A report by the Public Services Commission has highlighted poor infrastructure and staff attitudes as some of the reasons for compromised health services in KZN.
Stakeholders in the health sector say the recent report by the Public Services Commission on the level of service at healthcare institutions in KwaZulu-Natal should be a wake up call to authorities.
The PSC presented the report in Pietermaritzburg last week and gave a snapshot of the problems in health stretching back two and half years and covering 30 hospitals and clinics. Healthcare workers were found to lack motivation and providing often inadequate care to patients, including failure to guarantee confidentiality to HIV positive people.
Poor infrastructure is also a major problem including a general lack of space and congestion, which impacted on patient record keeping, poor ventilation in consulting rooms, insufficient office space for administrative units and a lack of in-house laundries.
Commissioner Pearl Sithole said the study was prompted by many complaints from the public through the media and complaints channels of the PSC. “These complaints ranged from alleged poor service, alleged poor professional conduct and care, and even alleged evidence of recklessness in core business of healthcare,” said the commissioner at the release of the report.
She added that while they had noted these challenges they were more concerned about the attitude of senior staff both in hospitals and clinics as it deviated from the Batho Pele principles which place emphasis on serving people. “When we got to some facilities we found queues with labels as to where HIV positive people should sit. There is no confidentiality and people are conscious of being labelled,” she said. Investigators had observed that senior officials remained in their offices and did not have first-hand experience of what patients went through when accessing healthcare, she added.
Dr. Sithole warned that by failing to follow simple rules, the department was rendering itself vulnerable to lawsuits, as there are lawyers keen to make a quick buck. The latest report tabled before the KZN Legislature indicates that medico-legal claims are running into millions of rands, as patients complain about treatment in hospitals including botched operations.
The report recommends a drastic change of institutional culture among the healthcare staff. “This is a department that purports to perform care to the citizens on a daily basis. It cannot afford to have its administrative and management practitioners completely suffocating in a rigid system,” said Dr. Sithole.
Northdale Hospital board member Rachel Soobia agreed with the findings of the commission, saying it was a wake-up call to everyone. She said that while there was no justification for the ill treatment of patients the workload was heavy for many. “In one ward at the hospital there are 36 beds and there are only two nurses that are keeping watch over all the patients. This is not a simple load and that is why the level of service gets compromised,” said Soobia. She also lamented the long process involved in the filling of vacant posts, which she described as encumbered by unnecessary bureaucracy.
Her sentiments were echoed by Edendale Hospital board chairperson, Mboniswa Skhakhane who stressed that something drastic needs to be done in healthcare facilities in line with the current times. “Our hospital is doing well when one considers the load of patients that need to be attended to, but truth be told, staff are overburdened and this is the reason for the hardening of attitudes from staff. When you are in the system and things do not improve there is a good chance that you become desensitised to the reality,” said Skhakhane. Members in hospitals are sometimes not privy to the realities of the institutions they serve, owing to the management’s plan to present a perfect picture. “This report certainly empowers us and will enable me to engage with management on a better footing. The challenge is also upon us to do a walk-about at hospitals for a first hand experience. I have done that and made some discoveries,” said Skhakhane.
National Health, Education and Allied Worker’s Union (Nehawu) organiser in the Harry Gwala Region which is made up of Pietermaritzburg and surrounding towns, Zimasile Giyama, said the report was an affirmation of their long-held position that the department needs an overhaul, especially when it comes to funding. The union has staged a number of protests and pickets, especially about the time it takes to fill posts at Northdale Hospital. The report has already been presented to Health MEC, Dr. Sibongiseni Dhlomo, acting HOD, Dr. Musa Gumede, and health portfolio committee chairperson Yusuf Bhamjee.