RHAP Response to “MINISTERIAL TASK TEAM COMMITTEE REPORT INTO INVESTIGATION OF SERVICE DELIVERY IN SELECT HOSPITALS”

RHAP Response to “MINISTERIAL TASK TEAM COMMITTEE REPORT INTO INVESTIGATION OF SERVICE DELIVERY IN SELECT HOSPITALS”

On the 14TH September 2017, the Minister of Health Dr. Aaron Motswaledi released the findings of a ministerial task team that investigated the status of service delivery in public hospitals. The report, 170914MTT_Report_14_September_2017 (1) findings confirmed the dire state of provincial health financing, the inadequacy of current budgets to sustain quality health service and the continued practice of not filling critical health costs which is impacting on quality of care delivered.

Since 2015 the rural health advocacy project has been advocating for an end to the moratoria on the filling of vacant post in the health sector. In our working paper on the causes, implications and possible responses to the implementation of staffing moratoria in the public system we drew 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 further pointed out that the purpose of the moratoria was primarily budget driven and argued for clear national guidelines to inform the management of cost containment measures particularly in human resources for health. These measures received strong support from the National Department of Health as well as National Treasury and led to the note in the 2016 National Budget for the protection of critical health posts.

In our presentation, Fixing the way we fund health – Committee Appropriations – 2 March 17, to the Standing Committee of Appropriations on the Division of Revenue Bill, in response to the tabling of the 2017 National Budget, we again argued that in spite of a national policy position on the protection of critical health posts, the provincial departments of health were, in fact, continuing the practice in a blunt attempt to manage rising costs. We further pointed out that the current policy of fiscal federalism which endowed provincial governments with significant executive authority in the reallocation of budgets placed a significant risk on public sector healthcare delivery by effectively underfunding health. The LIFE ESIDIMENI crisis provided a tragic insight into the Gauteng Department of Health operational practice of prioritizing expenditure cuts over patient well-being.

On the 14TH September 2017, the Minister of Health Dr. Aaron Motswaledi released the findings of a ministerial task team that investigated the status of service delivery in public hospitals. The report, 170914MTT_Report_14_September_2017 (1) findings confirmed the dire state of provincial health financing, the inadequacy of current budgets to sustain quality health service and the continued practice of not filling critical health costs which is impacting on quality of care delivered.

In the Ministerial Task Team Report that investigated the status of service delivery in public hospitals, findings confirmed the dire state of provincial health financing, the inadequacy of current budgets to sustain quality health service and the continued practice of not filling critical health costs which is impacting on quality of care delivered.

The report provides a number of recommendations to support possible redress of the current situation some of which have already been proposed by RHAP. These include urgent action on the decentralization of management delegation, prioritisation of critical health posts, strengthening of financial and procurement systems.

In conclusion, while the report focused primarily on selected public hospitals, RHAP is of the view that the findings can easily be applied across the public-sector health service platform. We are further cognizant of the ongoing financial challenges experienced in public sector facilities and while the NHI policy may provide some redress in the long term it is clear that urgent action is required now. To this end, RHAP has developed HRH prioritisation guidelines that can support districts and provincial health management teams to address HRH challenges in an equitable and efficient manner.

Presentation on the report in Parliament:  170914MTT_Report_14_Spetember_2017 (1)

Related work by RHAP:

RHAP presentation to the Standing Committee on Appropriations on the Division of revenue Bill Fixing the way we fund health – Committee Appropriations – 2 March 17

Guidelines NW Recruitment Prioritisation Tool_RHAP and AHP

RHAP_Working_Paper_Frozen_posts_July_2016 (1)

PosterPresentation RHAP RHC2017 on the Role of Advocacy in Protecting and Prioritising Critical Health Posts

Exec Summary and Guidelines Protecting Critical Health Posts

Five unacceptable trade-offs in pathway to UHC_Norheim_WHO

It’s time we fix the way we fund health care

http://bhekisisa.org/article/2017-03-02-00-radical-transformation-begins-with-fixing-how-we-fund-healthcare-in-remote-areas

Health budget fails to address HR crisis

RHAP Press Statement: 2016 Budget Speech Provides Commitment and Guidance on the Protection of Critical Health Posts