Gauteng freeze on new doctors, nurses except for critical posts
Gauteng Health has warned that posts are to be frozen and there will be disciplinary action if new staff is appointed
Not a single doctor that resigns at Gauteng hospitals may be replaced – unless, according to the provincial health department, it is a critical post. Now it seems nurses’ posts are also in jeopardy.
The head of the Gauteng department of health sent letters to district staff, heads of department, hospital CEOs and university deans warning them that posts are frozen. They were warned of disciplinary action if they tried to circumvent the ban by hiring staff and backdating appointment letters.
Departments at academic hospitals have been told only half of all people who leave will be replaced. Times Select has established that some foreign doctors’ contracts are not being renewed.Yet the Gauteng department of health denies there is moratorium on posts. Spokesperson Lesemang Matuka says the letter was an “internal memo” and critical posts will be filled. “There is no moratorium on critical posts.”
“They are lying,” said a doctor who works at the Chris Hani Baragwanath Academic hospital. Staff shortages are leading to difficulties serving patients and postponed emergency operations at night, various doctors told Times Select.
The letter states: “Due to the ever-increasing over-expenditure on the compensation of employees the department has taken a decision to sternly monitor the filling of posts in all facilities.”
The Gauteng department of health owes almost R7-billion to suppliers in unpaid bills, according to testimony that emerged during the Esidimeni hearings.The letter explains the human resources department, called eGovernment, has been prevented from adding new employees to the payroll system in order to stop new appointments. “Kindly be informed the Department of E-government has been requested not to process any appointment from all institutions under Gauteng Department of Health.”
The department said a centralised unit of officials will decide which posts can be filled. But Democratic Alliance spokesperson on health Jack Bloom said centralised appointments led to “red tape and delays”. He also asked how a central team could really ascertain what was happening at 34 hospitals and assess from afar which appointments were the most critical.
A senior professor said the situation was serious but not yet “critical”.
Another professor said it was hard to decide what was a “critical post” as most positions were critical. Even a junior nurse may have an important role in checking if operating equipment was sterile and without them a patient could die, he explained.
The professor said many heads of department are not replaced and so deputies land up doing two jobs.Some of the vacant posts include:
• Head of department of dentistry at Sefako Makgatho Health Sciences University.
• Operations are delayed at night at the Chris Hani Baragwanath hospital due to a shortage of staff in surgery and emergency outpatients.
• The interventional radiologist position at Charlotte Maxeke Academic Hospital, stopping diagnostic procedures that use CAT scans and MRIs, delaying both diagnosis and treatment or surgery.
A surgeon from central Africa, who has worked in South Africa for 12 years, says his contract at a hospital east of Johannesburg has not been renewed because the hospital was told there was no money. He supports his children at school and university and has been unemployed from the beginning of April.
The hospital pleaded with officials in a letter seen by Times Select that his contract be extended because they needed his surgical services. But all was in vain.DA spokesperson on health Jack Bloom said the situation was “critical”.
“It is causing havoc,” he said. With Gauteng already facing a medical negligence claims bill of R22-billion, Bloom says fewer staff could mean more cases as patients don’t get adequate care.
Last year, the Gauteng department was so late in paying negligence bills, the sheriff attached the department’s bank accounts.Doctors also fear they won’t get paid overtime for March, based on a second letter from the department to Gauteng head of department Professor Mkhululi.
“Our mandate is to process all appointments, overtime claims, ... to service providers payment of leave and service bonus on terminations.”
But the letter then concedes it has stopped processing overtime pay from March 28.
Many doctors work 100 hours a week and earn in total about 80 hours’ overtime.
The reasons doctors have been given is the Esidimeni crisis, even though the funding for the payouts comes from Gauteng province.
Others said the department was threatened with being put under administration by national Treasury, so it cut back on its biggest expense, which is doctors' salaries.