A Treasury grant is the best model to fund the state’s lab service, CEO says
Acting NHLS head Shabir Madhi says the service has not been able to invest in new equipment owing to the nonpayment of services by the provinces
The best way to optimally fund the National Health Laboratory Service (NHLS) would be for the Department of Health to have a budget allocated to the service.
This is the view of the acting CEO of the NHLS‚ Prof Shabir Madhi‚ whose organisation has been hit by a strike‚ resulting in a near total-shutdown of its laboratories.
The NHLS‚ Africa’s largest laboratory service‚ has been in crisis‚ long before last week’s strike.
It is owed billions by provincial health departments‚ operating on outdated equipment as a result. Senior staff are leaving because of financial uncertainty and there is a backlog of some tests.
And there is instability in the management ranks as both the CEO‚ Joyce Mogale‚ and chief financial officer‚ Sikhumbuzo Zulu‚ were suspended in February while two other managers resigned before they were due to face disciplinary hearings in July.
In addition to that‚ the head of procurement and the facility manager at the service had cases opened against them for corruption. Both of them resigned on the day of their disciplinary hearings in July.
One of the unions has suspended the strike and some workers returned to work on Wednesday.
Madhi said the service had also not been able to invest in new equipment to ensure the smooth running of the NHLS because of the nonpayment of services by the departments.
This had resulted in a backlog in kinship testing and anatomical pathological testing
Currently‚ provincial health departments pay for the laboratory testing services and some provincial departments owe the NHLS billions — Gauteng owes in excess of R2.5bn‚ Madhi said. In 2016 alone‚ Gauteng accumulated a debt of R780m.
Gauteng uses R154m worth of services each month and are paying the NHLS only R100m a month.
"Provincial health departments usually underbudget for procurement of laboratory testing services. Gauteng for instance‚ budgeted R1.2bn for the procurement of laboratory services, yet they spent R1.8bn last year. The best model for the funding of NHLS would be for it to get a grant from the Treasury‚" Madhi said.
He said for the new funding model to succeed‚ NHLS would have to determine what tests needed to be done.
"Presently‚ provincial departments decide what needs to be done. They would send samples without considering the costs and whether the testing is required‚" Madhi said.
Madhi said the financial uncertainty had resulted in the problems of senior highly-skilled staff leaving because of financial uncertainty.
"More senior staff start leaving and this creates a backlog. The financial problems do not allow us to retain staff and invest in new technology. Our IT system is outdated by at least five years as we do not have money to invest‚" Madhi said.
Madhi said that during the strike‚ the service prioritised the "essential tests" in some of its laboratories that were still functional during the strike.
The rest of essential tests were performed by private laboratory services‚ which charged the NHLS lower tariffs.
"Usually private laboratories charge a higher rate than we do. Private laboratories came to our assistance and reduced their rates substantially."