/ 12 November 2003

Baragwanath in crisis

Chris Hani-Baragwanath hospital is in a financial crisis because of a lack of a cost-allocation system and cost-monitoring measures, according to a National Labour and Economic Development Institute (Naledi) report released on Wednesday.

Presenting the report in Johannesburg, Naledi senior researcher Karl von Holdt told reporters there is no meaningful budgeting at the institution.

”In addition to this, there is high duplication of duties, wastage, corruption and theft at the hospital,” he said.

The report followed news stories that three senior officials of the hospital had been redeployed following allegations of overspending of about R120-million.

Chris Hani-Baragwanath hospital chief executive Reg Broekman and the unnamed heads of the finance and human resources departments were redeployed to the Johannesburg hospital and the Gauteng provincial health department respectively.

On Wednesday, the department announced it had sent an interim management team to look into the crisis at the hospital.

Naledi is a research component of the Congress of South African Trade Unions. It was commissioned by the National Health and Education Workers Union (Nehawu) to carry out the study.

The Naledi report says all managerial levels including wards at the hospital are in disarray and there is a serious lack of accountability and responsibility.

There is a shortage of executive and senior managers at the institution.

”At the moment there is a serious lack of management skills and non-availability of managerial skills among officials operating in the financial and human resource departments as well as patient care benchmarks,” the report read.

The report says the institution’s human resource department has no dedicated executive and over time its personnel has been reduced from 84 to 47.

Clerks, nurses, doctors and supporting staff are managed separately even though they work together in a ward.

There is an acute shortage of staff in all categories, and a 33% shortage of nurses.

On discipline, the report says a minority of officials, including nurses, from all structures are lazy, absent without cause, drink at work and carry firearms.

Most staff members complain that supervisors do not carry out disciplinary measures.

”There are no disciplinary measures from top to bottom. If a nurse steals clothes of a patient there will be no action taken against that individual. Instead senior officials will give a lecture on how should nurses conduct themselves. But the culprit is known,” said a nursing assistant interviewed by Naledi researchers.

”Management knows the rotten potatoes, and leave them alone.”

Nehawu and the Democratic Nursing Organisation of South Africa attended the press briefing.

The unions welcomed the department’s intervention at the hospital, saying it is a sign the government takes the crisis there seriously.

”However, in our view it is the lack of management resources, systems and expertise in the institution that made it impossible for the redeployed officials to accomplish their tasks,” the unions said in a joint statement.

”If the government plan consists simply of replacing old managers with new individuals, without addressing the underlying structural and resource problems, we predict that they will also inevitably fail.”

The unions said they have came up with proposals to help resolve the crisis at the hospital.

”We are currently working together with the management to implement these proposals as a pilot project in the hospital’s surgical department.”

The Surgical Wards Transformation Project is faced with the lack of financial support and constraints of the institution-wide managerial vacuum.

”We trust the new management team will support the project,” the unions said.

”We hope the team will cooperate with us in developing an institution-wide plan so that all the hospital’s departments are revived.”

The surgical department is manned by 200 nurses, 70 doctors, 16 cleaning staff and eight ward clerks. The department has eight wards and 250 beds. — Sapa