Millions of rands paid in overtime to doctors by the provincial health department are a symptom of serious medical staff shortages in the Western Cape. And this staff shortage, believes provincial auditor-general Willie Brits, could lead to a reduction in the standard of healthcare, which in turn could increase the department's liability in respect of medical claims. Brits's remarks were part of his qualified audit opinion of the department's 2003/4 annual report.
He pointed out: It was noted that medical legal claims increased from R23.4 million in the previous year to R68.7m in the financial year under review, of which approximately R36m relates to claims of negligence during the financial year under review. The department paid a total of R171.8m in various categories of overtime in the year under review.
Total personnel expenditure amounts to R2.4 billion. The report said medical services were also hampered by a lack of permanent and nursing staff. It is difficult to recruit and retain staff for a variety of reasons, for example, experienced staff are expected to enter the system at entry level posts and staff within the service are given inadequate incentives to remain.
The main categories that are affected include specialist trained nurses, medical officers and specialists such as radiographers, orthopedic surgeons and anaesthetists. In addition to the staff shortages, the annual report indicates that grants allocated to the three central hospitals are R86m short of the required amount to provide a tertiary service.
Groote Schuur, Tygerberg and the Red Cross Children's hospitals had been allocated the full national tertiary services and conditional grants. Although the department's unauthorised expenditure amounted to R441m, R393m of this amount constituted overspending from previous structures within the province.
Unauthorised expenditure for the 2002/3 financial year was R28m. The budgets allocated for emergency medical services, provincial and central hospitals for the 2003/4 financial year were exceeded by R20.6m. The report also said controls over pay sheets at various hospitals were still inadequate. The annual report will be discussed by the legislature on October 19. (Source: The Cape Argus, 12 October 2004).