Union warns CHW delays are deepening Northern Cape healthcare crisis

A FRONT-LINE workers’ union has cautioned that the Northern Cape’s healthcare crisis will only worsen if community health workers (CHWs) continue to face uncertainty over their employment status and if austerity measures are allowed to chip away at essential services.

In a statement issued in relation to Finance Minister Enoch Godongwana’s recent Medium-Term Budget Policy Statement (MTBPS), the National Public Service Workers Union (NPSWU) argued that delays in permanently absorbing CHWs – coupled with years of leadership instability in the provincial Health Department – have left front-line health staff “carrying an impossible load” as clinics and hospitals buckle under pressure.

The union said that the tenure – and eventual resignation – of Health MEC Maruping Lekwene had created a climate of uncertainty for workers on the ground. “Instability in leadership translates into instability in service delivery, and CHWs feel the impact first,” NPSWU provincial organiser Thapelo Thole noted.

Oversight exposes major failures

The warning coincides with Parliament’s Select Committee on Social Services’ recent oversight visit to health facilities in the Province, which highlighted widespread issues, including deteriorating infrastructure, severe staff shortages, broken equipment, medicine stockouts, and an expensive biometric system that remains non-functional.

These findings also align with the Auditor-General’s latest report, which flagged the department for ongoing financial mismanagement and yet another qualified audit.

Against this backdrop, the NPSWU pointed out that any budget tightening or hiring freezes “directly harm communities”, especially areas where CHWs are often the only accessible point of care.

“CHWs are the heartbeat of community health – reaching rural and under-resourced areas where clinics are few and distances long. If funding is cut or CHWs remain on temporary contracts, communities will suffer: weaker service delivery, rising health risks, and more insecurity for those doing life-saving work,” said Thole.

Union demands protection of front-line services

NPSWU has called for:

• Full, permanent absorption of CHWs in the Northern Cape without further delay
• Protection of public-health funding, particularly staffing and community outreach
• An end to hiring freezes that leave clinics understaffed
• A human-rights impact assessment before any spending cuts affecting health services

The union added that fiscal pressure “cannot become an excuse for abandoning public-health obligations” in a province already battling overcrowded emergency units, long waiting times, failing infrastructure, and chronic under-resourcing.

‘Communities are watching’

With the MTBPS having been delivered, the union maintains that the Province must now prioritise front-line health workers in the months ahead. It warned that austerity “is not neutral – it deepens inequality and destroys hope”, and urged communities to hold government accountable as the new budget cycles begin.

With the repercussions of oversight findings still unfolding, and healthcare workers reporting severe strain across Kimberley, Kuruman, Barkly West, Delportshoop, and other areas, NPSWU say the stakes could not be higher.

“CHWs deserve stability, dignity, and fair employment – and the Northern Cape cannot afford further erosion of its front-line health services,” the union said.