Quality of care suffers in ‘leaderless’ hospitals

NURSING trade unions are frustrated over the large number of Gauteng hospitals being led by acting CEOs and other high-ranking officials at the height of the Covid-19 pandemic.

The hospitals in question are Dr George Mukhari Hospital in Pretoria, Jubilee Hospital in Hammanskraal, Pretoria West Hospital, Bertha Gxowa Hospital in Germiston, Far East Rand Hospital in Springs, Pholosong Hospital in Brakpan, Bheki Mlangeni Hospital in Soweto and Tembisa Academic Hospital.

Gauteng Health head of communication Motalatale Modiba last week said the department had prioritised the filling of vacant posts as part of ensuring that governance structures continue to be strengthened towards better service delivery.

“Out of the seven posts, three were recently advertised and closed during the month of July 2021. One post is currently vacant. One post is in the process of being advertised. The other two posts are not vacant, however, they are occupied by acting appointees due to employer-employee related issues that are still being processed,” said Modiba.

However, Democratic Nursing Union of South Africa (Denosa) provincial acting secretary Bongani Mazibuko said they have noted a lot of indecisiveness as the acting CEOs are reluctant to make decisions and they are also afraid to make appointments, so it hampers service delivery and leads to a poor response to Covid-19 in certain cases.

“The challenges start with the provincial leadership, most of the positions including the HOD are occupied by people acting.

“Once we can get stability from the provincial department’s head office, then that will hopefully filter down to bringing some much needed stability in the institutions,” said Mazibuko.

He also lamented the fact that some of the CEOs had decided to take leave at the height of the third wave. One such CEO is Dr Relebohile Ncha of Helen Joseph Hospital who has been reported to be on annual leave for about three weeks. At the start of the third wave we published an article showing patients in wheelchairs wearing oxygen masks in corridors showing the dire shortage of beds.

Mazibuko said it doesn’t make sense for a CEO to take annual leave during the pandemic because in other medical facilities some healthcare workers have been recalled from leave to ensure there was enough medical staff.

“We know for a fact that in some institutions some of our members have been recalled from leave just to ensure there are enough hands on deck.

“We are aware some people have not taken leave since last year but that would have to be put on hold until we at least see the numbers declining. If the accounting head of an institution takes leave at the height of the pandemic, who will steer the institution?”

Young Nurses Indaba Trade Union (YNITU) general secretary Rich Sicina did not mince his words, saying according to them they have observed and analysed this as being done internationally to bring down the public health system in order to benefit those in government.

“We believe this thing is done intentionally. It's a cartel. We always ask ourselves who benefits from making sure that the public health system is disorganised.

“So if you have a disorganised public health system you are going to have a million dollar business on the other side which is private,” said Sicina.

“These CEOs do not have powers. Remember, when you are acting, your scope is limited. There are things you can’t do because obviously the central office will remind you even when you want certain things such as basic stuff or you want to hire more staff.

“We find hospital CEOs frustrated saying ’remember I am acting and my powers are limited. I am still going to request it from the central office’. And then the biggest question which we always ask is who hires and fires CEOs. It’s the central office of every province.

“So who benefits from a disorganised public healthcare system? It simply means it's the same central office... It's clear that someone somehow is benefiting. And who is this person who is benefiting from all this mess, it's the central office. Who is the central office? The central office is the government.

“Some of these MECs are planted, there are cadre deployees put in those positions to maintain the status quo, to maintain the looting, to maintain the mediocre and substandard way of doing things.

“By the way we don’t have only CEOs acting, we have acting clinical managers, nursing service managers, we have matrons, all of them in most cases, are acting in one hospital.”

When it comes to CEOs taking leave during this time of high number of Covid-19 cases, Sicina said the impact is disorganisation, gross shortages of medical material, gross medical negligence.

“The delegated CEOs continue to carry out their duties to the best of their ability, working together with management teams. They carry their duties with dedication and diligence in the interest of healthcare for the communities of Gauteng and the combat of the Covid-19 pandemic,” he said.

Modiba said the impact of the pandemic on healthcare workers’ well-being was well documented.

“Granting leave is part of ensuring that our healthcare workers are able to recharge and thus continue serving the people of Gauteng with dedication and commitment, as has been the case during this difficult period,” he said.

“CEOs also need to rest as they are also employees who deserve support and compassion, like all frontline employees in the battle against the global pandemic. They don’t work in isolation and have a management team which ensures that when the CEO is taking leave, services can continue seamlessly.”

DA spokesperson for health in Gauteng Jack Bloom said: “I have found that there are still acting CEOs at a number of hospitals despite premier David Makhura’s promise when he was elected for a second term that all CEO posts would be filled within six months.

“Acting CEOs do not have the authority of permanent CEOs, and this is particularly needed now when we face the Covid-19 pandemic. The department needs to explain why annual leave is being given at this critical time when all health staff are needed to save the lives of patients.”