South Africa: Doctors and Nurses Join Forces to Address Public Health Crises

 Feb 2013: South Africa

Doctors and Nurses join forces to address public health crises

Following recent media reports and government’s internal investigations into the country’s healthcare system, both SAMA and DENOSA met in Pretoria on Thursday 07 February 2013 to pave a way forward. Reports on alarming incidents at our hospitals are now appearing almost on a daily basis and are no doubt having a huge negative impact on the morale of health professionals who work at these facilities.

Most recent of these was yesterday’s report in the Sowetan on the death of more than 530 patients at Mankweng hospital in Limpopo within a space of four months. There has also been The Times expose of R1.4 billion reported to have been mismanaged by the Department of Health in the Eastern Cape. And then, of course, there were the many reports on the death of four babies at George Masebe hospital early this year and the subsequent march by the community to the hospital on Tuesday.

This also includes both the non-payment of health workers by the Gauteng’s Provincial Department of Health for the month of January as well as non-payment of R191 million worth of accruals by the Eastern Cape provincial department which date as far back as 2007. 

Both organisations met and agreed that these unfortunate events have soured the relationship between healthcare professionals and communities, and that they will potentially overshadow the great strides that the Department of Health has made in bringing new changes and improvements in the country’s health sector. These have included the appointment of new CEOs and the positive impact from the expansion of the roll-out of ARVs and positive impact thereof. 

With these latest developments in mind, both parties requested a meeting with the Minister of Health Dr Aaron Motsoaledi yesterday, as a matter of urgency, to look into these issues of concern as organisations representing health workers and to pave the way forward. Of major concern is that these incidents have damaged the relationship between health professionals and members of the communities who believe that the professionals are to blame for all the problems at the facilities.   

It is our honest view that the problems only surfacing now in our health system are the symptoms of a bigger problem with the country’s healthcare system, doctors and nurses merely being the faces of this system.  

These incidents point to the lack of a generally positive practice environment in our public health centres, which governments around the world should be committed to. In the South African case, almost all the eight pillars that make up the support of a Positive Practice Environment (PPE) in healthcare facilities are conspicuously absent, namely:

  • Safety: Lacking security measures at health facilities affect both patients and workers, which is not a conducive environment.
  • Supplies: The efficiency of depots needs to complement hospitals.  
  • Resources: Many hospitals operate without sufficient essential resources.
  • Payment: Staff often has to stage some form of protests for payment.
  • Education: Prior to the newly-formed Academy for CEOs, there were not too many opportunities for other management tiers.  
  • Support: There is not enough support for members to develop within their work areas. 
  • Equipment: Poor standard of infrastructure remains a challenge, which makes it even more difficult to cope with the number of patients who are served.  
  • Respect: generally, the lack of conducive environment for health workers affects negatively the manner professionals respect the profession.

Our reading of the situation is that the health system is overwhelmed by the little and decaying resources that it has, and this is compounded by the increasing population figures where both nurse-to-patient and doctor-to-patient ratios are excessively high – not to mention the rising burden of disease factor. These are all taking their toll on the morale of fellow health workers.

Way forward

–       Campaign for a Positive Practice Environment (PPE)

As a way forward, both organisations have agreed to work together by embarking on a campaign where all fellow health workers will be calling for a positive practice environment in our healthcare facilities. We believe that having a PPE in place will prepare the ground for implementation of the NHI, and will minimise the many medical-related litigation of negligence that fellow health workers face, and will make the health profession attractive once more.

Occupational Health and Safety will represent the first round of the campaign during which both parties and any interested stakeholders will join forces in calling for both physical and clinical safety in our facilities, regardless of their location.  

Details on the roll-out of the campaign will be communicated with the media once it is concluded, and the campaign will be based solely on restoring the image of the healthcare profession. 


Conclusion: Public expectations are high, but the system can’t meet them.


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