from Magna Carta
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Moms, especially working moms, dread that early morning call informing them that their nanny or live-in domestic worker has taken ill and can't make work that day, or worse, that week. Not only does this mean speedy planning and play date scheduling, but a whole domino-stumbling load of other problems.

It's not that easy to replace our nannies with just anyone because strong bonds are forged between kids and their nannies. Surely these women who are dedicated to caring for and protecting our families should receive the same care in return.

Sadly, the reality is that very few employers include medical benefits when negotiating a domestic worker's pay package. The excuse is always around affordability but with pending Low Income Medical Scheme (LIMS) legislation on the horizon this issue will be faced head on, impacting on the healthcare needs of some three million low-income South African's when passed in 2007.

What LIMS entails
The primary aim of LIMS is to partially relieve some of the burden from the public healthcare systems that have been put under immense pressure by the government's Social Health Insurance (SHI) policy. In order for this to happen our private health care and medical aid schemes need to be substantially adjusted so as to ensure affordability for low-income earners and their employers.

This has not, until now, been a feasible option for most private employers, considering the prohibitive cost of private medical aids or health care schemes. Usually it's the top earners in large corporate organisations that can afford to pay for private healthcare that get the subsidised benefits with access to discounted and private medical schemes. The remainder of the SA workforce with the highest risk factors as a result of daily exposure to poor conditions, exposure to people with serious illnesses and often incurring the harshest injuries are left uncovered.

Domestic workers and nannies fall into this category who when ill have no alternative but to wait the many hours in overcrowded hospital waiting rooms, often exposed to the sick and infectious patients also waiting their turns. Instead of receiving the treatment they need they are often infected with more heinous germs which of course are then spread at their own homes and the homes of their employers the very next day.

The only remaining solution it seems is to jump onto the private healthcare bandwagon that certain progressive companies have already launched. One of these is OCSACare that offer companies and individuals unlimited access to private doctors, with no queuing, as well as access to unlimited medication at no additional cost to the member. The fixed monthly of R150.00 is as easy as direct debit orders payment via the employer's credit card.

"Mums would rather know that the hands holding and feeding their children belong to a healthy individual, and not someone that struggles to take care of their own medical needs due to financial limitations", says Annie Matthews of OCSACare, "the standard of care giving from OCSACare to the privately employed individual and the factory worker is the same as we would expect and provide for ourselves".

What the law says
The South African Department of Labour's basic guide to domestic worker employment states that domestic workers must get wage deductions for medical insurance if the employer provides this, but there is no detail further detail specified in the guide.

Stephanie Dawson of Choice Child says, "By law an employer doesn't have to provide medical cover, so by default it does not form any part of the agencies responsibility when placing nannies and au pairs. We offer employers a pro forma contract to use as reference or as their template when hiring new staff. This covers what the employer has to offer by law; tax, UIF, leave and overtime, but on average less than 2% of nannies placed by us receive medical benefits. It is the responsibility of the employee to request this should they require it. They do not have the right to insist or demand. The employee has the choice to accept the position with the terms of employment offered by the employer or look for another position that better suits them."

According to Americannannyjobs.com many nannies looking for work privately or through an agency in most parts of the USA can expect the family that employs them to cover at least 50% of their health insurance for the first year of employment whereupon they will cover the full amount for the remainder of the employment.

The exact date or even month for the passing of the LIMS legislature in South Africa remains unconfirmed but it is clear that this legislation, along with emerging low cost private healthcare schemes will provide essential private healthcare solutions to our domestic workforce.

Visit www.ocsa.co.za for more information.