Health professionals urge finance minister to reverse budget cuts

More than 1,000 healthcare professionals, including dozens of department heads from the Western Cape’s public hospitals, have signed an open letter to finance minister Enoch Godongwana calling for a reversal of the “catastrophic” budget cuts imposed on the public health system.

The letter is also addressed to Western Cape premier Alan Winde and provincial finance MEC Mireille Wenger.

It comes hard on the heels of Western Cape hospital doctors sounding the alarm last week over the impact of the budget cuts on patients and staff, and an admission from health minister Joe Phaahla on Monday that the state cannot afford to hire all the doctors it needs.

Godongwana is expected to table his next budget on February 21.

“Over the last 12 months, national and provincial Treasury budget cuts have driven health services in the country and the province into crippling austerity.

“An initial budget cut at the beginning of the financial year was exacerbated midyear by a further unplanned reduction driven by the underfunded public sector wage increase. These cuts have affected healthcare services in the entire country,” says the letter.

“In the last three months, the entire health system in the Western Cape has been destabilised by indiscriminate freezing of virtually all clinical and non-clinical posts and a freeze on nursing overtime and agency budgets. Posts which have become vacant through retirement or resignation or natural movement in the system from training positions, now remain unfilled,” it says.

Last week, the Western Cape provincial government told Business Day it faced a R1.1bn budget shortfall for 2023/24 as a result of the cuts imposed by the National Treasury in the medium-term budget policy statement, with the brunt of the cuts borne by health and education.

Groote Schuur Hospital head of surgery Lydia Cairncross said the hiring freeze meant there were fewer staff available to safely run operating theatres, forcing hospitals to reduce their theatre lists and delaying or cancelling surgeries that patients had waited months or years for.

“It has had a severe impact on staff morale,” she said. Healthcare professionals felt compelled to speak out about the impact of the budget cuts on patient care, she said.

The letter’s signatories said cutting budgets for health and education affected the poorest and most vulnerable people in SA society.

“Continued austerity at this level cannot be mitigated with creative planning or improved efficiency. It will result in suffering and deaths amongst the people you have committed to serve. It will irrevocably damage a health system that has taken many decades to build,” it says.

Wits dean of health sciences Shabir Madhi said freezing and rationalising posts to balance the books in the short term was short-sighted because it undermined training and the longterm production of specialists.

“This will result in compromising the teaching of undergraduate and postgraduate students, compromising an already fragile ecosystem. Aggravating this is the uncertainty around NHI and its implementation, which is likely to see a further drain of specialist from the country,” he said.

Neither the Treasury or the Western Cape provincial government had responded to Business Day’s request for comment at the time of publication.

The Western Cape health department said last week that it was doing its best to protect direct service delivery positions, but conceded it was employing fewer nurses than a year ago.

“We have about 820 nursing positions earmarked to be filled soon, as well as around 441 doctor positions. Due to the national directive to curb expenditure, restrictions have also been placed on the use of agency staff,” it said.

The department’s records did not indicate a decline in the number of doctors employed year on year, it said at the time.