South Africa


No pay: Annual admin snarl-ups hit junior doctors on community service

No pay: Annual admin snarl-ups hit junior doctors on community service
The Charlotte Maxeke academic hospital on May 31, 2018 in Johannesburg, South Africa. (Photo by Gallo Images / Sowetan / Mduduzi Ndzingi)

Junior doctors across the country should have received their salaries on 31 January 2019, but the day came and went without a cent finding its way into their bank accounts. The ripple effects have been far-reaching as the euphoria of being placed at a medical facility turned to frustration and anger.

*Eric Madonsela had to make a choice – pay school fees or ensure that his son and two sisters went to school with food in their bellies. He chose the latter.

It should not have been a choice he had to make. Madonsela is employed as a community service doctor at the Mosvold Hospital, Ingwavuma, KwaZulu-Natal and was expecting to be paid on 31 January. But this did not happen and no explanation was given to him.

When he was eventually paid on 4 February it was “only a portion of our salaries”, adding that what he was paid now was less than what he got paid as an intern.

I was not able to pay for my children’s (my son, and my two sisters’) school fees, which are paid monthly. I had to prioritise food for them simply because I couldn’t send them to school on an empty stomach. I also had to cancel a trip home, so I basically last saw my family 38 days ago,” Madonsela said.

Madonsela was among hundreds of community service doctors, medical interns and medical officers employed by the state who were not paid their salaries at the end of January.

Daily Maverick spoke to some of the affected junior doctors based in Gauteng, KwaZulu-Natal and the Eastern Cape.

In Gauteng, a medical intern, who did not want to be identified, said that when they enquired as to why they had not been paid, they were told that “there were too many of us”.

We were confused as to how we could be employed, sign contracts, yet posts are not enough,” she said, adding that no further explanations were provided. She too was paid five days after pay day.

A medical officer at Empilisweni Hospital in Sterkspruit, Eastern Cape, *Karabo Mthethwa’s community service got off to a shaky start. Despite being allocated to the hospital in November 2018, when she arrived at the facility at the beginning of January she was told that the post she was due to fill had not yet been created. This effectively meant that they were not recognised as being employees at that hospital, despite being placed there at the end of last year. Eventually she and several colleagues were told to return home until the administrative issues could be cleared up.

It’s important to note that this thing is ongoing, literally every year. In 2016, my last year of school, people who had graduated years before me would tell me horror stories of ‘we’ve been going through this for a long time, when I first got to community service, I did not get paid for three months, you must prepare for the time when you go to community service’,” Mthethwa said.

When Daily Maverick contacted Mosvold Hospital, they vehemently denied any suggestion that any of their employees received their salaries late. “Everyone was paid on time, including overtime,” said Siyabonga Ndabandaba, the Human Resources Manager at the hospital.

Attempts to get through to Empilisweni Hospital were unsuccessful.

In a media statement on 9 February, the National Health Department said salaries would be paid by 11 February. At the time Health minister, Aaron Motsoaledi said he was “disappointed and highly distressed” at the non-payment of salaries.

When this problem came to the fore, the minister understood that the association representing the doctors, SAMA and respective administrations in provinces where this problem manifested itself had been meeting to resolve the matter speedily and that by 7 February 2019 the matter would have been settled: 7 February is a week after they should have been paid. Being paid a week later than expected is in itself not acceptable. It is very difficult for the ministry to fathom what difficulty managers could encounter that would lead to non-payment of a salary,” the statement read.

Further questions sent to Ministry of Health spokesperson, Popo Maja went unanswered.

But Dr Rhulani Ngwenya, a board member of the South African Medical Association (SAMA), said despite promises of payment, there were still some young medical professionals waiting for their salaries to be paid.

Ngwenya said when the department failed to pay salaries by 1 February, SAMA served the department with an interdict. The organisation also held a meeting with the Gauteng health department, which, it said, had the highest incidences on non-payment/late payment (with under half of junior doctors not getting paid in the province), to try find out what the cause of the problem was.

The organisation also wrote to the National Health Ministry, asking that a task team be formed to investigate why this had happened, what needs to be done to prevent it from happening again and how to hold those responsible accountable.

We have to find out why only three provinces got it right. Mpumalanga, Limpopo and Western Cape got it right. What are they doing differently?” said Ngwenya.

Jack Bloom, DA Gauteng shadow health MEC, blamed a “lack of forward thinking” as well as “administrative weaknesses”.

He said it was more a case of “bad financial management”, rather than an actual lack of funds. “Other provinces got it right. How is that? The National Ministry of Health must also be held accountable. They are aware of this problem, it’s something that happens every year around this time.”

According to Bhekisisa, a health news organisation, the Gauteng health department’s chief human resources director Sipho Senabe said technical errors by payroll administrators were behind the repeated delays.

Gauteng health spokesperson Khutso Rabothata referred Daily Maverick to statements issued by the department but declined to send them to the publication. DM

*Not their real names, as the doctors wished to remain anonymous due to fear of victimisation at their places of employment.


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