National Policy On Commuted Overtime For Medical & Dental Personnel

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NATIONAL POLICY
ON COMMUTED OVERTIME
FOR MEDICAL & DENTAL
PERSONNEL

DEPARTMENT OF HEALTH

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INDEX

Page

1. Policy Purpose 1

2. Glossary of terms/definitions 1

3. General Principles

3.1 Scope of applicability 2
3.2 Effect of Organization and Establishment Control 2
3.3 Payment of commuted overtime during periods of leave 23
3.4 Suspension 3
3.5 Training and research 34
3.6 Standby duty 4

4. Periodic review and control measures 47

5. Compulsory overtime and refusal to work overtime 710

6. Categories of overtime remuneration 1013

7. Specific Provisions 13

8. Policy Objective 13


NATIONAL POLICY ON COMMUTED OVERTIME FOR MEDICAL AND DENTAL

PERSONNEL

1. POLICY PURPOSE

The purpose of this policy is to regulate the management of the commuted overtime
system for medical personnel including its practical challenges. Specific monitoring and
control measures are therefore prescribed.

2. GLOSSARY OF TERMS/DEFINITIONS

2.1 Normal hours of work: The first 40 hours of work per week that a medical practitioner
is scheduled to work in accordance with a duty roster.

2.2 Commuted overtime hours: The hours of work additional to the total number of
normal hours of work required by the employer to render a health service within a health
facility in terms of operational needs. It should be only duty in excess of the prescribed
hours of attendance, authorized by the relevant delegated authority.

2.3 Commuted overtime system: A flexible system averaging the overtime hours worked
to accommodate medical practitioners who perform scheduled overtime on a regular basis
over a 4week period.

2.4 1st Oncall: The medical practitioner is on site at the health facility for the full duration
of the oncall hours. These hours are classified as actual commuted overtime hours.

2.5 2nd Oncall: The medical practitioner is offsite and is rostered for 2nd call in order to
be available to render clinical advice with regard to patient care.

 This could be advise rendered telephonically in which case 30% of the time spent at
home (offsite) will be classified as actual commuted overtime hours.

 Should the medical practitioner have to come in to the health facility to attend to clinical
duties, all hours spent onsite during 2nd call will be classified as actual commuted overtime
hours.

2.6 CEO: Hospital or Facility Manager that is not directly responsible for the management
of clinical services.

2.7 Chief Medical Officer: Clinical Manager who is directly responsible for the
management and control of clinical services rendered by medical practitioners and health
professionals.

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3. GENERAL PRINCIPLES

3.1 Scope of applicability

(a) The commuted overtime system is applicable to:

 All fulltime medical personnel employed in a permanent or temporary capacity who are
rendering actual clinical, patient related services on an organized basis within a health
facility may participate in the commuted overtime system where, on a continuous basis, the
need exists for the rendering of such overtime duties.

 A medical practitioner who has entered into and fulfills the requirements of a commuted
overtime contract.

(b) Exclusions: The commuted overtime system is however not applicable to:

 Parttime medical personnel who are employed for less than 40 hours per week as well
as sessional medical personnel.

3.2 Effect of Organization and Establishment Control

Medical practitioners do not partake in shift work. As a result of this, the filling of posts will
only reduce the need for overtime hours during normal hours of work, i.e. between 07:00 to
19:00. After hours, i.e. from 19:00 to 07:00, will always necessitate the rendering of
overtime duties.

3.3 Payment of commuted overtime during periods of leave

3.3.1 Commuted overtime is payable to medical personnel who participate in the
commuted overtime system for periods of annual leave within each financial year (i.e. from
1 April of a year to 31 March of that year) on the following basis:

 22 working days in respect of employees with less than 10 years’ service;
 26 working days in respect of employees with more than 10 years’ service;
 28 working days in respect of employees appointed as public servants prior to 1 January
1966 as well as former provincial employees appointed prior to 1 January 1978.

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3.3.2 Commuted overtime will not be paid during special, sabbatical, shop steward,
family responsibility and maternity leave. Provision must be made to ensure that the
amount of commuted overtime payable per month is decreased on a prorata basis in
cases where such absences occur during the course of a month.

3.3.3 With due regard to absences in respect of periods of sick leave where the individual
is not in a position to fulfill his/her commuted overtime contractual obligation during a
specific month, the commuted overtime rate must be reduced on a prorata basis.

3.3.4 No reduction of commuted overtime must however take place in cases where an
individual for the reasons as set out hereunder is able to fulfill his/her commuted overtime
contractual obligation during a specific month:

3.3.4.1 With regard to short periods of sick leave where an individual is absent on the
day(s) where he/she is not rostered to perform afterhour duties.

3.3.4.2 With regard to periods of sick leave where the individual is rostered to perform
afterhour duties, but is able to meet his/her afterhour commitment by interchanging
(swopping) his/her afterhour duties with other doctors in a specific month. This
arrangement must be approved by the supervisor (clinical manager). The supervisor
(clinical manager) must certify on the Z1(a) (leave form) that the commuted overtime
commitment for the sick leave period was worked in.

3.3.5 Carry over of commuted overtime hours: Medical personnel are not allowed to
carry over their rostered afterhour commitment for a specific month to the following months
to avoid the reduction of commuted overtime remuneration in the specific month where they
were not able to meet their rostered overtime commitment in respect of that specific month
due to absence on sick leave.

3.4 Suspension

Commuted overtime remuneration is not payable in cases where employees have been
suspended from duty with full emoluments. In view of the fact that commuted overtime does
not form part of the salary packages of medical personnel, it is not payable to employees
during periods of suspension from duty with full emoluments.

3.5 Training and research

3.5.1 The payment of commuted overtime remuneration is limited to the rendering of actual
patient related clinical services as needed by the Department of Health and therefore is not
applicable to any academic/ training or research functions.

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3.5.2 With regard to employees appointed on public service conditions of employment
(Joint Staff) at academic/psychiatric institutions in terms of the Joint Agreement, the time
spent by such personnel on teaching and research may not be included in overtime
calculations. The aforesaid employees may spend time to a maximum of 14 hours per week
on teaching and research activities. These activities must be included in the normal official
40hour workweek core service (i.e. the normal 40 hour workweek may consist of a
minimum of 26 clinical service hours and a maximum of 14 hours teaching/research
activities).

3.5.3 Time spent by registrars in receiving formal training/teaching is regarded as on duty,
whilst time spent on own study should not be taken into account.

3.6 Standby duty

3.6.1 In terms of the measures set out in the Collective Agreement on overtime (PSCBC
Resolution 3 of 1999), an employee may only be paid overtime remuneration for work
performed in addition to his/her contracted hours of work (i.e. 40 normal official hours per
week).

3.6.2 Periods of oncall are not regarded as standby duty according to the standby duty
measures applicable to the rest of public service employees.

4. PERIODIC REVIEW AND CONTROL MEASURES

4.1 In terms of the Public Finance Management Act, the Head of Department as
Accounting Officer must ensure that he/she implements and maintains effective and
efficient systems of financial and risk management and internal control measures. With due
regard to the above, the commuted overtime system as part of a remuneration system is
therefore subject to periodic review in order to reduce the risk of irregular expenditure
and/or financial misconduct.

4.2 It will be necessary for all participants in the commuted overtime remuneration system
to complete commuted overtime contracts.

4.3 The following mechanisms should be implemented to manage, monitor and control the
payment of commuted overtime efficiently:

(i) Normal working hours duty roster of the component
(ii) On call duty roster of the component
(iii) Duty hours register of the individual

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4.4 To further reduce the risk, the following control measures will apply:

4.4.1 Duty rosters must be made available to the Heads of Institutions in advance. The
duty roster must indicate the normal official duties required in the component and another
on call roster must indicate the individuals who are scheduled to be on 1st call and 2nd call.

4.4.2 The Heads of Institutions will verify the overtime worked by participants in the
commuted overtime system in accordance with their record of monthly duty hours and the
relevant duty roster of the component’s clinical service delivery.

4.4.3 All Heads of Clinical Departments/supervisors will certify the hours overtime worked
in the rendering of clinical services on a monthly basis for each participant to the system
within his/her Clinical Department/ Component. Furthermore, the said Clinical
Head/supervisor will also indicate the vacation, special and sick leave taken during the
month by each participant.

4.4.4 It is the responsibility of the Head of a Clinical Department/supervisor to submit all
applications for leave approved by him/her directly to the staff office of the institution. HR
offices will reconcile the duty hour register with the leave applications on a monthly basis.

4.4.5 The Head of Department, as Accounting Officer, may on instruction request audits of
the commuted overtime system within institutions from time to time, to monitor the
compliance of medical staff to the commuted overtime system and the conditions of the
contract in accordance with the duty rosters.

4.4.6 Commuted overtime can only be earned when performing actual patient related
clinical services at the workplace. This can either be 1st on call (onsite) or overtime
duties performed additional to the normal 40 working hours.

4.4.6.1 Notwithstanding the aforementioned, if the medical practitioner is offsite and is
rostered for 2nd on call, 30% of the time spent at home (offsite) will be classified as actual
commuted overtime hours.

4.4.6.2 Should a medical practitioner who is rostered for 2nd on call have to come in to the
health facility to attend to clinical duties, all hours spent onsite during 2nd on call will be
classified as actual commuted overtime hours.

6

4.4.7 All commuted overtime contracts of medical personnel will be reviewed annually on
an individual basis by the responsible Chief Directors in collaboration with the Heads of
Clinical Departments, in terms of the existing operational need for such overtime work.
Furthermore, all renewed contracts will be authorized by the Head of the Department of
Health or his/her delegate.

4.5 It must be emphasized that, in terms of the commuted overtime contract, the Heads of
Clinical Departments/supervisors will take responsibility and accountability should any
malpractice be identified with the compliance to the conditions and practices of the system.
In this regard cognizance should be taken of Section 81(1)(b) of the Public Finance
Management Act in the event of authorizing expenditure for overtime not performed.

4.6 Heads of Institutions as well as Heads of Clinical Departments/supervisors are
instructed to ensure that the above control measures are implemented and maintained
effectively.

4.7 When medical practitioners change from one work sphere to another or from one rank
to another, they will have to complete a new contract because of changed circumstances. It
must be accepted that such changes might result in a reduction in the commuted overtime
rate, e.g. appointment of a medical officer to CEO/Chief Medical Officer position.

4.8 The continued need for additional overtime hours should be reviewed when vacant
posts are filled.

4.9 It is the duty of Heads of Departments to ensure that persons who make themselves
part of fraudulent practices with regard to overtime, are dealt with in terms of the relevant
disciplinary measures.

4.10 Medical practitioners working in a capacity/rank identified to participate in the
commuted overtime system, must, before the commuted overtime remuneration is payable
to him/her, sign an undertaking in which he/she undertakes to accept that the payment of
the applicable commuted overtime rates be terminated:

 on transfer/promotion to a post/rank not identified to participate in the dispensation; and
 where the establishment position is favourable to such an extent that the need for
overtime on a commuted basis expires.

4.11 Commuted overtime payment terminates:

 where the recipient is transferred/promoted to a post/rank not identified to participate in
the dispensation;
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 where the establishment position is favourable to such an extent that the need for
overtime on a commuted basis expires;
 where the incumbent of a post of supervisor is not directly linked to the supervision and
management of clinical medical services.

4.12 The commuted overtime tariffs are fixed and must not be taken into account when:

 any benefits/payments are determined which are derived from/based on basic salary;
and
 officers and employees are classified according to their salaries, for purposes of granting
any service benefit, payment of housing allowance, overtime remuneration and any
allowance, etc.

4.13 Commuted overtime is payable, as is basic salary, in installments over a period of a
year together with basic salary and where a reduced/increased basic salary is payable on a
pro rata basis, for whatever reason, the commuted overtime tariff must be
reduced/increased in the same ratio.

5. COMPULSORY OVERTIME AND REFUSAL TO WORK OVERTIME

5.1 In terms of the Basic Conditions of Employment Act, 1997, an employer may not
require or allow an employee to work overtime except by an agreement. This agreement
may be an agreement between the employer and an individual employee or it may be a
collective agreement.

5.2 The collective agreement regulating overtime in the Public Service (PSCBC Resolution
No. 3 of 1999, Part VII) specifically stipulates that the definition of overtime in the relevant
agreement refers to work in excess of hours of work per week or month that an employee
has contracted to perform. With due regard to the foregoing an employee in the Public
Service cannot be compelled to work overtime. The commuted overtime system which was
consulted with organized labour is based on the same principles.

5.3 In terms of the commuted overtime system, medical personnel engaged in actual
patient related clinical work on an organized basis, may participate in the aforesaid system
provided that the operational need exists for the rendering of overtime duties and on
the understanding that the individual fulfills the requirements as set out in the relevant
commuted overtime contract. The contract only becomes effective once both parties have
signed it. It is therefore clear that fulltime medical personnel do not automatically qualify for
participation in the commuted overtime system, that participation is voluntary, that the hours
overtime to be performed are

8

per mutual agreement and that participation is subject to the terms and conditions as set
out in the contract. Therefore should an individual not be prepared to apply for participation
in the scheme, the terms and conditions of the relevant system does not apply to him/her
and the employer cannot expect such a person to perform overtime under normal
circumstances.

5.4 In terms of current legislation, an employer may only expect an employee to work in
excess of normal working hours in exceptional circumstances such as in cases of
emergency, and not due to other factors such as personnel turnover, etc. The employer is
also not in a position to compel an employee to perform overtime duties in cases where no
agreement on the performance of such overtime duties exists between the employer and
the employee. In the case of medical personnel, the commuted overtime contract
constitutes such an agreement. Although the foregoing has the effect that existing medical
personnel will be acting fully within their rights to refuse to work noncontractual overtime,
it has been held in court that an employer may dismiss an employee who
persistently and unreasonably refuses to work overtime as required by the employer
due to operational needs.

5.5 In order to accommodate the Department’s specific need regarding overtime hours
needed and with due regard to the fact that it is the prerogative of the Department to
determine the conditions attached to employment within the parameters of the regulatory
framework (i.e. Public Service Act, 1994 (as amended), Labour Relations Act, 1995 (as
amended), the Public Service Regulations, 2001, and Collective Agreements), the opinion
is held that institutional heads should, based on operational requirements, determine
before advertising and filling of posts whether or not it will be required of the successful
candidate to perform overtime duties on an organized basis. In cases where the successful
candidate will be expected to perform overtime duties on an ongoing, organized basis due
to the nature of the post, this issue must be specified in the advertisement, be included in
the job description and clearly stipulated in the relevant employment contract. In such
instances the successful candidate will be fully aware of the fact that he/she will be required
to perform overtime duties and by applying and accepting such an appointment on the
terms stipulated, the successful candidate is obligated to perform overtime duties. In these
cases the employer has the right to call in overtime in terms of the contract of employment
and refusal by an employee to perform contractual overtime will constitute a disciplinary
offence.

9

5.6 With due regard to the aforesaid it is advisable that the number of overtime hours
needed per institution be managed as follows:

5.6.1 Heads of Institutions must determine their actual clinical, patient related hourly
overtime need (operational requirements) per week, preferably over a 12month period.
Once the overall need has been established, the actual number of overtime hours required
per week must be allocated to the filled posts of medical/dental personnel (as applicable)
on an individual basis. With the aforementioned information at hand the institutional head,
on identifying the need for the filling of a vacant post in the abovementioned group, will be
aware whether or not the post incumbent will be required to perform overtime duties or
whether the overtime already allocated to filled posts can be reduced. In the latter instance
the current commuted overtime contracts of existing employees will have to be revised or
cancelled and new contracts entered into. Record of this exercise must be kept on file as it,
inter alia, could serve as documented proof should a dispute arise pertaining to whether or
not the requirement of the employer for the rendering of overtime duties in respect of a
specific post incumbent was based on operational requirements.

5.6.2 In cases where there is a need for the performance of overtime duties at an
institution and certain existing medical personnel at such an institution are not prepared to
perform overtime duties (i.e. not prepared to voluntarily participate in the commuted
overtime system or are no longer prepared to continue with the performance of overtime
duties as contracted for and cancel their existing commuted overtime contracts), their
discharge in terms of section 17(2)(c) of the Public Service Act, 1994 (as amended)
may be considered. Before proceeding with the termination of services in terms of the
aforementioned section, the following process should be followed. It is important to note
with regard to the actions as set out hereunder, that the employee must be afforded the
opportunity to be represented by his/her union representative:

5.6.2.1 Consultation process:

(a) Request the relevant employee in writing to perform the required number of hours
overtime duties per week based on the operational requirements of the institution involved.
In the request elaborate on the negative impact on the work situation (i.e. the effect on
service delivery to patients and his/her coworkers) should the employee not be prepared to
perform the required overtime duties. Request the employee to respond in writing within a
specified period of time whether or not he/she is willing to perform the required overtime
duties and should he/she not be prepared to perform such duties, to submit reasons.

10

(b) Should the employee respond negatively to the written request, inform the employee (if
verbally, follow up in writing) of the fact that his/her refusal to perform overtime duties has a
detrimental effect on service delivery to patients and that his/her action cannot be
accommodated in the work situation of the institution concerned. Furthermore, the
employee must be informed that the head of institution has no other option but to seek an
alternative position in another component in the same hospital or at another institution for
the employee in question where it is not a requirement to render overtime duties (i.e.
relocate by means of transfer mechanism). Also inform the employee that should it not be
possible to secure a transfer to another position under the control of the Department of
Health, the head of institution has no other alternative but to request a termination of
service in terms of section 17(2)(c) of the Public Service Act, 1994 (as amended).

5.6.2.2 Actions to secure other employment:

Approach (in writing) the higher level authority (Regional Director/Chief Director), explain
the problem and request them to indicate whether it is possible to accommodate the
employee in question in a suitable position at any of the institutions under their control.
Upon receipt of the response, inform the employee concerned whether or not he/she can
be accommodated elsewhere. Where applicable, execute the necessary transfer actions.

5.6.2.3 Termination of services:

In cases where it is not possible to accommodate the employee elsewhere, such an
employee must be informed that every endeavor was made to secure alternative
employment but without any success. Furthermore, that due to the foregoing and the fact
that the continuous employment of the individual at the relevant institution negatively
impacts on the operational requirements of the employer due to his/her refusal to perform
the required overtime duties, the employer has no option but to request the termination of
service in terms of section 17(2)(c) of the Public Service Act, 1994 (as amended). The
employee must be given the opportunity to respond within a reasonable time and such
response must be thoroughly considered before the final recommendation is made for the
termination of service.

6. CATEGORIES OF OVERTIME REMUNERATION

6.1 The commuted overtime system makes provision for four categories of overtime
remuneration. The purpose is to make provision for a flexible system in order to
accommodate medical and dental personnel who do not perform overtime on a regular
basis, as well as those employees who regularly perform overtime duties.
11

6.2 The four categories are as follows:

Group 1 04 hours per week May claim for actual hours
overtime worked where such
duties are needed, as applicable
to other categories of staff in
terms of PSCBC Resolution 3 of
1999
Group 2 512 hours per week Overtime remuneration is
(average of overtime payable at a fixed tariff equal to 8
worked may not be less hours per week at 1.3 of the
than 8 hours per week) applicable hourly tariff
Group 3 1320 hours per week Overtime remuneration is
(average of overtime payable at a fixed tariff equal to
hours worked may not be 16 hours per week at 1.3 of the
less than 16 hours per applicable hourly tariff
week)
Group 4 >20 hours per week Overtime remuneration is
payable at a fixed tariff equal to
16 hours per week at 1.3 of the
hourly tariff plus actual hours
worked in excess of the limit of
20 hours at the applicable
overtime tariff as per PSCBC
Resolution 3 of 1999
6.3 Group 1

As indicated above, the measures contained in PSCBC Resolution 3 of 1999 are
applicable provided that the control measures as set out in the aforementioned agreements
are adhered to. Application forms and time sheets in respect of such claims must be
completed by the relevant supervisors and submitted to the delegated authority for
evaluation and approval (currently District Managers, Chief Director (Academic Hospitals),
or Head of Institution). The commuted overtime contract is not applicable to medical
personnel who resort under Group 1. In general, a maximum of 4 hours overtime
remuneration is applicable to Group 1. This may only be exceeded in exceptional
circumstances.

6.4 Groups 2 and 3

Medical personnel who wish to participate in the commuted overtime system as indicated
in Groups 2 and 3 must complete the commuted overtime contract. The Heads of Clinical
Departments, are responsible for verifying the contract as measured against the need for
overtime services in their clinical departments. Heads of Institutions are responsible for the
approval of individual contracts and are accountable to the AuditorGeneral for the effective
control of the overtime system. District Managers/Chief Directors of Academic Hospitals are
regarded as Heads

12

of Institutions in cases where Heads of Institutions (medical superintendent/senior medical
superintendent) wish to participate in the commuted overtime system. Should it be required
of these personnel to perform overtime work in excess of 20 hours per week, they must be
compensated in terms of the provisions as set out for Group 4.

6.5 Group 4

6.5.1 With regard to individuals in Group 4, Heads of Institutions are urged to limit the
need for overtime duties in excess of 20 hours per week. Claims and the subsequent
payment for hours worked in excess of 20 hours per week shall under normal
circumstances be limited to a maximum of 32 hours per week in accordance with the
measures of Public Service Regulations, Part V, D2. This limit may only be exceeded in
exceptional, fully motivated circumstances, e.g. in cases where an individual is
compelled to perform additional overtime duties as the result of severe staff shortages or in
a crisis situation. Claims in respect of every hour worked in excess of 20 hours to a
maximum of 32 hours will be administered in terms of the measures and criteria as
contained in Chapter VII of Resolution 3 of 1999. These claims must be accompanied by
the prescribed application forms and time sheets, and must be duly completed by the
relevant supervisor to be submitted to the delegated authority on a monthly basis for
evaluation and approval. The claims must be supported by a written motivation, with due
consideration to compliance with the normal official 40 hour workweek.

6.5.2 All medical personnel (including those who participate in the commuted overtime
system at their own institutions) who are willing to perform additional duties at other
hospitals, community health centres and primary health care clinics, may perform such
duties. Such personnel may claim for actual hours overtime duties performed at the
relevant institutions at the prescribed rates as set out in Chapter VII of Resolution 3 of 1999
on the condition that the criteria as mentioned in the aforementioned paragraph are
adhered to and provided that the Head of the employing institution is in agreement with the
arrangements.

6.6 With regard to personnel in the occupational classes Chief and Principal Specialist, as
well as Medical Superintendent, the following restrictions are placed on the maximum
number of hours overtime which are payable according to commuted rates.

6.6.1 Medical Superintendent, Senior and Chief Medical Superintendent:

 Medical Superintendents and Senior Medical Superintendents who render clinical
services in excess of the 12 hours commuted overtime per week, may apply for inclusion in
Group 3 in order to provide relief where there is a need for clinical services.
13

 If a Medical Superintendent applies to partake in Group 3, the Group 2 (8 hours) contract
lapses. Medical staff may only partake in one commuted overtime contract during a specific
period.

6.6.2 Principal Specialist/Chief Specialist:

12 Hours per week.

7. SPECIFIC PROVISIONS

7.1 The payment of the commuted overtime rates is only payable to medical officers,
registrars, specialists and medical superintendents. (OSD terminology should be used in
terms of post classes.)

7.2 A Hospital Manager or medical superintendent who is not directly responsible for the
management and control of clinical medical services does not qualify for commuted
overtime.

7.3 The clinical operational officer who is the supervisor of clinical services will qualify for
commuted overtime.

7.4 Dentists:

7.4.1 There has to be an approved monthly overtime roster for dentists linked to specific
hospitals.

7.4.2 A standby allowance (or as may be determined) is paid for the days that the dentist
is on call.

7.4.3 Actual time worked is recorded in the register every time the dentist is called to
the hospital for clinical work.

7.4.4 The dentist is compensated at applicable overtime hourly rate for actual hours
worked (Group 1).

8. POLICY OBJECTIVE

8.1 The policy on commuted overtime for medical and dental practitioners seeks to guide
the dispensation, whilst ensuring that the employing authorities stay on top of matters to
prevent abuse thereof.

8.2 The fundamental tenets of this policy are dependent on the ability of the Department of
Health to meets its human resource needs in the Public Health Sector in the short, medium
and long term.

oOo

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9/4/2015 www.fshealth.gov.za/portal/pls/portal/PORTAL.wwsbr_imt_services.GenericView?p_docname=3139576.

NATIONAL POLICY ON COMMUTED OVERTIME FOR MEDICAL AND DENTAL

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