Call to pause “catastrophic” health care budget cuts

Health workers in the Western Cape gain signed an open letter calling for an stay to “catastrophic” budget cuts in the provincial department.

• The “indiscriminate freezing” on hiring in the Western Cape health department is negatively affecting care, say health workers in the province.
• The Western Cape government faces cuts of R6.7-billion to its total budget over the next three years.
• Provincial leaders agree that the budget cuts are “devastating” but say they are outside of their control.

More than 1,200 doctors, nurses and other health workers in the Western Cape maintain signed an open letter to Finance Minister Enoch Godongwana, Premier Alan Winde and Finance MEC Mireille Wenger, calling for an terminate to “catastrophic” budget cuts in the provincial department.

The National Treasury slit health budgets at the start of the 2023/24 financial year and introduced further cuts halfway through the year, recommending a hiring freeze on current posts. Provincial departments were also told to absorb the cost of an unfunded public sector wage increase.

On Monday, Deputy Minister of the National Department of Health Sibongiseni Dhlomo told protesting unemployed doctors in Pietermaritzburg that the department will be taking the issue of budget cuts to Parliament this week and interrogate that healthcare be exempted.

In January, GroundUp also reported how two of the Western Cape’s biggest hospitals, Groote Schuur and Red Cross Children’s Hospital, are facing significant staff shortages.

According to the open letter sent by Western Cape health workers, the provincial health system has been “destabilised by indiscriminate freezing of virtually every clinical and non-clinical posts and a freeze on nursing overtime and agency budgets”.

“A reduction in posts mean that today, and tomorrow into the foreseeable future, there are fewer nurses, doctors, general assistants, clerks, physiotherapists, radiographers, porters, occupational therapists, dentists and specialists to deliver desperately needed healthcare to the population.”

The hiring freeze has also meant that critical medical posts remain vacant due to resignations or doctors completing their training.

The health workers wrote that the cuts will cause a reduction of surgical theatre lists, causing a postponement or cancellation of operations; patients in need of specialist medical care to wait longer due to fewer available hospital beds; oncology (cancer treatment) services to be delayed, meaning that cancers are diagnosed at later stages with less chance of successful treatment; and gains in neonatal, infant and paediatric care to be “reversed”, among many other issues.

Currently employed health workers will be required to work harder and longer to fill the gaps, which may guide to “sleep deprivation, burnout and fatigue-induced errors”, according to the letter.

Premier Alan Winde and MEC Wenger responded to the open letter in a joint statement on 7 February.

In the statement, Wenger and Winde agreed that the “nationally imposed” budget cuts are “devastating” and that they disappear beyond health services and “have hit education and social development services”.

“This is exactly what the Western Cape Government warned of and which it is now fighting to halt and reverse,” the statement read.

Over the next three years, the Western Cape Government faces cuts amounting to R6.7-billion. According to Winde and Wenger, these cuts are more than the total combined budgets of the provincial departments of community safety, economic development, and cultural affairs and sport.

In November, the provincial government declared an intergovernmental dispute (IGD) with the national government over the cuts. Mediation in this matter remains ongoing.

Asked to respond to the open letter, the National Treasury told GroundUp that the budget for 2024/25, which will be tabled on 21 February, will provide some guidance.

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