Stuart Hess
THE Gauteng health department could save R1-billion if it accepts cost-cutting proposals made by health workers’ unions, including centralising services, eliminating private nursing in public hospitals, and scrapping private security, the unions said this week.
The figure is almost double the R550- million the Gauteng health department said it could save when it presented its hospital transformation plan to the provincial cabinet last year.
“We believe that if we scrap private services then this cost-saving figure is not impossible,” said Edward Khanyile, chairman of the Johannesburg branch of the National Education Health and Allied Workers Union (Nehawu), a member of the union research team that examined the department’s proposal.
The union counter-proposal on hospital transformation was due to be presented to the health department on Friday. Department spokesman Popo Maja said it was too early to say whether the union’s proposed cost savings are realistic. “We haven’t finalised the plan and we don’t know when it will be implemented,” he said.
Khanyile said the department had overlooked a number of cost-saving measures, such as the centralisation of hospital casualty departments. The union says that instead of being spread out among several hospitals, casualty services could be relocated to one central hospital, “creating a central pool of casualty officers,” and alleviating confusion about where people needing emergency services should go.
Khanyile also believed retrenchments could be avoided if the department stopped its practice of contracting private nurses to work in its hospitals. The Health Department’s deputy director general Eric Buch said the department was doing its utmost to avoid retrenchment: “We hope that by offering severance packages we could alleviate the problem.”
Buch said more than 3000 severance packages have been already approved and nearly 500 applications are under consideration.
Khanyile said the union hoped that transformation could begin by June. The health department initially said it would begin closing hospitals by the end of March – the three hospitals to be closed are Andrew McColm, Kempton Park and the Westfort psychiatric hospital. Seven hospitals are to be converted to primary health care centres starting July 1.
“We are now looking toward the third quarter of the year for implementation,” said Buch. He added that they were looking at the possibility of a more phased approach but would need to maintain contact with the unions.
Buch was concerned about the effect on morale of further delaying change. “People are worried because they’re unsure of what will happen in the future,” he said.
The unions and the department agree that Hillbrow Hospital should be downgraded to a district hospital with a community health centre and a maternity unit. But plans to transform Hillbrow Hospital are being put on hold.
But that could be delayed as the department considers the findings of a Wits task team headed by Max Price, dean of the faculty of health sciences at the university.
Price’s team has recommended that Hillbrow’s capacity be reduced from its present size of 700 beds to 400 beds, 100 of which would be used for patients with chronic illnesses such as Aids or tuberculosis. “Our proposal reduces the need for retrenchment and redeployment and keeps specialists in the public sector,” said Price.