KZN Health’s R452m sick leave bill
Durban - An alarming number of state health workers in KwaZulu-Natal are reporting in “too sick to work” - with absenteeism costing the province’s Health Department R452 million in one year alone.
This is according to the Health Systems Trust (HST), a respected NGO specialising in monitoring and research, in its annual review of the country’s health systems, released on Wednesday night.
It spoke of a crisis of ineffective health management in South Africa, painted a dismal picture of a lack of organisational support, and psychosocial stress among public health workers, resulting in high levels of absenteeism across all public health care facilities. According to the HST, this province is the worst affected.
Despite there being a national guideline on the medical surveillance of health workers, researchers found this was not being implemented.
“In some KZN institutions, medical surveillance programmes are managed by sessional doctors, mostly without any specific training in occupational health, and in others there is no medical doctor. Doctors without the necessary training are not able to assess hazards, nor are they able to recommend interventions to control these hazards or to implement medical surveillance to detect workers who are likely to acquire work-related diseases,” the report said.
The result was employees taking time off, leaving a huge hole in KZN Health coffers: R452m in 2014, compared with R15m the same year in the national Department of Health.
The latest findings come amid growing concern at the number of avoidable deaths at government health facilities and the impact of staff shortages and overworked workers in spite of an increase of more than 37% in the number of health professionals working in state facilities.
Reports of avoidable patient deaths and accusations of negligence among health workers have been further exacerbated by the latest findings that “moonlighting” among nursing staff in the public sector has had serious consequences in their performance.
While the Department of Health has tried to clamp down on moonlighting, this has failed to stop it. Nurses are driven by financial need to moonlight, with half of those interviewed by researchers reporting to be too tired to work on duty.
The report has called for a comprehensive evaluation of systems in place to monitor the health of public sector health employees. It recommends also that strategies be implemented to deal with ailing health workers who are unable to perform their duties at the required levels.
However, despite the low morale and rising number of sick health workers, researchers have found some positives in their analysis, acknowledging that the country had made remarkable inroads into transforming health care service delivery under the leadership of Health Minister, Aaron Motsoaledi.
“Since assuming the health ministerial portfolio, Dr Motsoaledi has provided charismatic and energetic leadership, raising the profile of key health issues and ensuring relatively widespread support for health sector reforms among a range of stakeholders. There are also many committed, competent, hard-working health service managers and health professionals contributing to change and doing an excellent job in implementing transformative health policies,” notes the report.
Key achievements noted in the country’s health transformation included the establishment of free primary health care facilities, placement of 3 million HIV-positive individuals on antiretroviral treatment (the largest HIV treatment programme in the world), and a successful strategy to prevent mother-to-child HIV transmission.
But, it said, these success stories had not been enough to turn around the overall performance of the health system.
It called for urgent attention to address the less-discussed “crisis of ineffective management, incompetence and failure of leadership and governance at all levels of the health system, exacerbated by a general lack of accountability”.
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