Causes, implications and possible responses to the implementation of staffing moratoria in the public health system in South Africa during times of budget austerity

Causes, implications and possible responses to the implementation of staffing moratoria in the public health system in South Africa during times of budget austerity

The purpose of this working paper is to draw attention to the causes, consequences and possible responses to the implementation of moratoria on the filling of posts within the health system. Human resource moratoria, also referred to as the ‘freezing of posts’, have become an increasingly common occurrence within the public health system over the last two years.

We draw attention to how austerity measures, as they are currently being implemented, are having catastrophic consequences for health care, particularly for rural health settings. These consequences include diminished capacity to deliver services; poor supervision of existing staff; weakened support processes (e.g. procurement); additional strain being put on already overburdened staff; and consequently, overburdened staff leaving the public service deepening the crisis.

We argue that a blanket approach to the implementation of moratoria on the filling of posts is a significant threat to the right to have access to health care as provided for in the Constitution and that such an approach acts contrary to the principles of administrative justice.

The working paper presents three scenarios that outline different approaches to managing budget austerity and their possible outcomes. The first scenario we discuss is the ‘continue on the current path of austerity’ approach, which involves the blanket freezing of posts as a cost saving measure. The second scenario we present is the ‘finding the money’ scenario where additional budget is allocated to account for cost increases. Finally, we present the scenario “reality check: maximising scarce resources to greatest impact”. In the last scenario we recognise that the funding crisis will continue and possibly worsen, and that a rationale, evidence-based approach is required urgently to protect critical posts and consequently minimise the impact on service delivery until long-lasting solutions can take effect. In this scenario the following actions are needed.

Access the full document here: RHAP_Working_Paper_V2_Frozen_posts_July_2016