Dispute at hospital
A DISPUTE between doctors and Frontier Hospital management on the allocation of duties and overtime payment has resulted in concern over service delivery.
Management confirmed in a statement from the office of CEO Sindiswa Tywabi that the issues had been referred to the South African Medical Association, but that no resolution had yet been forthcoming.
Junior doctors had, according to information received, indicated in a letter to management last month that concern existed over the allocation of duties. The situation was that the doctors, working in the accident and emergency wards, male and female surgical wards and the intensive care unit, had been told that they would also have to do theatre assisting duties when on call as from September.
This apparently transpired after specialists or senior medical officers were informed that they would not be paid for overtime exceeding 80 hours. The developments had, according to the doctors, raised concern that services would be compromised as the available doctors would inevitably have to leave a ward/s unattended at any one time. A doctor, who spoke on condition of anonymity, confirmed the situation.
Another source indicated that specialists were dissatisfied at not being paid for overtime exceeding 80 hours per month. Some specialists were working up to 192 hours in overtime. As such payment of overtime was not available, surgical juniors were having to work without senior cover on some days. Extra money was being spent on transferring patients to other hospitals to alleviate the load.
In the management statement, it was indicated that doctors had to perform overtime to ensure services on a 24-hour basis. A shortage of health professionals existed in line with global trends with doctors at Frontier compensated for 64-80 hours of overtime. The hospital had a minimum of two doctors on call every night with only one doctor in each department after hours and a second doctor – a specialist – available for assistance. While junior medical officers were paid to perform above 80 hours overtime when needed, specialists were not compensated for working over 80 hours due to minimal contact with the patient. This was being reviewed at national level.
The specialists had indicated that they were no longer willing to perform above 80 hours of overtime, with meetings with management failing to resolve the problem. The senior medical officers/specialists in the surgical department had also indicated that they would not perform any overtime beyond 64 hours which would affect the quality of services.
Junior medical officers were now on call on certain days without a second (a specialist) as back up.
Patients in need of specialist intervention were being sent to Frere Hospital in East London.
Management indicated that Sama had established a committee in the hospital to address the issues, but a meeting with management had not yet been held.
“Patients’ lives are not at risk as tertiary hospitals provide a safety net for the smaller hospitals and patients are up-referred for further management.”