Cutting doctors’ overtime will have a significant impact on service delivery, particularly on weekends and holidays, with one physician saying this could see hospitals struggling to maintain adequate staffing levels, leading to reduced services or even closures of certain departments.
This comes after the Gauteng Health Department reduced overtime budgets this year, forcing doctors to sign three-month renewable contracts that left them unpaid for April.
Patients were already being turned away, with some dying while waiting in long emergency queues at casualty wards, one frustrated doctor at Chris Hani Baragwanath Hospital told City Press.
While working overtime last weekend, she said, “we lost three patients in one shift, because we had no emergency surgeons on duty”.
“The cases relied on available doctors who did what they could. We lost a multiple gunshot wound patient, a bottle-stabbed patient and a poison-overdose patient, who all needed urgent surgery. But we had limited hands. We did our best to treat and stabilise them, but they did not make it. That is the sad reality of the public health system. Our hands are tied.”
Some lives could have been saved if the hospital had a full team of doctors in every department, she added.
Other hospitals are also taking strain: last week, a pregnant woman lost her baby after waiting for hours to give birth at Tambo Memorial Hospital.
The hospital said it had one gynaecologist on duty and no neonatal intensive care (NICD) beds for a baby that was born prematurely and severely underweight.
Gauteng Health spokesperson Motalatale Modiba said the department was working on addressing the issues affecting shortages in the current financial year.
The Health MEC defended the cuts, saying reducing the overtime budget for Gauteng doctors – from R3.45bn to R2.65bn – was aimed at “addressing inequalities and irregularities in the approval and management of commuted overtime”.
The DA slammed the decision, saying patients would be affected by short-staffed hospitals.
MEC Nomantu Nkomo-Ralehoko, in a written reply in the Gauteng legislature, said this “would lead to less paid overtime where there were disparities”, but the opposition said it would, in fact, result in delays and cuts in doctors’ overtime payments, reports City Press.
The party’s member of the provincial legislature and spokesperson on health, Jack Bloom, said doctors had been forced to sign new three-month overtime contracts, and many were not paid for these extra hours for April.
“Whereas R3.45bn was spent in the last financial year ending on 31 March, only R2.65bn is budgeted for this year, justifying fears that they will suffer a large pay cut.”
He said the department claimed the overtime budget cut in the new financial year –starting from April – was due to terminations, promotions and new appointees.
“This is a poor excuse, covering up the fact that patients in short-staffed hospitals will suffer when less overtime will be worked by essential doctors.”
But Modiba said Bloom was deliberately distorting facts.
He said that in February, the department announced a decision to withdraw the delegation to approve commuted overtime by CEOs of hospitals for the 2024/25 financial year.
He said this meant the HoDs would have to approve all applications for commuted overtime, and that this decision was necessitated by challenges in the management and monitoring of overtime, and consequence management, resulting in an over-expenditure.
Modiba said that in February, the department had explained that the changes were “aimed at improving efficiencies and maximising their limited resources to strengthen existing processes and put in place mechanisms to enhance accountability and prevent misuse of the system”.
City Press – Gauteng health department criticised as new system slashes doctors' overtime budget by R800m
See more from MedicalBrief archives:
Gauteng plan to review doctors’ overtime pay policy a ‘disaster’
Sama warning as Limpopo Health aims to slash doctors’ long hours
Gauteng Health fails to pay full January salaries to dozens of doctors