was submitted that the process is about
alignment to the Constitution, which is the
primary focus. But at the same time, process
could be used to redefine and clarify other
issues.
The fact that health workers are not allowed
to strike is not right and is a huge
disadvantage. There is need to improve in
terms of salaries etc. to reduce the need to
strike as well.
There is need to separate money issues from
the inherent value of human life. Health is
essential because of the sanctity of life and
no amount of money will ever be sufficient
for the work done by doctors.
It may not work to make it free for all.
Clarification – section 104 of the Labour
Act allows essential service providers to
strike in certain circumstances only.
Emphasis was placed on the need to dissect
the key issues, such as being given the right
tools, appreciation, etc. which will go a long
way to make their lives better. Further
emphasis was placed on the need to have a
serious look at the establishment as the
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Participants agreed that it is important that
essential services do not go on strike,
however, if people are have set in their
minds to be on strike it is difficult to address
They should not do their job at a
disadvantage, at their own expense.
What can be done, even without enough
money?
It will be critical to capacitate the HSB, to
give it funding, to give it teeth. The rest of
the issues coming up now will then follow
on from there.
system was put in place a very long time
ago and needs to be seen from a modern
perspective.
Essential is equated to being there.
Some of the other aspects raised by
participants were for the bipartite
negotiations.
Is it possible to have an independent Board?
What is the role of the board? Parent,
protector, mediator? Especially on the
aspect of strikes and collective action.
The role is similar to that of the employer,
an agency that employs health workers on
behalf of government. This role includes
management, training & development,
discipline. These functions are resident in
the HSB but can be delegated to lower
levels. If the Board needs to make decisions
with financial implications, they need to
have Ministry approval because the
paymaster is the same – government. The
Board also needs to be adequately funded
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Let the Constitution be amended to make
the HSB a Commission, even if it is a long
process, so that it can be properly funded.
and resourced, including personnel, just as
the Ministry needs to be adequately
resourced to ensure the right to healthcare.
I
IFunding the Board will not directly benefit
workers
Whether Commission or Board, there is one
Consolidated Revenue Fund where all
moneys come from and go to for
disbursement. Section 76(4) of the
Constitution on the right to healthcare: the
aspect of progressive realization is key. The
effort must be seen and there is need to
establish benchmarks even financially.
Participants continued the discussion and raised the following aspects:
Issue/Comment Response
There needs to be clarity on the list of who
is essential.
On list of essential people in terms of
statutory instrument….. All those people
registered/regulated by councils, e.g. the
people covered by the Health Professionals
Councils – those people should also be
included in that list. Also those that train
other cadres should also be included.
hat SI might have been overtaken by events
and other categories of people ought to be
included. There is need to revise that list to
reflect all essential workers working in the
health sector, make the list exhaustive. The
SI falls under Ministry of Public Service so
that also needs to be managed.
Confusion as to whether Labour Act refers
to health workers too.
Concerns were raised on whether it would
not be more prudent to not have a list but to
refer to those regulated by the Health
Professions Act as amended from time to
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time, to make the definition/reference more
flexible for the future?
However that still leaves others like general
hands who are not listed anywhere but
actually are also essential.
The current Board has 2 or 3 nurses,
f how long does someone remain a nurse
and what criteria is used to appoint those
nurses?
t was noted that there is need to address the
issues looking ahead not backwards. But
their ability & documented wealth of
experience is definitely a factor.
Nevertheless, those are some of the
refinements that must be articulated and be
part of the legal framework.
On the balance of skills on the HSB, Human
Resources expertise is also important
especially since the core business is being
the employer and human resources issues
are always coming up. There is a need for at
least 1 or 2 human resources practitioners
on the Board, along with the other skills
being considered.
Is there a maximum number of board
members? There must be at least one
representative of different disciplines across
the healthcare spectrum on the board
On Hospital Management Boards (HMBs),
from a district hospital perspective – it is an
important board which has power to hire
and fire so they need to have the relevant
expertise.
Can one easily find/locate this expertise for
those hospitals that are in the bush, to allow
the board to function? Is the statutory
instrument perhaps more workable than the
HMB set up? (The Community Health
Councils – SI…of 2000)
T.
On the function of the Chair of the HSB & There are no clear provisions in the current
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the Executive Director (ED) – does the Act
provide for the post of the ED and what are
the functions listed, so that they do not clash
Act but referred to in section 10(1) & (2).
Where the Chair is highlighted, it should
actually be the Executive Director.
It was suggested that there can either be the
Chairman without the executive
function/power and the Executive Director,
or the Executive Chair without the
Executive Director but working with the
Secretariat.
Participants submitted that on proposal for
finance controls, handling of accounts – as
far as public finance is concerned, the
Public Finance Management Act is the
overarching Act. What more can be added
in the Health Service Act in that regard?
It was stated that there is need to include
both internal & external auditing (Public
Accountants and Auditors Board)
Stakeholders noted that the Constitution is
encouraging good governance but the Act is
not clear on how the HSB conducts its
business or arrives at its decisions. It is not
clear/documented, which is a big gap. There
need to be guidelines created on how they
conduct their business.
It was stated that the Second & Third
Schedules of the Act attempt to speak to the
procedures & operations of the Board hence
there is need to have reference to this in the
deliberations.
The Act does not talk about the structure of
the Secretariat or lay out each
office/function.
To what extent are CSOs & community
organizations represented/included on
HMB, as they represent the perspectives of
the communities which are served by that
particular hospital?
This was noted as an important point for
consideration
On freedom of association, whether even an
engineer can join/represent doctors – section
58 of the Constitution speaks to freedom of
assembly & association. Section 86, the
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limitation of rights and freedoms.
Otherwise, they are free to associate with
whoever they want.
Constitutional labour rights apply to all
citizens with no discrimination. Is the SI
saying that health workers do not fall under
the Labour Act, still constitutional then?
26. CLOSE OF DAY 1
Once the plenary session was concluded, the Director of Pathology acknowledged that there
were many issues requiring alignment as evidenced by the lively discussions, which warmed
up as the day went on. He reminded participants about the importance of the thematic group
discussions to be held the following morning where they could thrash out the issues and deal
with the contentious issues that require close scrutiny.
37. DAY 2 PROCEEDINGS
7.1 Thematic Group Discussions & Report Back Participants were put into thematic groups and discussed specific issues with a view to
coming up with concrete recommendations for lawmakers and policymakers alike. The group
questions were as follows:
GROUP 1
Comment on and make recommendations for improvement of the Act in terms of the
governance of the Health Service.
Make any other recommendations as necessary.
GROUP 2
Analyse the provisions relating to Hospital Management Boards (their constitution and
operations) and suggest improvements to the Health Service Act in that regard.
Make any other recommendations as necessary.
GROUP 3
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Discuss strategies of financing the Health Service.
Make any other recommendations as necessary.
GROUP 4
Identify the labour issues raised by the Constitution which require alignment in the Health
Service Act, with reference to relevant regional and international best practices.
Make any other recommendations as necessary.
Below is a table highlighting the discussion points and recommendations that were made by
the various groups:
GROUP 1
Governance
Health Service Act
Functions of the Board
Appoint qualified and competent board members
Include accountability, transparency
Membership of the Board
• Gender considerations –section 17(b) of the Constitution – both genders are equally
represented in all institutions and agencies of government at all levels.
• Have a full time executive chairperson and deputy chairperson.
• Minimum of two and maximum of five other members, recommended by the
Minister appointed by the President.
Delegations of functions by Board
• Appointment of Hospital Management Boards must be done by HSB in consultation
with the Minister.
Appointment of Health Service Secretariat
s10 (1) the Board shall appoint the health service secretariat headed by the Executive
Director who is an ex officio member of the Board.
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s10 (2) The Executive Director shall….
Appointments, promotions & dismissals
• s12 (4) Health Service Board Secretariat.
Second Schedule – Conditions of Service of Board Members
• s3 (1) a period of 3 years and a maximum of two terms.
• Minister not to alter the fixed period of three years.
Any other recommendations
• Section 18(1) Amend to reflect responsibility on the Ministry.
GROUP 2
Hospital Management Boards
• Remove Section 18(1), withdraw corporate status
• HSB to appoint (based on merit) HMBs in consultation with the Minister
• Composition: Community member/Community based organisation, Finance advisor,
3 with Medical Background, legal advisor. Have gender balance.
• HMBs to report to HSB
• CEO and Clinical Director/Medical Superintendent to sit on HMB as ex officio
members (secretariat)
• HMBs can recommend hiring and firing but that mandate should remain with HSB
• Hospital Management Board tenure 5 years with an option of 1more term (2nd
Schedule Section 3(1))
• Third Schedule
– Alter, improve property of hospital in consultation with Public Works
– Remove power to invest moneys not immediately required by the hospital
– Fix terms and conditions, including fees charged with Minister Health,
Finance in consultation with the HSB
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GROUP 3
Strategies for financing
According to the Constitution of Zimbabwe Section 76 provides for the right to health care.
Section 76(4) - The state must take reasonable legislatives and other measures within the
limits of resources available to it, to achieve the progressive realisation of rights set out in
this section.
Sources - Health Services Act provides for sources of revenue under section 21
• Fiscus – treasury
• Donor funding
• Health Services Fund
• Investments
Other sources – potential sources
Section 302 of the Constitution is the avenue which permits other potential sources of
revenue to be introduced through an act of parliament, which is the Health Services Act:
• Tollgates
• Carbon tax
• Tobacco
• Beverages (High energy drinks, alcohol)
• Aeroplanes
• Withdrawals
• Exportation of health
• NSSA
• Occupational health diseases
• Sales tax (VAT) - Get a small percentage by capturing everyone.
Earmark a small percentage from all the above potential sources of revenue to health.
Sections of the Constitution that speak to health issues (what should be provided)
• Section 9 (2) Good governance :The state must ensure that all institutions and
agencies of government at every level, in particular Commissions and other bodies
established by or under this constitution, are provided with adequate resources and
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facilities to enable them to carry out their functions conscientiously, fairly, honestly
and efficiency
• Section 19 (2)(b) Children : have shelter and basic nutrition, health care and social
service
• Section 29 Health services
• Section 76(4) Right to health care: The state must take reasonable legislatives and
other measures within the limits of resources available to it, to achieve the
progressive realisation of rights set out in this section
• Section 21(2)(b) Persons with disabilities: consider the specific requirements of
persons with all forms of disability as one of the priorities in development
• Section 305 (3e) separate estimate of revenue and expenditure must be given for
each of the following. Health service Board to get direct funds from the treasury.
Safeguards for management of public of public funds
• Section 308 Duties of custodians of public funds and property: (proper
management of funds -internal and external audit) we want a new provision which
deals with duties of custodian of public funds (Health Services Fund)
GROUP 4
Labour rights
Constitution - Section 65 (1) as read with section 24 sets out fundamental rights of
employees
Health Service Act
Section 13(1)
1. Board in consultation with employees and Minister should be involved in fixing
reasonable remuneration packages for worker
2. Conditions of service should be set in line with regional & international standards
Constitution - Sec 65(2) Freedom to join Associations
Health Service Act
Section 16 (1)
1. All categories of workers should be allowed to form associations of their choice &
register with the HSB (Those associations not registered will not be recognized and
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7.2 Plenary session Following feedback from the group discussions, the participants made the following
contributions during the plenary session:
Comment Response
On Group 1’s presentation:
The following suggestions were made:
The executive chairman post should just be chairman
(non-exec) and maintain the post for executive
director (ED).
Amend Act to say there shall be a chairman.
Refer to Civil Service Commission and all the other
executive commissions, where the chair is not
executive but there is usually then an executive
secretary. An executive chair is an anomaly in terms
of the Constitution. Need to look at the terminology
It was submitted that the age limit
for board members should be
specified. Proposed age is 65years
and below.
Furthermore, it was noted that age
limits are provided for in the
Constitution, JSC gives 70 year age
limit for all judges to have retired. It
was suggested that participants can
revisit the definition of the elderly in
will be encouraged to formalise their association)
2. HSB submit the registered unions/associations for endorsement by Minister
Constitution - Section 65(3) Right to strike – restriction for essential services
Health Service Act
Additional sub-section in Act
The law may restrict the exercise of this right to strike in order to maintain essential
services but the workers must be protected from unfair labour practices by the
employer
Constitution - Section 65(7) - Paternity leave?
Other recommendations:
HMB governance issues-
HSB to appoint HMB in consultation with Minister
Section 19(2)(a) of Act - CEO/Medical Superintendent should not chair HMB
meetings
20
used in the Constitution. A There is need for clarity
on the functions of the Chair and alignment to
template set out for Judicial Service Commission
(JSC) and other such commissions.
Executive Director's term of office should also be
stipulated, not just be a permanent employee with an
open-ended contract. Refer to section 205 of the
Constitution since the role is the same as a Permanent
Secretary.
the Constitution, section 82.
Participants were advised to refer to
section 320(1) on terms for
commissioners as reference point.
It was further stated that there is
need to spell out the composition of
the board members.
The following suggestions were
made: since core business of
MoHCC is patients & their staff,
ensure that there are doctors, nurses,
a lawyer, HR & finance person.
Refer to JSC composition as well in
the Constitution, section 189.
The board should be aligned to the
professionals they are representing
in the health sector. Also include
other health disciplines
representatives, not just one or two
fields.
It was recommended that terms in
the Act should coincide with those
in the Constitution.
On Group 2’s presentation:
Participants noted that the current
situation/arrangement on HSB delegating authority to
hire & fire is preferable, rather than allow HMBs to
be the final authority. HSB remain as the appeal body
before we go to labour court. HSB cannot be player
In response it was stated that in a
rural setting like a district hospital, it
may be difficult to find cadres with
the necessary expertise. Community
Health Council under another SI
might be a better approach.
21
& referee at the same time (SI 117/06). Status quo
should remain.
Giving HMB the delegated authority to discipline –
for the Civil Service, the Commission retains this
power/authority, so why should HSB delegate to the
HMBs? The responsibility should remain with the
Board.
HMBs are for strategic oversight, not for day to day
affairs. The technical people on the ground must
support the board and account to it – the whole team,
not just the CEO (who is often ex officio) – it is an
administrative issue and also a legal issue from the
Health Professions Act.
Clinical Director is the practitioner in charge of the
institution
It is cause for concern that the Act provides for
investigation of misconduct for people in the Health
Service, but not for Board members. That should be
inserted.
Terminology of HMB is still problematic –
governance aspects are not coming out as they should
be. Perhaps call it Hospital Advisory Board, and
define what that means
But on the ground, the Civil Service
Commission delegates to line
Ministries, then appeals forwarded
to the Commission.
That delegation should not be put in
the Act, should be through circulars.
S237(2) of the Constitution speaks
to that, but it still requires an
outline/mechanism for that
disciplining process for the
Commissioner
On Group 3’s presentation:
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Health Levy, National Aids Trust Fund not
mentioned because they already exist.
Stakeholders needed clarity on the funding referred to
in S305 on direct funding from treasury
Consider adding salt, sugar, fat as
taxable items
Funding for the operations of the
board
On Group 4’s presentation:
Instead of having a list, just stipulate that “all health
workers” or “everyone who works in a health
institution” is essential, even the accountants and
general hands.
How exactly will the employees be protected from
unfair labour practices? Need to have examples.
Resource mobilisation skills should also be
considered critical on the boards, people with a mind
for investments
Section 65 of the Constitution – there should be
collective bargaining happening
Look at definition already in the
current Act – section 9. So the list is
actually incomplete.
The group felt they would leave the
details to the technocrats who will
be coming up with the draft.
Depends on availability of
resources, economic conditions.
8. CONSOLIDATION OF SESSION PROCEEDINGS AND WAY FORWARD A Legal Research Officer from the Centre for Applied Legal Research gave a summary of the
session proceedings and reiterated some of the key issues that had come out of the
deliberations of the stakeholders. She indicated that the next step was the hosting of the
Southern region stakeholder consultative workshop to be held in Bulawayo in the coming
weeks. Thereafter, the Ministry would consolidate the stakeholder recommendations. This
input would be used in compiling the Cabinet Principles to be used in drafting the final
Health Service Amendment Bill at a write-shop conducted with legal experts from the
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Attorney General’s Office (Legislative Drafting Division) and the Ministry with the support
of IMT.