The decision by the Gauteng Department of Health to “review” the policy of overtime for doctors – a requirement of the job to ensure hospitals can operate around the clock – has been condemned by unions and other concerned parties, who warn it will place patients’ lives at risk.
Acting head of department Lesiba Malotana wrote to CEOs and senior managers on 15 February announcing the withdrawal of their authority to approve commuted overtime payments from 1 April, pending a policy review, and saying that overtime payments would now have to be signed off by head office.
It said it was not doing away with overtime payments “in their entirety” but was merely reviewing its policy to ensure it sticks to its budget, reports BusinessLIVE.
However, the decision has not been well received by some quarters, with the Health and Allied Workers Indaba Trade Union (Haitu) describing it as “baffling”.
Centralising decision-making on overtime, instead of allowing hospital CEOs to continue to manage their own staff rosters and to allocate overtime to doctors in line with the needs of their facilities was a “disaster in the making”, the union said, and would risk patients lives.
“The Gauteng Health Department is highly inefficient. (It) runs procurement on behalf of all healthcare facilities in the province and (has) completely mismanaged that process. Many hospitals are forced to operate with severe stock shortages of essential items because the department is clueless and is also looting the procurement expenditure. If they are given the power to manage overtime, the outcome will be deadly consequences for everyone,” it said in a statement.
Overtime hours can constitute up to a third of many doctors’ salaries, said SA Medical Association Gauteng spokesperson Mark Human.
Department spokesperson Motalatale Modiba said the plan was to bring annual expenditure on commuted overtime back within its allocated budget of about R2.2bn.
Although he was unable to specify the extent of the overspending, he said it ran to “millions” and had been flagged by the Auditor-General as an area of concern.
“Controls at facility level are not being properly managed, so instead of a CEO finalising commuted overtime, it must now be signed off by the department head,” he said.
DA provincial health spokesperson Jack Bloom said the decision meant doctors’ overtime would be cut from 1 April and cause short-staffing at night, on weekends and on public holidays.
“It is unclear why the approval of overtime has become problematic – is it poor administration or is the department trying to save money at the expense of doctors and patients?” he said.
Solidarity’s network co-ordinator for doctors, Pierru Marx, said the move would add a new burden to a system “known for administration nightmares” and would probably be frustrating for doctors, who were contracted to work commuted overtime.
Meanwhile, MEC Nomantu Nkomo-Ralehoko said the Gauteng Department of Health plans to vet all senior managers’ qualifications, from director level upwards, to “maximise skills” in the system, News24 reports.
Speaking at a Forensic Medical Services indaba in Johannesburg last week, she said she would be reviewing the department’s organisational structure, which has been in operation since 2006 – to improve efficiency across service platforms – and this would necessitate a review of the current skills base within the various units.
The process will begin with senior managers “to ensure suitably qualified officials who will improve service delivery are in key positions”.
BusinessLIVE article – Gauteng health moves to rein in overtime expenditure (Restricted access)
News24 – Gauteng Health Department to vet qualifications of senior managers
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