A significant step towards bolstering healthcare services in Gauteng has been made, with the long-delayed signing of a memorandum of agreement (MOA) between the Gauteng Department of Health and Wits University. 

The MOA announced on Wednesday comes after six years of delays and inaction that saw patient care being affected and the academic training of healthcare professionals in the province being hamstrung. 

This new agreement sets stronger parameters for roles and responsibilities for both parties. Among others, it includes clearer outlines for the division of time allocated for academic and research responsibilities among joint staff, and also the payment of allowances and remuneration outside the public service. 

Hopes are that an improved, more structured partnership will iron out some of the operational – even trust – issues that have dogged the relationship between the two entities, especially as the provincial health department has been in crisis management for years.

Wits University has hundreds of staff members and students undergoing training at seven hospitals in the province, as well as at the four key hospitals of Rahima Moosa, Helen Joseph, Chris Hani Baragwanath and Charlotte Maxeke in the greater Johannesburg area. 

Dean of the Faculty of Health Sciences Professor Shabir Madhi. (Photo: Supplied)

Dean of the Faculty of Health Sciences Professor Shabir Madhi said: “The MOA will help to regulate the relationship with the health department and hospital managers to facilitate the delivery of quality teaching and training on the clinical training platforms as well as the conducting of globally recognised research, while paving the way for the provision of better healthcare services for patients in the province. 

“One of the challenges which we have faced is that hospital management doesn’t have an adequate understanding, in many instances, as to the role the university plays in those facilities, as well as the role of the university when it comes to employment and oversight of joint staff.” 

The MOA will now allow for joint decision-making on appointments, recruitment, management and disciplining of joint staff; agreed acceptable standards of the clinical service platform to meet the requirements of academic activities; and the development of joint mechanisms to deal with constraints and challenges related to the clinical functioning at the hospitals. 

Madhi said the MOA will be supplemented by separate memorandums of understanding to “unpack the way that we work … because unless we have all the relevant parties signed up and working collectively, the MOA will be just another piece of worthless paper”.

He added that the MOA will mean greater accountability by both parties, while finding improved internal avenues to resolve issues. 

“It provides us with a pathway to avoid having discussions in the public domain, which can be a more productive way of getting things done. But when patient care has been compromised, or the education about healthcare workers is compromised, or when those subcommittees are not working – then rest assured, Wits will remain vocal.

“The MOA does not remove the freedom of speech or the need to hold each other accountable publicly.”

The MOA will run for five years and is regarded as a “framework to combine resources, maximise output, and improve the quality and service of healthcare delivery, particularly with regards to clinical and academic activities”, according to Gauteng Department of Health spokesperson Kwara Kekana. 

A timeframe of three months has been set down to establish three key joint subcommittees focused on improving the governance and management of the province’s academic hospitals. These will be an overarching committee, a governance committee and an academic health complex committee. 

MEC for Health in Gauteng Dr Nomathemba Mokgethi. (Photo: Gallo Images / Sharon Seretlo)

Gauteng’s Health MEC, Dr Nomathemba Mokgethi, called the MOA “[An agreement that] will help to ensure the most efficient, cost-effective, appropriate and sustainable use of our joint resources”.

Former Wits Dean of the Faculty of Health Sciences Professor Martin Veller, who was involved in setting up previous versions of the MOA between the university and the Gauteng Department of Health, cautioned that the success of any agreement hinges on will and commitment, capacity, continuity and filtering out political interference. 

“There have been three previous iterations of this MOA. So, while it’s wonderful to have an agreement, it needs to be pulled through – it cannot fall apart when there is instability and administrations and MEC appointments change. 

“We have to find a way to remove politics from hospital management,” he said. 

Veller said there is “incredible depth of expertise and capacity within the university environment, including in management of hospitals, which can then be brought in to strengthen the department of health”. 

He added that a strong MOA can build trust, ease antagonism on the ground, allow for the possibility of training in a wider environment and ultimately improve patient care. 

“The more academic responsibility there is across a platform like the Gauteng Department of Health, the more healthcare goes up … It’s been proven the world over,” Veller said. DM/MC