GEORGE NEWS - The impact that impending budget cuts by National Treasury are to have on health staff and services at government hospitals, that are already under severe pressure, is causing extreme concern.
Finance Minister Enoch Godongwana is expected to make an announcement in this regard in his 2024/2025 budget speech, to be delivered in February.
Hospitals have had to cope with restrictions placed on the hiring of staff following Godongwana's medium-term budget policy statement (MTBPS) in November.
He announced control measures for posts in national and provincial departments because wage increases in the 2023 public service wage agreement were higher than budgeted for.
At the time, media reports cited senior officials at three academic hospitals in Cape Town sounding the alarm over the freezing of critical vacant posts at these facilities, in accordance with the national directives.
Daily Maverick reported that this had created a situation that is "impossible" to manage and it not only affected patient services, but also the training of doctors.
It was expected to worsen in the coming financial year.
These hospitals are already running at massive shortfalls in the current book year, with Groote Schuur having a shortfall of R264m, Tygerberg R275m and Red Cross War Memorial Children's Hospital R31m.
Effect on George Hospital and the district
George Herald tried to establish how George Hospital and the district hospitals in the Garden Route area are coping with the more stringent budget controls.
George Hospital CEO Michael Vonk declined to comment, saying that the Western Cape Department of Health and Wellness is tasked with communication in this regard.
The department's acting deputy director of communications, Dwayne Evans, said the department is doing its best to limit the direct impact, which may include longer waiting times at health facilities because there are few staff available.
No patients will be refused emergency and basic medical care and treatment, although there is a need for some service re-prioritisation across the department's services.
While the finalisation of the 2024/5 budgets is being awaited, a detailed response regarding specific posts and services that will be affected cannot be provided.
In the meantime, the department has put in place internal control measures to manage the filling of critical posts within the available budget.
"A provincial process has been instituted to obtain provincial consensus and authorisation for critical posts prior to being advertised and filled," said Evans.
Patients collecting medication at the Conville Clinic dispensary.
Reducing the impact
"We are engaging in internal consultative processes to look at potential additional cost-saving measures within the department to help reduce the potential impacts on the health system.
"Some measures will be managed at facility and district level, while some measures may be implemented across the province," said Evans. He noted that these measures will always consider the effect they will have on patient service.
"The department is doing its best to protect direct service delivery staff positions. It is important to keep in mind that employment figures fluctuate monthly as people enter and leave the department due to ill health, retirement, or alternative employment.
"Due to the national directive to curb expenditure, restrictions have also been placed on the use of agency staff."
The postponement of maintenance and infrastructure projects is also being "managed", he said.
While waiting for more clarity, the department has started to engage service managers on how best they can prepare for these cuts.
Managers are receiving support in deciding how to allocate their resources.
"The head of department, Dr Keith Cloete, has issued regular updates to staff formally on how we are navigating the current fiscal challenges. Various managers have also engaged their staff, keeping the communication lines open.
"We acknowledge and empathise with our staff that this national situation is causing anxiety and we will continue to engage them as the information becomes available," said Evans.
Earlier this week, National Health Minister Joe Phaahla attributed a high number of unemployment among junior doctors to budget constraints.
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