The doctors involved in Thumela wanted to find out what our colleagues’ opinions are regarding the proposed new Commuted Overtime policy in order to assist with providing a united and informed response. One of our directors was going to a SAMA meeting and wanted to have some idea the concerns so this survey was quickly designed and conducted.

Below are your responses in summary form. We received a total of 367 responses after sending out links on Facebook.

Some of the recurring themes of responses have been highlighted in each of the sections. We are busy collating the individual responses and will be able to give a more detailed breakdown including responses according to the various doctor categories and so on.



Category of doctor


fairness current

Themes: Many reported working more than the hours you get paid for and working more than others. Being able to plan for your monthly income also came up regularly. A number of both juniors and seniors acknowledged that consultants need to be retained in the state sector through a decent package which includes overtime.

read contract

 We included a copy of the new COT policy for responders to read.

Stay in state

 Over a third of responders reported that they would definitely leave the state sector if the policy went forward as is.

Def normal hours

Themes of reasons to disagree:

Most disagreements stemmed from the use of the “first 40 hours” concept, and issues related to early calls in the week and hours after 4pm therefore being “normal”, as well as working more than 40 hours as normal work hours

COT definition

Themes of reasons to disagree: concerns re not having a cap, the “delegated designated authority” and “operational needs”, issues with the definition being too vague

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Themes of reasons to disagree: issues re lack on-site facilities to sleep or rest, being too complicated to enforce, covering multiple hospitals, the fact that consultants are often giving advice telephonically throughout the night, on-duty/on-call rather than on-site

who should get off-site

equal percentage

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Themes of reasons to disagree: it still requires you to put your life on hold, unable to plan, your mind being on work, issues regarding the low basic salary were brought up by many, consultants will be highly affected by this change and was reported as unfair

is the contract clear

How do you feel time spent on-site during an off-site call should be calculated?

There were many different opinions given, themes included: quoting legislature that stipulates we should be paid 1.5-2 times our hourly rate, others said left as is, some said at least 50% of overtime while others 100% of overtime, some mentioned specifics regarding off-site payments as including travel time, others said needed to be given in longer time periods due to the disruption and inability to sleep afterwards.

What do you think defines ‘performing actual patient related clinical services at the workplace’?

Complaints about this being too vague was a serious concern that came up regularly. In addition to the usual activities listed, many also specified that advice, training and administrative tasks also should be considered

HR capacity

Thumela firstly would like to note that the new policy is not on a claim-based system but remains a commuted overtime-type contract. This aspect of the contract has often been misinterpreted by both HR and doctors and we would like to clarify that the auditing/logging of overtime hours is to ensure that you are regularly reassessed and placed in the correct category of overtime (eg. 13-20 hours per week)
Themes of reasons to disagree: HR understaffed, HR inefficient and delayed, track record of non-payments, unable to handle current tasks

Please provide suggestions on how overtime should be paid

Themes: fixed monthly overtime for everyone, basic salaries were brought up again here, many suggested it should remain in the same format as currently, others brought up that the overtime needed to reflect legislature


 obligatory overtime

Further overall comments from questionnaire responders:

Disappointment and frustration with the DoH/Gvt were expressed, and some expressed anger

Doctors need to be appreciated

Should be consulted before policy changes such as this

Doctors need to unite

Salaries and overtime need to increase, not decrease

Whole salary needs to be looked at including basic

Issues re some individuals abusing the system

Comments from Thumela 

Thank you for participating in the survey, it helps to give us a more informed and balanced response to the communication channels with our unions like SAMA and the DoH itself.

As one can see, there are a number of varied opinions on various aspects of the policy which require further interrogation and analysis.

From our perspective, it is good to see doctors taking an interest in understanding policy and the systems in which we find ourself. As Thumela, we are passionate about trying to do our bit to help improve the system and hope that we can use this information to help advance our cause as doctors.

This survey was designed and distributed by Thumela.

We do acknowledge that there are areas where the questionnaire could have been improved had we had more time to design and do extensive background research. Owing to the short-notice of the SAMA meeting and our need to design the survey quickly, we hope that this managed to be the starting point of some discussions and research so that we can come up with the best possible solution and policy that works for both the doctors and for the DoH, but most importantly the patients.

To communicate with us please contact or