Chris Hani Baragwanath Hospital. Picture: SUNDAY TIMES
Chris Hani Baragwanath Hospital. Picture: SUNDAY TIMES

SA’s health system needs to grow its management capacity to correct the disjuncture between infrastructure and financial planning, says a report by the Health Systems Trust.

Consolidated health expenditure is set to rise 8.3% over the medium term, making it the fastest-growing category of government spend after debt servicing and post-school education. But public health is still marred by poor-quality services and low levels of accountability.

The SA Health Report prescribed leadership stability, a change in management strategies and strong managerial capacity to achieve greater efficiencies in the sector.

Examples of unfilled key positions abound. The Office of Health Standards Compliance CEO post has been vacant since July 2015. The National Health Laboratory Services has acting personnel filling key positions, including the CEO, chief financial officer and chief procurement officer.

Health Minister Aaron Motsoaledi recently blamed the dismal state of the KwaZulu-Natal public health department on a lack of skills in human resources management as well as managing supply chains and procurement systems.

Chris Hani Baragwanath, SA’s largest public hospital, has been without a permanent CEO since January 2016 when Sandile Mfenyana was moved to the Gauteng health department head office 10 months before his contract expired.

The report found that managing a combination of low growth and high-cost pressures presented a challenge for health managers in SA.

Health Systems Trust CEO Themba Lebogang Moeti said a number of managerial staff in hospital facilities were well trained in medical capacities but had moved to administrative positions, often without being adequately trained for their role.

"These skills are in short supply," Moeti said. "Managerial skills at provincial and district level must be improved to upgrade the quality of healthcare because if primary healthcare is improved, it will ease the pressure in secondary care."

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