THE stability of health services across KwaZulu-Natal is under threat as key leadership positions, including those of hospital CEOs and senior managers, have not been filled due to budget cuts.

Health MEC Nomagugu Simelane expressed concerns that key positions are managed by individuals who are in an acting capacity because the department is not in a position to fill these critical roles. She briefed the members of the finance portfolio committee on these and other budget-related challenges recently.

Members of the Health portfolio committee and labour unions concurred with her concerns, stating that the situation is critical and needs to be urgently addressed.

Addressing the Finance Committee members regarding the state of the department’s finances, MEC Simelane said the department was projected to overspend by more than R4 billion, but they managed to reduce this by a billion rand by halting many essential activities to save money.

“In the last financial year, we projected an over-expenditure of R4.7 billion. The department then had to go back and re-strategise on how it would reduce that over-expenditure. We were able to implement a number of cost-cutting measures, including stopping some of the projects we had planned.

“We halted the purchase of vehicles, stopped community outreach programmes, and ceased providing services in government activities. As part of our cost-cutting measures, we had to redirect funds and stop buying generators for some clinics.

“We were able to save a billion rand, but we overspent about R3.7 billion on COE (compensation of employees), and we are unable to reduce anything there because these are staff that are already in the system. The cost-cutting measure of stopping projects every year is not sustainable because some of these projects are essential for the department.

“The budget cuts in the last five years are the reason we are where we are today. It leaves us with staff that is unaffordable but already in the system, and therefore we cannot let them go,” she stated.

“As a result, the Department of Health has many acting positions. This is not because we are unwilling to fill the posts, but because when a staff member vacates, we are unable to fill it. There are numerous vacancies in our hospitals that we are unable to fill,” she said.

Dr Imran Keeka, chairperson of the Health Portfolio Committee, stated that the issue of acting CEOs in hospitals is not new. He said they have requested details to be presented at the next Health Portfolio Committee meeting.

“While I understand that progress is being made, the fact that facilities have individuals acting in senior positions for prolonged periods creates instability, weakens accountability, and often generates expectations that those in acting roles will be permanently appointed.

“This can lead to unhealthy competition and even contribute to a toxic working environment. It is therefore prudent that these vacancies are filled sooner rather than later, notwithstanding those vacancies where there are significant financial implications,” he said.

National Education, Health and Allied Workers Union (Nehawu) leader in KwaZulu-Natal, Ayanda Zulu, expressed concern that many vacancies remain unfilled in public health.

“Last week, the Department advertised 11 CEO posts, which we support, and they must be urgently filled. There are hospitals that are still not catered for, particularly the Tertiary and Regional Hospitals.

“Apart from CEOs, the majority of the senior management, from Head of Department to the Deputy Director-Generals, are also acting, which causes instability in the department. Our members are performing duties that are supposed to be performed by five or more people, causing strain and stress to workers.”

“While we acknowledge that the vacancy rate remains very high in the department, we call upon the National and Provincial Treasury to prioritise health when allocating their budget. As the union, we say no to austerity measures imposed by Treasury.”

THE MERCURY

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