/ 30 May 2007

Lack of staff hits SA healthcare, say researchers

Most state hospitals suffer from critical staff shortages, researchers told the South African Human Rights Commission (SAHRC) on Wednesday.

”Staff shortages are a critical problem in most public hospitals and are generated by underfunding and a national shortage of professional skills,” said Karl von Holdt of the National Labour and Development Institute (Naledi).

Shortages of support workers such as cleaners and porters compounded the problem as nurses and doctors had to step in to do some of their work.

”Skilled nurses have to do everything, including jobs that are not theirs, and this exacerbates the conditions of healthcare services.”

Von Holdt was giving evidence at a three-day SAHRC hearing in Johannesburg on the state of healthcare services.

A nurse interviewed by the Naledi research group said it was impossible to introduce things that would improve healthcare.

”We also have to do inventory, push patients to other departments, clean floors, take a trolley to fetch food and dish up … all because there is a shortage of support staff.”

SAHRC advocate Kaya Zweni, who investigated rural health services, said shortages of nurses in remote areas were even worse.

He said nurses preferred working in urban areas, mainly because health working conditions in rural areas left much to be desired.

”Shortages of water and sanitation problems were some of the reasons that set rural health facilities apart from urban ones.”

Von Holdt said many health workers were demotivated, and ended up resigning or retiring. Private clinics also lured staff away from state institutions.

Another shortcoming at state hospitals related to management problems. A lack of authority and accountability was commonplace.

”There is no clear focus of power and decision-making … the overall effect is pervasive disempowerment of managers,” Von Holdt said.

”This gives rise to a management culture in which administration of rules and regulations is more important than managing people and operations or solving problems.”

Health Minister Manto Tshabalala-Msimang — still recuperating from a liver transplant operation — also attended the proceedings.

She said shortages of healthcare professionals was partly due to poaching by overseas countries. Patients also tended to flock to urban centres instead of using their local clinics.

”Some of the conditions could be avoided if people use facilities in their communities instead of congesting hospitals for minor medical problems,” the minister said.

She said she would give a more comprehensive response on Friday, when all the evidence had been given. — Sapa