Following reports last week that some provinces did not have the budget for nursing and medical intern posts to accommodate many who had undergone community service, there has been a nationwide scramble to access Treasury funds, as well as from NGOs and the private sector, writes MedicalBrief.
The Gauteng Health Department plans to fast track the filling of community service nurses’ vacancies. “The role of nurses is crucial in the healthcare system, they are the heart and soul of the system and the department will continue to prioritise them,” head of department Professor Mhululi Lukhele is quoted in a News24 report as saying.
This comes days after KwaZulu-Natal Health secured 300 vacancies for nurses in the province as a part of President Cyril Ramaphosa’s stimulus package. The programme is aimed at boosting the public health sector through the creation of more than 5,300 jobs in South Africa.
Negotiations towards ensuring that the remaining number of community service nurses are contracted is said to be ongoing between the Gauteng Health, the private sector and NGOs, the report says. “Although the implementation of our recovery plan is beginning to bear fruit, it is appropriate to share that the Department is not yet out of the woods. We are faced with a challenge to manage the high compensation of employees,” Lukhele further explained.
The cost currently accounts for 60% of the department’s budget, making it difficult to create new jobs or absorb professionals, according to Lukhele. Lukhele also assured affected staff members that despite challenges face by the department, work is being done to resolve the hinderances relating to placements.
“I would like to appeal for their patience and cooperation at this crucial time,” Lukhele concluded.
There were tears and cries of joy when 300 newly recruited nurses and nursing assistants were last week welcomed into public service at Grey’s Hospital in Pietermaritzburg, reports The Mercury. The hiring of the medical staff – who are made up of 150 enrolled nurses and 150 enrolled nursing assistants – forms part of the government’s stimulus package to boost the health sector through the creation of more than 5300 jobs throughout the country.
Among the nursing assistants hired was Nompumelelo Majola, who had spent 13 years looking for permanent employment. A week ago, on the day of her mother’s funeral, Majola got the call to inform her that she had been hired. “I could not believe it. I’d like to thank President Cryil Ramaphosa and MEC Dhlomo for making our dreams come true,” she said.
Fighting back tears, an emotional Gugu Mdlalose, from KwaMashu, who was placed at Wentworth Hospital, said: “This was going to be my 14th year of not working since qualifying as a nurse.”
Health MEC Sibongiseni Dhlomo is quoted in the report as saying it was good knowing that 300 families now had breadwinners. “We hope that by hiring 300 of them we are going to make a change and bring meaning in terms of quality of service to our people.”
Dhlomo added that the province would soon be announcing the employment of porters (160 posts), general orderlies (160 posts), pharmacy assistants (50 posts) and artisans (15 posts), who would also be employed as part of the stimulus package.
Western Cape Health will have more than double the number of medical interns this year, as well as more doctors and specialists, which Health MEC Nomafrench Mbombo is quoted in The Times as saying, would drastically improve health services. She said that 333 interns had been placed across the province – an increase of 204 compared with just over 120 the province has had over the past few years.
“The interns are from across the country and have been placed in our system to help them gain the necessary experience to be able to add value to the public health system,” Mbombo said. This increase will obviously go a long way in improving service delivery in our province.”
New posts in the Western Cape include three medical specialists, eight registrars, nine community service doctors, 42 professional nurses and six forensic pathologists. Gauteng is getting 15 medical specialists, 10 registrars, 20 community service doctors, 40 specialist nurses, 10 social workers and 100 porters. KwaZulu-Natal is getting 97 registrars, 150 enrolled nurses, 50 pharmacy assistants and 160 porters, while the North West is getting 20 medical specialists, 28 registrars, 28 medical officers, 42 pharmacy assistants, 145 emergency medical services staff and 285 medical staff.
At least 109 medical interns have joined various health facilities in the North West province for practical training, reports IoL.
North West Health spokesperson Tebogo Lekgethwane said the interns joined as from 1 January , with 22 deployed to health facilities in Bojanala District, 17 in Ngaka Modiri Molema District and 70 in the Dr Kenneth Kaunda District. “Dr Ruth Segomotsi Mompati District has no accredited medical facility to train medical professionals,” he said.
North West Heatlh MEC Madodo Sambatha welcomed the interns at Klerksdorp Hospital during their orientation. Sambatha said the health sector was in need of additional health professional and the presence of new health officials would help speed up health service delivery in the province.
“I am not going to accept that a patient has no bed. Patients do not admit themselves. They are admitted by health professionals who clearly prescribe the level of health care service, intervention and ultimate admission.
“It is the responsibility of management of the hospital to make sure that the beds are available during the time of need, including necessary medical tools to make work of health professionals easier to execute,” Sambatha said.
It was earlier reported that a cash crunch had resulted in two provinces letting hundreds of nurses go after training them at a cost running into hundreds of thousands of rand from the public purse. The Star reported that for the first time in many years, Gauteng and Limpopo were not able absorb nurses who underwent community service in the previous year despite the country grappling with massive staff shortages in the public health sector.
The report said the provinces had informed the nurses it did not have funded posts for them. The provincial departments funded the nurses’ four-year tertiary studies, aiming to use them to address personnel shortages crippling public clinics and hospitals.
The report said the head of Gauteng Health Department Mkhululi Lukhele said in a circular that all 2016/17 and 2017/18 community service nurses “appointed additional to the post establishment” should not be kept in service beyond February”. Lukhele said this cohort should be appointed on a month-to-month contract for January and February. “All affected nurses should be encouraged to apply for posts with the private sector institutions that were engaged by the department,” said Lukhele.
“Institutions are instructed not to appoint external professional nurses in vacant funded posts. Only the nurses that have completed their community service in the Gauteng Department of Health must be considered for appointment in vacant funded posts. It must be emphasised that there should not be any community service nurse contracted beyond February 2019 as this special dispensation would have lapsed,” Lukhele added.
The report says that that much to their shock, Gauteng community service nurses were told of this in impromptu meetings last month. “We were told in December that we have until February to find jobs because there are no posts. Just like that. No one told us anything before,” a nurse at the Rahima Moosa Mother and Child Hospital said.
“They are saying the government doesn’t have money, it doesn’t have funded posts. We’re asking ‘so, where was the money coming from in the past two years?’ Now we’re told, ‘No, we put you in false posts.’ They are telling us we were in cleaners’ posts. What kind of cleaner earns the same salary as a professional nurse?” she asked. She said more than 50 nurses at the Rahima Moosa alone faced being without jobs by the end of the next month.
The report said Gauteng Health spokesperson Lesemang Matuka did not respond to emailed queries but Limpopo Health MEC Phophi Ramathuba has spoken out publicly about a cash crisis forcing her to release 444 workers who were doing community service. The figure initially stood at 586 but the Limpopo finance department agreed to fund 142 posts of medical officers.
“To appoint all these professionals, it will cost us an additional R333m per financial year,” Ramathuba said. “Unfortunately, the provincial treasury advised us that we cannot do so because there’s no additional provision in the provincial purse…”
The report said a visibly emotional Ramathuba said 400 of the personnel they had to let go were former bursary recipients. “We’ve sent these professionals to school to gain skills based on our needs and now we’re unable to appoint them.”
The Rahima Moosa hospital nurse said services were bound to be hamstrung by the cuts in hospitals and clinics. She recalled a night last month where only three community service nurses manned a maternity ward of 38 patients. “There’s no staff. We’re usually assisted by agency staff,” she said.
The SA Nursing Council’s latest statistics prove the need for trainees – there are 287,079 registered nurses in the country, but their average age has increased, with 29% aged between 50 and 59, and 27% aged between 40 and 49. City Press quotes the Democratic Nursing Organisation of SA (Denosa) and the Young Nurses Indaba Trade Union (YNITU) as saying that the problem extends beyond Gauteng and KZN to Free State and Limpopo, where hundreds of trained and qualified nurses sit idle.
YNITU president Lerato Madumo-Gova said the only provinces they were aware of that were not experiencing similar problems were Western Cape and Northern Cape. “This community service idea was a bad one from the beginning. The idea was that the provinces would do the training and once the service was complete, it would be a national responsibility to place the nurses. I think they were trying to copy and paste what was being done with doctors, but even at that level there are problems. There is no HR planning and no heads are rolling,” she said.
In terms of community service and intern doctors, Dr Edward Ngwenya, a SA Medical Association member, asserted that around 1,600 South African-born-and-trained doctors had been placed at medical facilities.
National Health Department spokesperson Popo Maja said the department was responsible for the allocation of statutory posts, which were limited to internships and community service, while the provincial departments were responsible for recruitment and appointment.
“Once a nurse has completed his/her statutory year of community service, he/she is eligible to apply for registration and enter the usual labour market. There is no automatic transition into posts and they need to apply in the usual manner,” he said.
Maja advised the unemployed nurses to apply for the 674 posts advertised as part of the presidential stimulus package, or head for the private sector.
“Life Healthcare group will be recruiting roughly 250 nurses in the coming quarter, Mediclinic currently has 30 jobs advertised and will be updating its website with additional posts in the coming days,” he said.
Denosa has, meanwhile, accused the Health Department of misleading the public about its plans to fill nursing vacancies. Denosa acting general secretary Cassim Lekhoathi said in a report in The Times that the department had filled existing vacancies without creating new jobs.
Lekhoathi said the department did not have enough money to fill vacancies, particularly in Gauteng and KwaZulu-Natal which had the most vacancies. Lekhoathi questioned why the department was training nurses it could not employ and how it was spending the R50bn announced by President Cyril Ramaphosa last year as part of an economic
stimulus and recovery plan.
“So they (the DOH) must tell us in writing, how many people they are saying they can accommodate and what about the rest,” Lekhoathi said.
According to a service-level agreement between nursing students and the DOH, the DOH pays for nurses’ training and in return they work for the DOH for a period of time. Lekhoathi said: “Now the department is saying no, they are prepared to release the students. The students don’t have to owe them money and then they are free agents. The agreement clearly states that the students, upon completion (of training and community service), will have to pay back the time.”
He said nurses would struggle to find jobs and private sector hospitals might not hire them because they train and place their own nurses.