External consultants are draining the Department of Health's coffers and must be curbed, says the National Health and Allied Workers Union (NEHAWU).
"Even with a bigger budget, the fact is a large portion of the budget gets spent on consultants, billions in fact, while we have many doctors and nurses not employed. Too much money is also being spent on settling medico negligence.
"The National Health Insurance is our baby but we need to have basic measures in place. Human capital, resources, leadership, proper infrastructure, and strong financial administration skills. We don't have these at the moment," NEHAWU Provincial Secretary in KZN, Ayanda Zulu told IOL.
His comments follow an IOL revelation on the investigation by the Health Ombuds Office into health care in KZN.
Serious cases are being investigated over alleged negligence in patient care - with KwaZulu-Natal topping the list.
But, it is a juggling act. Highly skilled health professionals continue their exodus from public health, leaving the state no option but to use private consultants.
Their ability to curb the brain drain has not yielded adequate results to address the rising shortfall in facilities - and is set to get worse if the proper groundwork is not laid to roll out the government's ambitious National Health Plan, which aims to provide a more equitable health service.
The plan, which, once fully implemented over the next 10 years, aims to shift a reliance on curative health care to a preventative health service. Less reliance on hospitals for basic health and more community-based health care.
But, for this to happen, the country will need more nurses - a lot more. An aging workforce, inadequate training colleges, and poor urban-rural distribution of human resources only add to the crisis, which is getting worse.
The shortfall of nurses is Currently, the shortfall of nurses is approximately 26,000, and this is expected to rise to 100,000 by 2030.
The increase in the health budget this week seeks to address this challenge, but the question is, will it be enough? Health received a whopping increase of R28.9 billion, up from the previous financial year, taking it to R329 billion. But, nothing to plug the gap left by the withdrawal of US funding of critical HIV services.
"We are disappointed that the Minister did not adequately address the need to resource the shortfall as a result of Donald Trump’s decision to halt President’s Emergency Plan for AIDS Relief (PEPFAR). This erratic decision by a megalomaniac cuts access to resources supporting millions of South Africans, research, treatment centres, CHWs and those affected by certain diseases, including HIV-AIDS," said NEHAWU in response.
And, the boosted health budget is unlikely to address critical areas needing immediate fixing, argues NEHAWU.
"Health care has collapsed in KZN. Many facilities are without essential equipment and basic items to deliver basic health services. Prince Mshiyeni Hospital had been without water for weeks. Even the jo-jo tank ran out. The department is in denial. We won't stop calling for change until we see a change," added Zulu.
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