Health Management

Chris Hani Baragwanath management under scrutiny

Written by Health-e News

The credibility of Chris Hani Baragwanath Hospital’€™s management is under scrutiny, following the recent media expose’€™ of poor conditions in the facility’€™s maternity ward.

The audio is in isiZulu. See the English summary below.

MABUTHO: Isibhedlela iChris Hani Baragwanath, eSoweto eningizimu-ntshonalanga neGoli, singesinye sezibhedlela ezidume kakhulu kuleli. Muva nje lesisibhedlela sibe ngundabamlonyeni. Lokhu kulandela umbiko wabezindaba obonise abantwana abathathu abasanda kuzalwa  befakwe ekhalibhothini elilodwa ngenxa yokwentuleka kobhasikidi bokufaka abantwana abasanda kuzalwa kwi maternity ward yalesisibhedlela. Lombiko uholele ekujutshweni kwethimba eliyisipesheli ukuba liphenye ngaloludaba. Phakathi kwezinto ezitholwe ilelithimba ebeliphenya ukuthi kunokwentuleka kobhasikidi babantwana abasanda kuzalwa njengoba bengu 119 esikhundleni sokuba babe 150. Lelithimba liphinde lathola ukuthi minyaka yonke lesisibhedlela sichitha imali engu R9.4 million wamarandi kwisabelo mali saso esingu R1,1 billion saminyaka yonke sikhokhela izindleko zezingcingo. Konke lokhu kuholele ukuthi unqqongqoshe wezempilo kuzwelonke uDr MantoTshabalala-Msimang kanye nowesifundazwe saseGauteng, uMn Brian Hlongwa basole iziphathimandla zalesisibhedlela. Ungqongqoshe u Brian Hlongwa uthi iziphathimandla kumele zichaze kabanzi ngalokhu ngoba ngesikhathi ethatha lesisikhundla sakhe wathatha isinqumo sokuthi anikeze iziphathimandla zezibhedlela amandla agcwele okuphatha kanye nokubhekana nezinkinga zemihla ngemihla.

BRIAN HLONGWA: Somebody has to account. Why a cardboard was used, for an example? Because you have people who are the heads of the units, who are supposed to be monitoring the performance of the unit on a daily basis –  if there are things that are missing or a shortage of what ever, be it equipment or supplies. That is why you have management in place that is supposed to make decisions.

MABUTHO: Nongqongqoshe kazwelonke uDr Manto Tshabalala-Msimang uyameseka uzakwabo esifundazweni saseGauteng, uMn Brian Hlongwa, kwelokuthi kumele iziphathimandla zezibhedlela zichaze uma kunezinkinga. Uthi lokhu ukusho ngoba zinikwe amandla agcwele okuphatha. Uthi futhi umnyango wakhe uchithe ezishisiwe izimali uqeqesha iziphathimandla zezibhedlela ngamakhono okuphatha.

DR MANTO TSHABALALA-MSIMANG: We have done a lot of training for the CEOs in an effort to enhance their management skills and expertise. And I think we really have put a lot of effort in that regard, certainly we expect returns from the management from right around the country from the resources that we inject in the training.

MABUTHO: Kepha u Karl von Holdt oyi Senior Researcher esikhungweni iNational Economic Labour and Development Institute (NALEDI), nosanda kwenza ucwaningo ngezinkinga ezikhungethe izibhedlela ezahlukene kuleli kubalwa ne Chris Hani Baragwanath, uthi akumele kugxekwe abaphathi bezibhedlela kuphela ngezinkinga. Uthi ukusho lokhu ngenxa yokuthi abaphathi bezizibhedlela abanikiwe amandla agcwele okuphatha kanti kunjalo nje basebenza ngaphansi kwesimo esilukhuni sokwentuleka kwabasebenzi.

KARL VON HOLDT: There is pervasive disempowerment of managers. The managers are unable to solve problems or unable to take accountability for certain things to happen. There is a pervasive system failure and management is very under-resourced. That is exacerbated by shortage of support staff; cleaners, ward attendants, clerks and porters. And the result is that nurses – skilled nurses – have to do the work of support staff as well as their own.

MABUTHO: Maqondana nodaba lokuthi umnyango wezempilo unikeze igunya lokuphatha kanye nokubhekana nezinkinga zemihla ngemihla iziphathimandla zezibhedlela oka von Holdt  uthi unenkinga ngeziphakamiso nezincomo zekhabhinethi. Uthi ukusho lokhu ngoba ocwaningeni lwakhe uthole ukuthi kunengozi yokuthi ezinye zezinqumo ezithathwa ikhabhinethi zigcina ngokushiwo kanye nasemahhovisini eziphathimandla zomnyango, kazifinyeleli lapho kumele zifinyelele khona.

KARL VON HOLDT: There is a real danger that the recommendations or the decisions of Cabinet  and so on, remain simply paper decisions –  decisions that are not implemented, and they are lost in the bureaucracy of the Health Department.

MABUTHO: Oka von Holdt uthi isixazululo enkingeni ekhungethe izibhedlela ukuthi iziphathimandla zezibhedlela zinikwe amandla anele okwenza ngendlela umsebenzi wazo, kuphinde kwandiswe abasebenzi kanye nokuqeqeshwa kwabahlengikazi.

KARL VON HOLDT: Management needs to be resourced adequately and there need to be an adequate budget for the staff numbers, so that you can overcome staff shortages; and nurses’€™ colleges need to be re-opened. We need a massive effort of training nurses; and they need to be re-integrated with the hospitals so that trainee nurses are in the wards and they are assisting with the problems there.

MABUTHO: Okuhlalukayo kulenkinga ekhungethe isibhedlela iChris Hani Baragwanath kanye nezinye ezingaphansi kukahulumeni ukubaluleka kokusebenzisana kanye nokubambisana phakathi kweziphathimandla kanye nezikhulu zikahulumeni ukuqinisekisa ukuthi akuqhubeki ukwanda kwemibiko engemihle ngezikhungo zezempilo zikahulumeni.

English summary

Chris Hani Baragwanath management under scrutiny

The credibility of Chris Hani Baragwanath Hospital’€™s management is under scrutiny, following the recent media expose’€™ of poor conditions in the facility’€™s maternity ward.

The media expose’€™ ‘€“ which  showed three newborn babies bundled in one cardboard box due to the shortage of baby cribs – prompted the Health Department to set up a task team to probe the matter.

The task team discovered that the hospital has 119 baby cribs, instead of 150. It also found that the hospital spends R9, 4 million of its R1, 1 billion annual budget on telephone bills.

In a recent media briefing on the matter ‘€“ which was also attended by the Minister of Health Dr Manto Tshabalala-Msimang – the Gauteng Health MEC, Brian Hlongwa, put the blame on hospital management – saying it needs to account.

‘€œSomebody has to account. Why a cardboard was used, for an example? Because you have people who are the heads of the units, who are supposed to be monitoring the performance of the unit on a daily basis –  if there are things that are missing or a shortage of whatever, be it equipment or supplies. That is why you have management in place that is supposed to make decisions,’€ said Hlongwa.

The national Health Minister, Dr Manto Tshabalala-Msimang echoed Hlongwa’€™s call for the hospital management to explain itself on the matter. She said the Health Department is expecting returns from the managers of hospitals countrywide, as it has injected a lot of money in improving their management skills.

‘€œWe have done a lot of training for the CEOs in an effort to enhance their management skills and expertise. And I think we really have put a lot of effort in that regard, certainly we expect returns from the management from right around the country from the resources that we inject in the training,’€ said Tshabalala-Msimang.

However, Karl von Holdt a Senior Researcher at National Economic Labour and Development Institute (NALEDI), who has recently finished research on the problems faced by public health institutions, says the facility managers should not be solely take the blame for the wrongs that happen in their facilities. He says facility managers have not been empowered adequately to deal with the daily basic challenges in their facilities.

‘€œThere is pervasive disempowerment of managers. The managers are unable to solve problems or unable to take accountability for certain things to happen. There is a pervasive system failure and management is very under-resourced. That is exacerbated by shortage of support staff, cleaners, ward attendants, clerks and porters. And the result is that nurses – skilled nurses – have to do the work of support staff as well as their own,’€ said von Holdt.

Regarding the Health Department’€™s claims that the facility managers have been empowered to deal with daily basic challenges, von Holdt says ‘€œthere is a real danger that the recommendations or the decisions of Cabinet and so on, remain simply paper decisions – decisions that are not implemented, and they are lost in the bureaucracy of the Health Department’€.

According to von Holdt, the solution to the problem lies in decentralizing power to the management of the facilities and in addressing the shortage of human resources.

‘€œManagement needs to be resourced adequately and there needs to be an adequate budget for the staff numbers, so that you can overcome staff shortages; and nurses’€™ colleges need to be re-opened. We need a massive effort of training nurses; and they need to be re-integrated with the hospitals so that trainee nurses are in the wards and they are assisting with the problems there,’€ von Holdt said.

 

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