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The Democratic Nursing Organisation of South Africa (DENOSA) in Limpopo held its Provincial Executive Committee (PEC) meeting from the 14th to the 15th of September 2023 at Polokwane Royal Hotel in Polokwane to deal with the number of issues affecting nurses and healthcare services in the province.   

These issues include, among others, the changes to duty rosters in the hospitals and clinics, shortage of nurses, implementation of 24-hours services that are not in compliance with the Policy on Provision of 24-hours in the Primary Health Care, and the implementation of austerity measures regardless of the gross shortage of nurses.

DENOSA is gravely concerned about the instability created by the employer in changing off-duties for nurses in the hospitals and clinics without following proper consultation processes.

These changes are not in the best interest of service delivery, but deliberate measures to deal with the shortage of nurses and to save costs which ends up denying our communities their basic human right of access to quality health care service.

As a nurses' organisation, it is our firm belief that the designing and implementation of duty roster is the responsibility of Operational Managers in the wards and clinics in consultation with registered nurses in the units. It is not the responsibility of Nursing Service Managers to design the duty roster but to oversee the implementation. Nursing Service Managers should allow Operational Managers an opportunity to manage their units and clinics as per the contract of employment considering that duty roster is not one-size-fits-all since the dynamics of units and clinics differ from one facility to the other. The changes to duty rosters failed to take into consideration the socio-economic circumstances of nurses but treat nurses as mere tools of trade.

DENOSA, as a recognized union organising in the Department of Health, referred this matter to the Limpopo Bargaining Chamber and further requested a Special Chamber meeting to formally consult with the Department of Health on changes effected to duty rosters.The meeting will be held after confirmation of the date by the Limpopo Chamber.

DENOSA is making a call to the Department of Health to suspend the implementation of changes to duty rosters pending finalization of consultation at the Limpopo Chamber.

On Implementation of Austerity measures and continuous budget cuts:

The organization takes note of the implementation of austerity measures and continuous budget cuts by the Treasury in the province, with specific target on Compensation of employees  budget vote. Continuous budget cut for the Department of Health denies our communities access to their basic human right to health services. Most clinics are no longer providing 24-hours services due to gross shortage of personnel such as nurses and cleaners. 

DENOSA calls for Limpopo Treasury to exempt the Department of Health from this continuous budget cut and to make provision for additional budget to cater for appointment of the newly qualified professional nurses on a permanent basis to strengthen human resource in the hospitals and clinics. 

Appointment of additional nurses and cleaners will ensure that most of clinics provide 24-hour services to our communities, in particular rural areas.

On Implementation of 24 hours Policy in the Clinics:  

The PEC has learnt with serious concern the abuse of power by District Executive and PHC Managers who continue to intimidate and harass nurses in the clinics by forcing them to open during the night despite not meeting criteria and checklist in terms of Policy on Provincial of 24 hours service. The act by these managers is reckless and irresponsible. The policy on 24-hours service was developed and approved by the HOD and MEC who are both Medical practitioners with clear conscious and understanding of the importance to create a conducive environmental for both patients and nurses in the clinics.

As the nursing organisation, it is our responsibility to ensure that the employer complies with the prescripts such as Acts, Resolutions and Policies including the one on Provision of 24 hours service at the Clinics. Non-compliance with the Policy compromises the safety of nurses and the community members especially during loadshedding at night as majority of the clinics which are being opened to provide 24 hour services do not have back-up power system as required by the policy.

Backup power system is required to generate power and supply other medical equipment during load shedding. The rechargeable portable lights supplied to clinics are not back-up power systems because they provide light only.

The situation also compromises the quality of care received by the patients. 

DENOSA supports the implementation of 24-Hours service only in the clinics which comply with the requirements in terms of Policy on provision of 24 Hours in the clinics. 

The organisation further calls upon the employer to stop intimidation and harassment of nurses by forcing them to provide 24 hours in the clinics which do not meet requirements in accordance with the Policy. 

On training of nurses: 

The organisation is gravely disappointed by delaying tactics by the Department of Health by dragging its feet in the consultation process about Policy on Recognition of Prior-Learning, which is an agenda item at the Limpopo Chamber. This Policy will give Enrolled Nursing Assistants and Enrolled Nurses who do not meet admission requirements an opportunity to enroll for Diploma in Nursing, taking into consideration their knowledge and experience acquired in practice. 

DENOSA call upon Department of Health to come the party at the Chamber and assist in concluding the Policy on Recognition of Prior-Learning before the new intake for nursing students by Limpopo College. The organisation further makes a call to the Department of Health to prioritize nurses training by allocating sufficient budget to ensure that Limpopo College of Nursing admits students in all five campuses in accordance with accredited slots from South African Nursing Council taking into consideration the aging population of nurses in the province.

The PEC called for the improvement and transparency during selection processes starting from shortlisting up until the end.

Issued by DENOSA Limpopo