A radically democratic, worker-led union of frontline health professionals committed to transforming South Africa’s health system.
We, the frontline clinicians of South Africa, united in our conviction that health care is a public good and a human right, establish this Constitution to create a democratic, worker-led union that defends the dignity, rights, and conditions of clinicians and patients alike.
In the face of widespread state and private sector corruption, bureaucratic unaccountability, and political neglect, we found DOCSA as a radically democratic, bottom-up alternative. It shall be governed directly by its members, guided by the principles of transparency, equity, accountability, and collective power.
This union is not just another organisation — it is a profound break from the top-down bureaucratic structures that have long dominated South Africa’s labour movement. DOCSA is an expression of a new kind of unionism, one founded on direct democracy, where power flows upward from the members, not downward from distant executives.
We believe that democracy, in its truest and most uncorrupted form, is not the occasional election of leaders but the daily rule of the people over the institutions that govern their lives. True democracy is not representation — it is participation. It is not leadership — it is collective decision-making. It is not control from above — it is autonomy from below.
Democracy, as currently practiced, stops at the gates of our workplaces. But if the workplace is where we spend our lives — where decisions are made that affect our bodies, our patients, and our futures — then democracy that excludes the workplace is not democracy at all.
We believe the next horizon of democracy is workplace democracy, and there is no better sector to begin than health care. The dysfunction, inefficiency, and inhumanity of the South African health system originate not in a lack of resources or policies, but in a fundamental structural flaw: the system is not led by those who deliver the care.
Our health system is ruled by bureaucrats, controlled by politicians, captured by private profiteers, and administered in a top-down manner by managers who do not face patients. This disconnect is the root of our crisis.
We aim not only to improve working conditions or advocate for salaries — though we shall do so — but to fundamentally transform the health care system. We believe that hospitals and clinics must be worker-run, clinician-led, and democratically controlled by those who labour within them in the service of the public.
This vision includes all who face patients and contribute to their healing and care. DOCSA is proudly and consciously inclusive of colleagues in all health professions: dentists, physiotherapists, speech therapists, occupational therapists, clinical psychologists, clinical associates, and others who serve alongside doctors and nurses at the frontlines of care.
We recognise that true health care is delivered by teams, and the future of a just system depends on the unity of all clinicians across professions, in both struggle and governance.
A health system run by its workers in the interest of the public is not a utopian dream — it is the rational, necessary next step for a country still scarred by inequality, inefficiency, and authoritarian administration. Only a clinician-led system can ensure health care serves the people, not the politically connected.
DOCSA exists to build the organisational foundation of that future. This Constitution lays the groundwork not only for a union, but for a new way of thinking about power, labour, and democracy. We will prove in practice that when clinicians govern themselves, they do so more fairly, efficiently, and ethically than any top-down administration ever could.
Let this Constitution serve as a beacon for a new model of unionism and of health care — one in which real democracy is lived daily in the workplace, and in which the health system is reclaimed as a democratic, living structure for the people of South Africa.
We do not ask for permission to lead ourselves. We claim it — together.