Public Service committee calls for urgent reforms at Kalafong Hospital

The Portfolio Committee on Public Service and Administration made several recommendations to address the challenges facing Kalafong Hospital in Pretoria west, including outdated organisational structure, staff shortages, and poor maintenance.

The parliamentary committee visited the hospital in Atteridgeville this week during its week-long oversight programme in North West and Gauteng. It also visited two other hospitals – the Mahikeng Provincial Hospital and the Moses Kotane Hospital in the North West.

Several issues raised at Kalafong Hospital

Committee members raised several issues after engaging with staff and conducting a walkabout at Kalafong Hospital on Thursday.

One of the issues mentioned was the outdated organisational structure that does not meet the needs of a tertiary hospital serving a growing patient base. In addition to a shortage of suitable posts, the hospital has seen low staff morale and burnout as a result of an increased workload.

The hospital also has a high turnover rate since it finds it difficult to retain and attract qualified staff. The inability to fill open positions was attributed to financial limitations.

Taking note of the challenges, the committee decided to ask the provincial health department’s leadership to come before it and discuss the problems in order to create a clear plan for Kalafong Hospital.

ALSO READ: Kalafong Hospital services affected by water shortage

Of the three hospitals visited, Kalafong has been by far the most crowded, according to committee chairperson Jan de Villiers.

“The committee has seen first-hand the pressure the hospital is under due to the number of patients it serves. Committee members noted that all three hospitals share common problems that are often beyond the control of hospital management,” the committee said in a statement.

Serious structural issues

De Villiers said the findings at Kalafong Hospital were symptoms of more serious structural issues that needed to be resolved before progress could be made.

The committee identified five main issues that the provincial hospital should address urgently.

Among these was the poor maintenance of the hospital building. It observed that one of the crucial vacant positions is that of facility management unit manager.

“We observed the same story in all three hospitals. Maintenance and continually doing it is a challenge,” the chairperson said.

ALSO READ: Gauteng health dept launches independent probe into Kalafong hospital fracas

“This surely affects the morale of the public servants who work here – the doctors and nurses and all the other people – if the building is not being maintained properly.”

Instead of relying on provincial approvals, the committee suggested reviewing the current system to find approaches to give hospitals more control over how they manage their building and maintenance projects.

Outdated organisational structure

The 50-year-old hospital’s outdated organisational structure was another issue expressed by committee members. To make sure the facility has the right number of employees and specialists to provide much-needed services, they suggested it be examined and upgraded immediately.

“It is absolutely unacceptable that the organisational structure of this hospital has not been updated. How can we expect public servants working here to deliver services to people if they do not have the capacity and certainly not the required number of specialists?” de Villiers asked.

Members also heard that essential equipment is lacking, which impacts services and waiting times. For example, laboratory tests have a six-hour turnaround time.

Members also discovered in the neonatal ward that in order to provide services to more patients, vital, life-saving equipment is required.

ALSO READ: Water crisis: Supply restored to Kalafong Hospital after weeks-long outage

The chairperson said the broader need for digitalisation has caused equipment challenges. He pointed out that in many departments, the hospital still uses outdated equipment and paper files.

“Digitisation through technology can help streamline and speed up processes such as queue management and pharmaceutical dispensation processes, which can assist staff,” de Villiers said.

The committee also raised concerns about staff retention and general human resources management at the hospital and requested clarification on budget constraints.

Vacancy rate at 11% at Kalafong Hospital

During a briefing by top management, they informed members that the hospital’s vacancy rate is 11%. Dr Olebogeng Modise, the acting CEO, said the hospital is operating at half its capacity while needing at least 5 000 employees to function effectively.

The chairperson pointed out that staff retention problems stem from the hospital’s infrastructure condition, equipment availability, and other factors.

“When a doctor must choose between working in a hospital where everything is nice and it works or where there are challenges with all the things mentioned here, then obviously it is difficult to retain that doctor or any of the staff. So, staff retention and filling of vacancies must be addressed urgently,” de Villiers said.

ALSO READ: Kalafong Hospital suffers water shortages

The committee also expressed concern with the length of time it takes the hospital to resolve disciplinary issues, some of which date back to 2021. Members discovered that 35 out of 38 disciplinary charges are still pending resolution.

Noting the number of appeals following disciplinary proceedings, the chairperson said, “We need to seriously engage in discussions about how these disciplinary processes can be sped up and made more efficient, as it prevents management from having to recruit new personnel to fill the posts where people are supposed to leave after the conclusion of disciplinary proceedings.”

The committee also suggested looking into ways hospitals may become less reliant on government support and more financially independent by producing their own income.

Issues documented in report

“It cannot be that these hospitals cannot create new revenue streams and become more financially independent because if they try any revenue enhancement, it goes back to the provincial government,” said the chairperson.

Every issue brought up by committee members will now be documented in a report, which will also be forwarded to the appropriate provincial and national departments for investigation and resolution, including the Department of Health and the Department of Labour.