Following the approval of the new Single Salary Schedule (TSU) for the civil service, a public debate about the improvement of services provided in state institutions arose, assuming that the new schedule would be an incentive for employees and agents of the sector.
In the health sector, the debate pointed out that the new salary would be proportional to the improvement in the provision of services in the National Health System (SNS).
Although the TSU was partially suspended due to detected irregularities, it is being implemented for all level 1 professionals, those earning the minimum wage.
It is in this context that the present article arises, with the objective of succinctly perceive the benefits and challenges of the TSU for health sector employees. For a better understanding of the debate under analysis, it is crucial to bear in mind that the health sector is one of the most important in the country, because of its sensitivity in all segments. In fact, there is a strong connection between the degree of sensitivity of this sector and public professionals in general, but particularly those in the health sector.
Following this logic, the TSU produces positive multiplier effects for health professionals. The same effects go through the improvement of their quality of life, especially when reflected in the purchasing power of these professionals. The evolution of salaries in the civil service is linked to fiscal sustainability, and, in the case of Mozambique, it is also linked to the goals agreed with multilateral donors on the percentage of spending on wages in the State Budget (OE), which seeks to recover the erosion of purchasing power and compensate workers for increased productivity. It is recommended that the determination of these needs be linked to the general level of wages, the cost of living and its fluctuations. However, the outbreak of the pandemic caused a profound transformation in the relationship between the SNS and its users.
Increase in Operating Expenditure
From a budgetary point of view, the TSU represents an increase in spending on wages, taking into account the doubling of the minimum wage, in a context where the Economic Social Plan and the State Budget (PESOE) present operating expenditures at 56% for 2022, an overwhelming magnitude that in practice means that for every 100 meticais, 56 meticais should be withdrawn to pay wages. In fact, the TSU representes worrying increments on the budgetary point of view foreseen for 2023, with regard to the functioning of the sector and consequently in total expenditure.
In a scenario in which the quality of total expenditure is associated with the quality of the evolution of investment expenditure, the bulk of the public sector revenue curve, and of the health sector in particular, does not follow a normal distribution, i.e., there are more people earning low salaries, although there are prospects for raising more revenue, resulting from the exploration of natural gas, return of the International Monetary Fund (IMF) and the World Bank, which may attract more investors that can contribute to revenues.
In the health sector, operating expenditures (salaries, fuel for transport, purchase of medicines and other consumables, etc.) are well regarded as they follow an international standard. However, the quality of these expenditures should be accompanied by increases in basic equipment, such as utensils (gloves, medicines, etc).
From a performance point of view, we understand that salaries in the public sector in general and in health, in particular, are absolutely low, contributing, in the first place, to the demotivation of workers in their activities. With the TSU, however, it is expected that professionals will be more motivated and provide services to users in a dignified way. The salary increase, on the other hand, suggests that there will be greater supervision of workers’ performance. In other words, we mean that the salary increase should be proportional to the improvement in the provision of services to the user.
Salary Growth VS Improved Service Delivery
Motivation, by concept, refers to the maximization of concentration and efforts in work performance. This motivation would be a result of improved wages, taking into account the minimization of concerns answered by the satisfaction of basic needs.
With the TSU, the capacity of the minimum wage to cover the basic food basket improves on average from 19 to 30%. There was more than the correction of the inflationary effect. There was a real and historical increase in the minimum wage, which means that professionals will have a significant recovery in the basic food basket, even though inflation is constantly increasing, as a result of the rise in the price of fuel in the international market.
With the TSU, the weight of the average monthly cost with the basic food basket registers relative improvements of atypical magnitude in the whole time series (3.22%). In other words, this means that, in real terms, the TSU recovers the response capacity of families, as well as respects the minimum permissible levels of wages, guaranteeing the right to a minimum wage that is sufficient to cover the minimum living conditions. A health system, which depends on qualified people who treat patients directly and whose care allows no margin for error in hospital treatment, makes sense that there should be a wage increase. The high cost of treatment, the risks and errors related to handling the machines may be associated with the emotional conditions of those responsible for the treatment, hence the salary increase for this professional class makes sense.
TSU Recovers 15.36 Dollars for Health Professionals, but Misses 22.14 for Basic Food Basket
In fact, in a deeper analysis, we can observe that until 30-04-2015 the minimum wage was 3002 Meticais, in a context where the MZN/USD exchange rate was 34 Meticais per dollar unit, which means that the wage could buy 88.29 dollars, from 2015 to 2022. Before the TSU, the minimum wage was around 4668 Meticais, an amount that could buy 72.94 dollars. With the TSU, the minimum wage increased to 8468 meticais by discrete approximation, translating into a minimum wage from 72.94 to 136.92 dollars. As such, workers recover $15.36 lost from 2015 to July 2022, however it still falls short of the minimum amount needed to cover the basic food basket, with an increment of $22.14 needed for a satisfactory response.