Health minister outlines priorities

By Gabi Khumalo

Pretoria – Newly appointed Health Minister Aaron Motsoaledi has outlined the key priorities his department is to give special attention to.

Financial management, information technology, infrastructure services and human resource management and development have been identified as the main points of focus.

Minister Motsoaledi said on Monday the four challenges were the main areas of weaknesses in the department – and all could be traced back to somewhere within the health system.

“Whether it is a municipality, provincial government or national government throughout any government department, these are the main challenges that led to problems, protests and various forms of discontent pointing to several weaknesses in government.

“From the briefing I have received, I have come to the conclusion that these four areas should be the main points of focus with the department, but in addition and as different from all other departments, I would like to add quality of care,” Dr Motsoaledi said.

He said his department would launch the Prevention of Mother-to-Child Transmission (PMTCT) Acceleration Plan within the next two weeks,

The plan would take the country further in achieving the Millenium Development Goals (MDGs) which speak to maternal mortality, infant mortality and combating HIV and AIDS, Malaria and Tuberculosis, among others, an area he said the country was lagging behind in.

“If we don’t do something drastic; we won’t meet the MDGs. We are lagging behind, hence we need to change and accelerate the PMTCT Plan,” Dr Motsoaledi said.

He further announced that within the next two weeks, the department will deal with norms and standards between the national, provincial and district health system.

“This is to curb the tendency of a federal approach towards the health system, which has slowly but surely crept into the system,” he said.

On the issue of overspending by provincial health departments, Dr Motsoaledi said he will come up with cost containment.

“We will endeavor to do this without compromising the Quality of Care and Services due to the public,” he noted.

Regarding under-performing provincial departments, Dr Motsoaledi explained that while he was allowed to set norms and standards, if the health system in a certain provincial department was however collapsing, he was allowed to act and find ways to intervene.

He also noted the problems facing the South African Nursing Council, saying he will meet with relevant stakeholders to discuss the problem as the Council has been facing difficult experiences for a long time. – BuaNews

Get out now, SANC staff tell registrar

By Jacques Breytenbach

Staff at the South African Nursing Council have staged a sit-in at the registrar’s office after hearing allegations that her contract was extended “illegally” for three months by the chairperson of the council’s board, Jabu Makhanya.

Employees of the council, under the banner of the National Education Health and Allied Workers’ Union, refused to work on Wednesday when they learnt that the registrar and chief executive officer of SANC, Hasina Subedar, had turned up for work although her contract ended on Tuesday.

Chairperson of Nehawu at SANC, Andile Bibi, said the extension of Subedar’s contract was illegal because it was not a decision made by the council’s board, but an individual pronouncement by Makhanya.

But Subedar said the decision to extend her contract had come straight from Health Minister Barbara Hogan.

“Because the minister is in China at the moment, the ministry forwarded an email on her behalf to the chairperson of the council’s board, Jabu Makhanya, informing her that my contract had been extended until a decision was reached with regards to the appointment of a new registrar,” she said.

Subedar wouldn’t comment on whether she would accept the position again if it was offered to her by the minister.

Bibi and the staff body said the SANC had become inefficient in providing nurses with the necessary services because of Subedar’s mismanagement of the council.

When the Pretoria News went to investigate on Wednesday, staff pointed out the scale of the mismanagement at the council.

The entire second floor of the SANC building in Arcadia is littered with boxes of files containing information on the entire South African nursing fraternity.

Also in the boxes stashed in offices and lying in the passageways were the files of nurses working overseas.

Staff members said that if a fire were to break out in the building, all the files would be lost as there was no electronic back-up system.

They also said there were no fire extinguishers on the second floor.

The only advice to employees working on the floor is a sign in the passageway that reads: “In case of fire, close the door.”

Nehawu has blamed the registrar for this. It says she is the one tasked to ensure an adequate IT system is in place in which the files can be stored in an electronic archive database.

Subedar said it was not true there was no back-up system.

“Some files have been scanned and are stored,” she said.

“Some have not. It is in our plans to have a sufficient filing system in place. The council has not necessarily been functioning the way it wanted to over the last couple of months, but it has been functioning.”

Bibi said Nehawu’s sit-in was not in any way aimed at any financial gain, but the protest would continue until Subedar resigned.

Subedar said she would be back at work on Thursday.

“If the ministry has entrusted me with this task for three months, then it is my responsibility to do it to the best of my ability.”

This article was originally published on page 4 of Pretoria News on April 02, 2009

Health care is in crisis – nurses

May 01 2009 at 02:38PM

By Esther Lewis

STAFF shortages in the primary health-care system have plunged the sector into “crisis”, with nurses expected to do the work of doctors and cleaners, say industry insiders.

“We are expected to read ECGs, stitch up patients and administer drips. Some nurses are not trained to do these duties,” said a nurse who works in a day hospital and spoke on condition of anonymity.

They also had to sweep floors, mop up blood and change bed linen in delivery wards, said the nurse.

Some nurses worked 14-hour shifts, and although entitled to a 30-minute tea-break and an hour’s lunch-break, with hundreds of patients waiting to be helped she said they hardly ever took them.

“We are burnt out, but can’t take stress leave or even study leave because there is no staff to cover our shifts,” she said.

After 20 years as a nurse, she plans to upgrade her qualifications. “Once I do that, I’m leaving the public sector because I see no future here, only darkness. What we’re doing now is working for our salaries, not the patients, and it shouldn’t be that way.”

A nurse who works in Khayelitsha said the same was happening at her facility. “This place is overpopulated, nurses deliver about eight babies per day. Staff don’t want to work here because we’re overloaded and stressed out,” she said.

Higher rates of tuberculosis, diarrhoea and other illnesses linked to poverty compounded the problem, she said.

“There is a crisis. Primary health-care in mostly working- class townships is collapsing,” said Suraya Jawoodien, the National Education Health and Allied Workers Union’s provincial secretary.

She said staff-patient ratios were unacceptable: “It’s not unusual for ordinary nurses to do work they don’t have the training for,” she said.

This article was originally published on page 3 of Cape Argus on May 01, 2009

Be wary of the RN contract trap

For many foreign nurses (RNs) the chance to immigrate to the US is the opportunity of a life time. For so many, immigrating to the US is the reason they went to nursing school and took up the profession. Many others, such as marketing majors, physicians, computer engineers, etc. have switched professions to become nurses in order to immigrate to the US.

The shortage spurred the growth and creation of hybrid industries such as nurse registries and temporary nursing staff companies. These types of companies assign nurses on a temporary basis with their client hospitals, medical facilities, and private homes.

A nurse working for one of these companies for example, might find herself working at Hospital A for 2 days out of the week and Hospital B for 3 days. Then, a few months later, working 4 days for Hospital C. The RN goes wherever her employer has been contracted to provide services. She is not an employee of the hospital, but rather the registry company.

Because of the shortage, various RN employers (hospitals, agencies, RN staffing companies) heavily recruit for RNs overseas. Foreign RNs who wish to immigrate are delighted at the opportunity the recruiters offer and are often all too eager to sign up.

While this path may be one of the easiest ways to immigrate, it is not without its pitfalls. Employment-based sponsorship means the RN will be allowed to immigrate if the RN intends to work on a permanent basis for the petitioning employer. This is a critical condition of immigrating that carries consequences if not fulfilled.

During the typical recruitment process, the RNs are promised sponsorship in exchange for working for the employer. Contracts are prepared and representations are made regarding the nature of work, type of work, place of work, working conditions and wages. Many RNs are so eager to immigrate, they do not carefully read these contractual documents, ask serious questions regarding the terms and conditions, or have the contracts reviewed by their own attorney.

In the excitement of the prospect of immigrating to the US many RNs are seduced with the notion that the dream job awaits them in the US. For some this is true, but for many, it has drastic consequences. The RNs gloss over the contracts and assume an attitude of, “I’ll deal with it later.”

The most common contractual clause that wreaks havoc on an immigrating RN’s life is the breach of contract damages clause. Most contracts typically require the RN to work for a specific number of years and failure to do so triggers the damages clause. The damages can range from $15,00 to $50,000 dollars!

Many RNs signing these contracts are unfamiliar with the litigious culture in the U.S. Some come to the U.S. and find the working conditions and salaries they were told they would receive are not the same as represented when first recruited. Some conditions are so unbearable.

For example, being placed in graveyard shifts in hospitals far from home. Or, not being placed in any hospital and collecting no salary while the sponsor tries to obtain a new client for the RNs placement. Many of these RNs then leave their employers and this is when additional tragedy strikes.

The employer begins a campaign of harassment and may sue for breach of contract and obtains a judgment against the RN for the penalty amount. The judgment typically comes with a wage garnishment order. This means the RN’s new employer is required to pay a portion of the RN’s wages to the sponsor to cover the judgment. Because RNs are in a licensed occupation requiring a reporting of where they work, it is very simple for the sponsor to locate the RN and exact the judgment.

But, worse than a breach of contract is the possible immigration consequence. The RN has obtained permanent residency because she stated she intends to work on a permanent basis for her sponsor. By leaving or changing employers shortly after entering the U.S., she has now opened the door for the Immigration Service to revoke the green card! Some employers immediately notify the Immigration Service when an RN leaves exposing the RN to possible green card revocation and deportation.

For many others, the immigration consequence comes several years later when the RN is applying for U.S. citizenship. The Immigration Service reviews the basis of the green card and determines how long the RN worked for her sponsor. If it determines that the RN has only worked for a short period of time, it may begin revocation and deportation proceedings against both the RN and her family members who obtained green cards through her.

These tragic consequences can be avoided by careful review in the beginning. For many of those currently in the position, there is still immigration and contractual relief available. The U.S. Constitution prohibits slavery and indentured servitude and because in many cases the sponsoring employer breaches the contract, the employee is not liable for any damages. This core constitutional value is the basis for providing relief to those forced to leave their sponsors. This will be the subject of our second part of this article.

Author’s Note: The analysis and suggestions offered in this column do not create a lawyer-client relationship and are not a substitute for the individual legal research and personalized representation that is essential to every case. – OFW GUIDE

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