The Office of the Health Ombudsman is battling to resolve serious complaints against public and private health facilities because it has no money to hire investigators.
Health-e News reports that the complainsts, classified as high and extreme risk, can relate to death and injury, for example, but budget constraints mean the watchdog can’t employ enough investigators to look into the many violation complaints.
“This has contributed to several unresolved complaints,” said Ombudsman Professor Taole Mokoena.
In a response to questions before Parliament last month, Health Minister Joe Phaahla said that between 2018 and 2023, of the 307 high and extreme-risk complaints submitted to the office, fewer than half have been resolved. A total of 159 remain unresolved.
Consequences of backlogs
Dr Larisse Prinsen, senior lecturer of public law at the University of the Free State, warned that unresolved cases have an impact on healthcare and quality of services, and lead to a lack of accountability and transparency.
“A perception could be created that healthcare providers are exempt from the laws, rules and guidelines that regulate the healthcare sector,” she said. “This might potentially lead to increased instances of negligence or malpractice.”
Unresolved complaints were also likely to undermine public trust in the healthcare system.
“This might lead to continued systemic issues in healthcare facilities or establishments, such as low standards of care, the overlooking of mistakes, or unethical, unprofessional or unlawful behaviour,” she added.
Chronically understaffed
Between 2016, when its doors opened, and 2023, the Office of the Ombudsman received more than 14 000 complaints.
Many (96% or 13 791) are low-risk and can be resolved by the complaints call centre: a minority are high (0.79% or 112) and extreme (0.32% or 45) risk.
Health-e News picked up discrepancies in the numbers of high and extreme risks complaints between what the Minister cited in his response to Parliament versus what is recorded in the health ombud’s 2022/2023 annual report.
When asked for clarification, Mokoena said that the 159 unresolved cases referred to by Phaahla included those that were backlogged, from the unit’s inception in 2016, to the end of the 2022/23 financial year.
He added that the 45 extreme risk cases shown in the annual report were received during the 2022/2023 financial year, and require “a robust analysis and investigation process, and are handled by the complaints investigation unit”.
But the unit is severely short staffed, and has been since it opened in 2016.
Mokoena said his office has been granted funding under the Medium Term Expenditure Framework to appoint additional staff, but this was “not sufficient to handle new and ongoing complaints”.
There were plans for a request for funding for special temporary employees to address the outstanding backlog.
An organogram proposed at the first Presidential Health Summit in 2018 recommended a complement of 113 staff with a budget of R132m over a five-year period. But there’s been little movement in this regard.
“In fact nothing has been done … and currently the budget is R23m, far short of the ideal proposed budget five years ago”, reads the office’s annual report.
In his Parliament response, Phaahla said the allocation from the medium term budget would go towards employing the current staff on a permanent basis. “However, additional funding will still be required to appoint permanent staff to augment the capacity and ensure the mandate of (the office) is fulfilled,” he added.
Prinsen believes that resolving cases efficiently through the health ombudsman’s office could mitigate the need for the ballooning costs of litigation.
“When wronged patients feel their complaints are not being adequately addressed, they may resort to legal action,” she said.
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