Employees ’ perceptions of the implementation of affirmative action in the health sector in the Standerton District in South Africa

Since the inception of a fully democratic government in South Africa in 1994, government and trade unions have been placing increasing pressure on government departments and public institutions to introduce steps to correct racial discrimination through the implementation of affirmative action (AA). This study, which was carried out in the Standerton Health District, assesses employees’ perceptions of and attitudes towards the implementation of AA. A quantitative design was used. Data was gathered from a total population of 360 employees by means of a question­ naire. The study revealed the following major themes: • Respondents feel that if AA were effectively implemented, there would be an increase in productivity. • There is strong support for the implementation of AA appointments. • The implementation of AA will fail if the goals of AA are not properly and effectively communicated to all employees.


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The implementation of AA will fail if the goals of AA are not properly and effectively communicated to all employees.

Background
Several government institutions have already implemented affirmative action and non-discriminatory policies.The aims of these policies are to address and rectify the disparities in employment within the labour market that arose as a result of apartheid and other discriminatory laws and practices.The Employment Equity Act 55 of 1998 has certain clearly stated intentions; the first of these is to promote equal opportunity and fair treatment in employment by eliminating unfair dis crimination, and the second to implement affirmative action measures to redress the disadvantages in employment experi enced by designated groups (black people, women and people with disabilities) in order to ensure their equitable represen tation in all occupational categories (South Africa, 1998).The Standerton Health District, which is where the researcher works, comprises Standerton Hospital, Standerton Clinic, Balfour Clinic, Siyathemba Clinic and five mobile clinics, and is situated in the Eastern Highveld of Mpumalanga.There is a staff complement of 360.It is abundantly clear that the Standerton Health District is still characterised by racial in equities at the managerial and supervisory levels.Disparities in employment, supervisory levels and occupa tion promotions have created pronounced disadvantages for black people, women and people with disabilities.Redress ing these disparities, in essence, needs the commitment of management as well as the entire workforce through the pro motion of equality and the correction of imbalances in em ployment opportunities as required by the Constitution.It is crucial that the implementation of employment equity cor-

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Curationis November 2001 rect the effects of discrimination, and the workforce must there fore be more representative.

Terminology Equal opportunity
Equal opportunity refers to the provision of exactly the same opportunities with regard to employment practices to all peo ple.This means in essence that any post that is available must be open to all people.Human, Bluen and Davies (1999:7) state that the following main principles should guide the defi nition and implementation of affirmative action: • It is a means of creating equal employment opportuni ties.

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There should be a sense of proportionality to the quali fied labour pool.

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Affirmative action should not be interpreted in terms of rigid quotas.

Affirm ative action
The Employment Equity Act 55 of 1998 defines affirmative action as measures designed to ensure that suitably qualified people from designated groups have equal employment op portunities and are equitably represented in all occupational categories and at all levels.Adams (1993:82) sees affirma tive action as a means to an end, defining it as a temporary measure designed to facilitate the process of creating equal employment opportunities by eradicating racism and sexism at various levels of organisational life.
Affirmative action is an effort to develop a systematic ap proach to opening the doors of education and employment to qualified individuals who happen to be members of groups that have experienced long-standing and persistent discrimi nation (Gracia, 1997:4).
Affirmative action was first implemented in America, where it appears to have achieved some of its main objectives.Ac cording to Thomas (1996:108), more than half of the US workforce now consists of minorities, immigrants and women.South Africa could learn from the American experience of continued redress of past imbalances.
A history of affirmative action In South Africa the apartheid model created a mindset in which black employees were legally and informally prohib ited from advancing to the skilled or managerial level in a "white" organisation situated in a "white" group area (De Beer, 1998:9).Racial discrimination was one of the defining features of apartheid and was entrenched in a range of statu tory provisions for many years.In the area of employment, the most visible legislative measures designed to afford racial privilege were incorporated in the policy of reserving jobs for certain groups of people (Adams, 1993:6).According to Adams (1993:6), Afrikaners used their vote and formed what ever alliances were necessary to gain power.Once in power, they passed legislation such as the Industrial Conciliation Act of 1924 as affirmative action to ensure positions for whites as opposed to using cheaper black labour.
According to Kahlenberg (1996:6), the legacy of discrimina tion has caused a concentration of blacks in lower-level posi tions for the following reasons: • Black people were disproportionately poor.This has been a legacy of unequal opportunity, which has been created by skills imbalances in the past.

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White people stereotyped black people as poor and as either criminals and vagrants or as peo pie to whom orders should be given, not from whom orders should be taken.Wingrove (1993:123) indicates that organisations have appointed blacks to positions where they have the least influence or decision-making power, or else they appear to have been appointed to senior positions, but decisions are taken without their involvement.

Problems associated with affirmative action
Despite the positive intentions of AA programmes, AA is of ten not implemented well in South African organisations.Several factors have a negative impact on the success of the AA implementation process:  (1996:133) states that affirmative preference has in reality too often been some form of corrupt decision-making in which someone's personal friend got the job or promo tion.As a result, an incompetent person from a designated group could find success through corruption, whereas a com petent person might fail.All people from designated groups then suffered from the stigma created by affirmative prefer ence.It is essential that when affirmative preference is im plemented, efforts be made to implement AA effectively.

Impact of affirmative action on productivity
In most instances, the lowering of standards is used as an excuse for not implementing AA.It is presumed that black employees lack ability, and that affirmative action recruits will deliver work of poor quality in comparison with white employees.Those who use this argument have tended to as sume that in the past, standards were the only criteria used in South Africa to determine who got a particular job.Job res ervation ensured that black people were legally barred from undertaking a wide range of work simply because of the col our of their skin, and regardless of whether or not they had the skills to undertake the job.

Aims and objectives of the study
If management is transformed and the designated groups fill senior positions in the District, the credibility of the health facilities may improve.It is therefore crucial to obtain the perceptions of the employees about this situation; hence the aim of the study, which was to ascertain the attitudes and perceptions of employees regarding the implementation of affirmative action in the Standerton Health District, and to ascertain employees' previous experiences with regard to AA.This extended to the following information:

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Acceptance or resistance experienced by employees in terms of the implementation of AA • The availability of and access to policies and procedures guiding the implementation of A A

Research procedures
A quantitative survey design was used.According to Bless and Higson-Smith (1995:43) and McMillan and Schumacher (1994:42), a quantitative survey design is a methodology that collects information from a wide range of cases, and is gener ally used in eliciting people's reactions, perceptions, beliefs and attitudes.This design was thought appropriate for the Standerton Health District because of the large range of re spondents it could cover, resulting in generalisable findings.

Population and sampling
The population frame to participate in this study consisted of 360 Standerton Health District employees.The sample frame for the survey equalled the entire staff complement, i.e.N = universe = 360 employees.Prior to the actual visit by the re searcher, the Principal Personnel Officer of the District was contacted and asked for a printout of all employees for the eight facilities for the purpose of sampling.

The instrument
A new instrument was developed for this study, the rationale being that no similar instrument in the area of AA in health was available for reuse.The development of the question naire was based on the key aspects of AA, the Employment Equity Act and the Skills Development Act.The question naire collected the following main types of information: • Respondents' biographical details in order to estab -lish respondents profile • Likert scale-type questions (30 items) that elicited re spondents' perceptions, opinions, beliefs and attitudes regarding AA (Huysamen, 1994:126) Validation of the instrument For the purpose of instrument validation and checks on reli ability, the questionnaires were issued to two other independ ent researchers for review and then piloted amongst six em ployees (Mouton, 1996:103).This process allowed for the identification of difficulty in questions, accuracy and appro priateness of the instrument, i.e. the length, ambiguity and bias of the questions.Item analysis of the Likert scale, which is an examination of the extent to which the composite index relates to its individual items, was done and items yielded positive external validity (Babbie, 1995:G3).

Data collection and capturing
The questionnaire was self-administered.The researcher vis ited the Standerton Health District and distributed the ques tionnaires amongst respondents, a method considered to be most appropriate in achieving the highest response rate (Bless & Higson-Smith, 1995:107).During data collection, a total of eight facilities (i.e. the hospital, clinics and district office) were visited and the District Manager was requested to in form employees that they would be receiving questionnaires and to urge them to complete them.

Findings Respondent profile
A total of 246 participated in the survey, i.e. completed the questionnaire and returned it.This constituted a response rate of 68%, with a theoretical margin of error of 2,04, and a standard deviation (SD) of 1,96 at a 95% confidence interval level.Of the participants, 84,4% were female and 15,6% male.Their age groupings were as follows: 16,3% were in the age group 21-30 years, 35,4% were in the age group 31-40 years, 32,1% in the age group 41-50 years, 15,4% in the age group 51-60 years and 8% were 61 years old and above (N=246).
One assumption of AA policy is that for its implementation to be fully successful, employees appointed to or earmarked for AA positions should be competent and highly skilled/quali fied.For this reason the academic qualifications of the staff members were ascertained, and it was found that 24,0% had matriculated, 20,6% had achieved a qualification between sub A and standard 7 and 6,6% held degrees.From table 1 above, it is evident that the educational qualifi cations of the majority of Africans in the Standerton Health District range from no qualifications at all to lower-level quali fications.Opportunities for staff training and development should therefore be created for this group in order to equip them for AA appointments without sacrificing standards.
Table 2 : M anagem ent levels by racial group (N = 2 3 3 ) whites' opportunities of occupying higher positions, which could lead to fear and demotivation among this group.Affirmative action is associated on one hand with a drop in productivity (item 4), and on the other, with a lowering of standards (item3) (Innes, 1993:13).

Perceptions of affirmative action
Table 3 presents the responses to the 30 statements relating to AA that were presented in a three-point Likert-type scale.

Perception of affirmative action (N = 2 4 6 )
Employees' perceptions and attitudes regarding the imple mentation of affirmative action at the Standerton Health Dis trict are summarised and discussed in various themes.Theme discussions are based on extracts of table 3 with referencing made to item numbers.

Resistance of whites
The majority of the respondents have the following opinions about whites' resistance to affirmative action: • There is fear that affirmative action could reduce drop.Whites, however, constitute a small fraction of the sample (21%).

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There is a belief that racist attitudes by white managers are enough to slow down the imple mentation of affirmative action because these manag -ers are threatened by AA (items 12 and 18).• White employees are less supportive of affirmative action employees than they are of white employees.Their perception is that the chances of whites getting higher posts will be reduced (items 26 and 5).

Managem ent practices
Managers should become more participative in their mana gerial styles to foster the implementation of affirmative ac tion.In this regard, employees suggest a more consultative approach to facilitate the implementation of AA in the work place.There is also considerable agreement that affirmative action will definitely fail if management does not communi cate the goals of affirmative action to all people involved in the process (items 19, 20 and 27).

Labour relations
The following opinions about labour relations are widely ex pressed: If affirmative action were to be properly implemented, there would be a decrease in complaints of discrimination in the work situation and unfair labour practices, and labourers, the majority of whom are black, would be less aggrieved with management practices than is currently the case (items 14, 15, 23 and 24).It therefore appears that A A could have a positive impact on labour relations in the district.

M otivation
Judged by responses in items 1 and 27, it appears that af firmative action has a major influence on employee motiva tion: Black employees would be motivated to work harder if they were given the chance to occupy higher positions, since many have not been afforded opportunities for advancement.Once given a chance, however, they would be motivated to work harder to prove their capabilities.
There would be more co-operation in the work situation if all race groups were given opportunities to work together and this could motivate the affirmative action employees to im prove their performance.This would signal the end of inef fective token appointments.

Training and development
There are different perceptions as to whether educational dis advantages have made blacks less capable than whites.A sig nificant 56% of black respondents are of the opinion that edu cational advantages have caused a barrier in terms of the ca pabilities of the two race groups.There is a high degree of agreement, also supported by Wingrove (1993:123), that when black employees are placed in senior positions, they are not given authority by management to make decisions on their own.Blacks are appointed to positions where they have the least influence or decision-making power, i.e. their post has "a grand-sounding title, but it is stripped of all its decision making powers" (Innes, 1993:15).Some of the opinions con cerning training and development in the district are as fol lows:

Recommendations
The study has elicited a number of challenges and possible recommendations, which are discussed below:

Discrim inatory practices
To eliminate discriminatory practices, the researchers recom mend that programmes on non-discriminatory practices and familiarisation with policies in the Standerton Health Dis trict be held.These programmes could include workshops and sessions on diversity management and intercultural commu nication.
To design and develop an appropriate recruitment strategy for the Standerton Health District to satisfy the requirements of achieving representativeness in line with the Employment Equity Act, the district office should keep statistics of person nel from all the facilities under its jurisdiction in terms of race, gender and disability.

Policies and procedures
For AA to be implemented effectively, it is important that internal policies be formulated in order to provide guidance and clarification.
cial stereotypes and building better relationships between dif ferent racial groups.It is furthermore essential that senior man agement filter down the District's mission statements to lessen the gap in communication and observe whether these state ments are complied with in such a way that they do not lose their meaning.

Training and development
Based on the perceptions regarding training and human re source development, diversity sensitisation programmes should be conducted with a view to stimulating acceptance of affirmative action as a whole.
To overcome the resistance of whites to the implementation of affirmative action, specific training programmes need to be developed.For instance, sensitisation programmes, which iden tify substantive and perceptual grounds behind this resist ance, and focus groups aimed at areas of resistance, would be considered appropriate interventions.
The proper implementation of affirmative action in order to enhance productivity and increase work standards revolves around the issue of training and developing affirmative action candidates.This should be preceded by proper recruitment and selection practices based on capabilities to avoid token ism.

Conclusion
This study was carried out to assess employees' perceptions of and attitudes towards the implementation of AA in the Standerton Health District.Respondents feel that if AA were implemented effectively, labour relations would improve, thus creating an environment conducive to increased productivity.While there is support for the implementation of AA, certain programmes such as effective communication and training and development should be key features of the overall AA strat egy if its implementation is to succeed.Assessing the percep tions of employees regarding the implementation of affirmative action is essential to identifying problem areas and to develop ing appropriate action plans to improve the situation.
Policies and procedures should be clear in guiding the implementation of affirmative action in order to avoid misunderstanding of the principles.Where procedures are not well defined and communicated, they should be redesigned in order to aid effective implementa tion.
The implementation of affirmative action is to the ad -vantage and benefit of the department and its commu -nity.It should not be based on fear or tokenism and should therefore not compromise service delivery.
W ingrove(1993:5)states that "affirmative action" is an American term first introduced by President Kennedy in 1961, but only legislated for the first time in the United States by President LB Johnson in 1965.Its origins lie in the Univer sal Declaration of Human Rights formulated in the 1940s by the International Labour Organization, which states that eve ryone is entitled to pursue his/her material well-being and spiritual development irrespective of his/her race, colour, sex or any other status.At present in South Africa, affirmative action is an anti-discrimination measure reinforced by legis lation, namely the Employment Equity Act 55 of 1998.

Table 2
reveals that the majority of Africans occupy lower and non-management levels.However, 13 respondents did not indicate their portfolios.The need for affirmative action, coupled with training and staff development, which was il lustrated in table 1, is again apparent from table 2.

Table 3 :
Perception of affirm ative action