Cape Town - A crisis in the public health sector is inevitable, due to the Department of Health’s freezing of vacant posts, doctors and nurses’ unions said.
The move is meant to cut costs, but unions including the Cape Metro Health Forum say this could result in worsened service delivery in an already ailing public health sector.
The SA Medical Association (Sama), including Junior Doctors Association of SA (Judasa) and National Education Health and Allied Workers Union (Nehawu) said the policy by the department not to automatically fill vacated posts would, in the long term, “hurt the public sector” as many of the affected jobs were crucial clinical posts.
Such a move also added pressure on the existing health workers who often had to take time off and sick leave due to exhaustion and stress-related illnesses.
“We foresee a worrying trend developing in which our health system will be void of senior expertise needed to train and mentor doctors in developing their skills in order to best serve patients,” said Judasa chairman, Dr Zahid Badroodien.
Since last year, the department, as part of austerity measures following budget cuts by the national government, has not been filling some posts which became available due to retirements or resignations.
Department spokesman Mark van der Heever confirmed the department was currently reviewing every vacancy and only filled vacant posts “based on operational requirements”.
“It is a reality that reduced budget allocations put extra strain on the health system. The constrained economic environment is a challenge to the entire department and every vacancy is critically reviewed, as it has always been done as part of good governance,” he said.
According to the latest 2015/2016 annual report, there were 4 149 employees that left the department, with 1 777 resignations and another 1 710 leaving due to expired contracts. Four hundred and eighteen employees retired, while 82 staff members died and 71 were medically boarded.
Of those who resigned, 399 left for better remuneration, 816 resigned from their current positions, 202 started their own business and 104 left for other occupations. The majority - 1 286 - of those who resigned were aged between 25 and 49.
Van der Heever wouldn’t confirm how many posts had since been filled. “I cannot give you totals as these are institutional-based, but if a post is a critical one, it will be filled to ensure continued delivery of health service.”
But the irate unions and the health forum lashed out and cautioned the freezing of posts should not affect any clinical posts, including nursing and doctor positions, as all such posts were critical.
Dr Mark Sonderup, vice-chairman of Sama, demanded the department should cut the “unnecessary” administration and management jobs instead of clinical posts.
He said while freezing posts could benefit the department in the short term, long term it would have unintended consequences and could negatively affect the delivery of health services.
“We appreciate that there are budget constraints, but the non-filling of posts should never compromise service delivery,” he said.
Badroodien called on the department to prioritise the employment of health professionals “who add hands and skills to an already understaffed profession”.
“Taking the number of health professionals out of the system only places an unnecessary burden on all role-players, with the patients being the worst-affected. Needless to say, it will also have a direct effect in the short term on our ability to deliver a service to an overburdened patient population.”
Damaris Kiewiets of the Cape Metro Health Forum and Nehawu provincial secretary Eric Kweleta said the freeze not only took away much-needed skills, it also placed extra pressure on existing staff.
Kiewiets said Delft and Macassar community health centres were some of the facilities that were negatively affected by the freezing of posts, and for several months the facilities had no clinical nurses.
Cape Argus