Hearings on work conditions at Khayelitsha District Hospital bring no changes

The Public Service Commission (PSC) told the Committee on Petitions and Executive Undertakings (CPEU) in Parliament that if the management of Khayelitsha District Hospital (KDH) had implemented some of their recommendations, the situation at the hospital would not be so bad. The CPEU wanted to know what the PSC had done to look into allegations brought by members of the National Education Health and Allied Workers Union (Nehawu) about conditions at the hospital.

Employees at the hospital accused management of intimidation, victimisation, and poor working conditions resulting in poor service provision. The PSC had been instructed to investigate these allegations following a visit by the committee chairperson, Dumisani Ximbi, to the hospital. His visit was prompted by a “petition received from Ms Nobunto Fuzane directing complaints against the KDH staff for negligence, and … poor and incomplete record keeping from the KDH staff.” The committee concluded that there was, among others, a problem of “staff shortages relating to the high number of disciplinary hearings and firing of senior staff members at the Khayelitsha District hospital.”

On the 8th of November 2018, the PSC presented 12 findings and recommendations relating to the issues raised in the petition. The overall finding of the investigation was that “there was merit in most of the allegations that the union was making” but the commission pointed out that “the severity and the veracity of certain conclusions drawn by Nehawu were contestable.”

Once the findings were made public, the union signed a petition against the PSC, alleging a cover-up “regarding reported irregularities, maladministration, nepotism, fraud, poor working conditions and victimisation of employees within the Khayelitsha District Hospital.”

“There are no reasons for the PSC to cover-up for anyone or anything. We are constitutionally bound not to take sides,” said PSC Commissioner, Dr Moeletsi Leballo.

Nehawu members and other witnesses told the committee that conditions at the hostpital have not changed, that they still face victimisation and service delivery to patients is poor.

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Poor working conditions and victimisation

Testimonies at the hearings described victimisation by hospital management and senior managers. Nehawu branch secretary, Dr Moses Witbooi, told the Members of Parliament that those that are vocal get targeted. He said that when workers complain about their treatment by senior managers, the complaint can drag for a long time, but when management wants to discipline workers it takes them a week to get rid of the worker.

Meline Warnick, Operations Manager for the maternal and neonatal unit told the MPs that the number of patients they have to attend to is too much to cope with. “The staffing for a unit that deals with women’s health issues is inadequate so that goes to tell how the hospital is being managed,” she said.

According to Warnick, an experienced nurse was moved from the unit and her replacement was not a match for the job. “That resulted in me being the only person who can perform TOP (termination of Pregnancy) and that affected the efficiency of the unit. I was constantly told that I need to make use of agency staff,” she said.

“For someone to work at the unit, they have to be a registered nurse with a competency certificate. There are few nurses who are comprehensively trained or have a competency certificate in TOP,” said Warnick, who was there when the unit and the hospital was opened in 2012.

“When I raised all these issues I was constantly victimised by the head of nursing and was handed notices to attend disciplinary processes,” she said.

Sam Manga, a Clinical Program Coordinator responsible for infection control, told the committee that the psychiatric unit at the hospital is under-resourced and that there are no housekeeping staff for the unit.

“There are no housekeeping staff for the unit. The ward is supposed to have 30 beds but there are 65 patients that are admitted at the ward currently,” said Manga.

According to Manga, most of the nurses that have been recently employed come from pyschiatric hospitals though this is not a requirement. The head of nursing, he said, has experience in psychiatric care and favours people with similar background for employment.

Melanie Bennet, a training manager at the hospital, told the committee that she resigned after she was punished for raising concerns about staff shortages and declining clinical governance at the hospital.

She considered committing suicide rather than face the bullying of her seniors. “I don’t know how many times I’ve driven home and sat in my car … thinking of hanging myself in my garage rather than going back to work,” said an emotional Bennet.

Asked about the concerns raised by witnesses, the Department of Health said that they have “made extensive responses to the NCOP [National Council of Provinces] committee in the past on this matter” and that in “the majority of the concerns, the Department has acted and intervened.”

A spokesperson for the health department said that it had received legal advice against attending the hearing. The MEC for Health in the Western Cape, Nomafrench Mbombo, had to be subpoenaed to answer questions.