Pretoria - Half the positions in South Africa’s state hospitals are vacant - and that’s not including specialists or chief executive officers.
The South African Institute of Race Relations (SAIRR) said 56 percent of doctors’ posts in the public sector were vacant, as were 46 percent of nurses’ posts.
In numbers, that’s 14 351 fewer doctors than the country needs, and 44 780 fewer nurses. The figures exclude dental assistants, specialists, nursing assistants or student nurses.
The 2010 numbers are from the Health Department’s human resources strategy until the 2016/17 financial year.
SAIRR researcher Lerato Moloi said the numbers were worrying.
“The three focal points of the National Heath Insurance (NHI) scheme, as outlined by the (department), are to ensure every South African has access to quality health services; to decrease the burden of disease; and, to improve the overall performance of the health system,” she said. “With such vacancy rates, these objectives seem unachievable.”
The figures come on the tail of numerous reports of staff shortages at public hospitals around the country. At hospitals in Gauteng, Limpopo and the Eastern Cape, this has been linked to increased mortality rates - particularly in maternity wards.
Limpopo was worst affected, needing about 5 700 entry-level doctors and more than 15 600 nurses. Four children died recently because of staff shortages linked to holiday leave.
The Eastern Cape needed another 16 683 nurses. Last year, specialists at the Port Elizabeth Health Complex released a damning statement blaming the limited numbers for a drastic increase in infant and child mortality rates in 2012, with growing surgery waiting lists in every other department. KwaZulu-Natal was close behind, short of nearly 3 000 doctors and 4 300 nurses.
Gauteng needs another 1 600 doctors and 1 700 nurses.
On Thursday, Health Minister Aaron Motsoaledi said 102 of the 118 hospital chief executive positions advertised last year had been filled.
“We want to state that this recruitment was a very difficult process because we were looking for the best quality,” the minister said on Thursday.
The chief executives take up their positions on February 1, when they will go for induction at the recently launched Academy for Leadership and Management in Health Care.
At the academy they will also be taken through the role they will have to play at the helm of the hospitals.
“Early last year, we embarked on a massive recruitment drive, advertising 92 posts from national and 30 for provincial departments,” Motsoaledi said.
He said studies had found that hospitals were not well managed because their chief executives were not trained for the tasks they faced. “We found that those (chief executives) with a health background fared better in their positions.”
During an assessment of chief executives, Motsoaledi and his team had discovered that some positions were filled by acting officials and others by unqualified staff.
Criteria set for the new managers include the basic requirement, over and above the qualifications they must have, that they are health workers.
They are also required to have five years’ experience in middle or top management in health, and for central hospitals, to come in at a position no lower than that of deputy director-general.
Motsoaledi admitted that the process had been tough and quality scarce in some areas, and that long hours of interviews often ended with no appointments being made.
He chaired the four Gauteng interviews, to which he was accompanied by his deputy, Gwen Ramokgopa, and director-general, Precious Matsoso.
The interviews saw Steve Biko Academic Hospital’s Dr Ernest Kenoshi retain his position, albeit being promoted from manager level; and Thulani Madonsela taking over at Ga-Rankuwa’s Dr George Mukhari Hospital.
He said: “The interviews sought out professionals who displayed the ability to lead and manage, on top of being adequately qualified, and we asked them for a plan for their first 100 days in office.”
Motsoaledi said he was confident that the newly appointed chief executive officers were the best equipped to steer hospitals in the desired direction, and to effect the ideals set out in the re-engineering programme.
Some pockets in the country, however, remain without executives: 16 positions remain unfilled in areas like the Eastern Cape, where the reclassification of hospitals is being undertaken, and Limpopo, whose department has been fraught with problems. In the Free State, the recruitment process was disrupted by the death of Health MEC Fundiswa Ngubentombi in December. “They asked that the process be delayed and we will start soon,” the minister said.
There was no time frame in which the appointments had to be done, he said, adding: “The head-hunting continues. (When) we (find) the right people, we will make the appointments.”
The appointments form part of the minister’s plans to overhaul the public health system.
The process is aligned with the NHI plan, which is aimed not only at improving the quality of health care delivered to the poor of the country, but also ensuring accessibility to health services by everyone.