The Gauteng health department has assured healthcare professionals that it is not scrapping overtime payments for doctors in their entirety but simply reviewing its policy to ensure it sticks within its budget.
Acting head of department Lesiba Malotana wrote to public health facility CEOs and senior managers on February 15 announcing the withdrawal of their authority to approve commuted overtime payments from April 1, pending a policy review. All overtime payments will now have to be signed off by head office.
Commuted overtime is a requirement of the job designed to ensure hospitals can operate round the clock. The hours can be considerable, and constitute up to a third of many doctors’ salaries, according to SA Medical Association Gauteng spokesperson Mark Human.
The Gauteng health department’s move was intended to bring its annual expenditure on commuted overtime back within its allocated budget of about R2.2bn, said spokesperson Motalatale Modiba. He was unable to specify the extent of the overspending but said it ran to “millions” and had been flagged by the auditor-general as an area of concern.
The conclusion of the Health and Allied Workers Indaba Trade Union (Haitu) that the Gauteng health department had cancelled overtime was baffling, he said. “Controls at facility level are not being properly managed. Instead of a CEO finalising commuted overtime, it must now be signed off by the head of department,” he said.
“I can’t see how people can be opposed to a review to maximise resources and enhance accountability.”
Haitu issued a statement on Friday condemning the department’s “decision to cancel overtime” for doctors, saying it would put patients’ lives at risk.
Centralising decision-making on overtime, instead of allowing hospital CEOs to continue to manage their own staff rosters and to allocate overtime to doctors in line with the needs of their facilities was a “disaster in the making”, said the union.
“The Gauteng health department is highly inefficient. [It] runs procurement on behalf of all healthcare facilities in the province and [has] completely mismanaged that process. Many hospitals are forced to operate with severe stock shortages of essential items because the department is clueless and also looting the procurement expenditure. If they are given the power to manage overtime, the outcome will be deadly consequences for everyone,” it said.
DA provincial health spokesperson Jack Bloom said last week that the Gauteng department’s move meant doctors’ overtime would be cut from April 1 and cause short-staffing at night, on weekends and on public holidays. “It is unclear why the approval of overtime has become problematic — is it poor administration or is the department trying to save money at the expense of doctors and patients?” he said at the time.
Solidarity’s network co-ordinator for doctors, Pierru Marx, said the move would add a new burden to a system “known for administration nightmares” and was likely to prove frustrating for doctors, who were contracted to work commuted overtime.
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