Filling of vacancies in the departments of Health, Social Development, and Home Affairs and contribution to delayed service provision: Auditor-General of South Africa briefing

Meeting report

Auditor-General of South Africa presentation: opening remarks
Mr Barry Wheeler, Corporate Executive, Auditor-General of South Africa (AGSA), said that the figures presented for the departments were not completely accurate to date as information from the 2010/11 Annual Reports were used for this presentation. The information was not audited and this was the latest information available that the Auditor-General (AG) could use for this report. There was no reliable information on the current situation.

Health sector: presentation
Mr Wheeler presented the vacancy rates for the Department of Health. He said that according to the information of the annual report 2010/11, a total of 289 731 (69%) of posts were filled with a total of 129 506 (31%) being vacant. He then presented vacancies versus posts filled per province, with Gauteng, Northern Cape and Western Cape levels remaining the same over 2009/10 and 2010/11. The Eastern Cape, Mpumalanga and National Departments had all decreased their vacancy rates over 2009/10 and 2010/11 with the Free State, KwaZulu-Natal and Limpopo increasing their vacancy rates over the same period. He noted that even though Limpopo had a vacancy rate of 45%, there was a slight improvement from the previous year’s rate.

Mr Wheeler presented the vacancy rate per programme. Programme Two, District Health Services, had the highest vacancy rate at 37%. This programme was one of the most critical to ensure that the Department of Health fulfilled its mandate. He said that the department found it difficult to simply fill posts as other factors also had to be taken into consideration, such as suitable candidates for the posts who has undergone sufficient training. Programme One, Administration, was also concerning with a vacancy rate of 31% as well as programme Four, Provincial Health Services, at a rate of 28%. He then gave an analysis of vacancies in relation to total vacancies, and this revealed that District Health Services was at 62% of all vacancies.

Mr Wheeler gave a vacancy analysis per province for Programme One. The Northern Cape had the highest number of vacancies with 59% of its posts unfilled. KwaZulu- Natal, Mpumalanga and Gauteng also had a high number of vacancies in this Programme. Mr Wheeler explained that this was not a good sign as this Programme was the core of functioning within the department. If there were vacancies in this Programme it indicated that at some level the top structures management could be lacking. The Eastern Cape on the other hand, had overfilled its vacancies by 8%. This had subsequently resulted in some posts being removed. Mr Wheeler then presented the vacancies per critical occupation. Posts that were lacking the most were medical practitioners, dental practitioners and pharmacists. There was also a big need for professional nurses and intern pharmacists.

Mr Wheeler gave a breakdown of critical occupations vacancies per province (see slide 9). He said that Mpumalanga had the greatest shortage of critical occupations and the reason for this was because the province did not have a university therefore the province had trouble attracting young people in the medical field. Mr Wheeler gave a list of other factors impacting on service delivery in the core programmes which were:

Poor retention of skills due to favourable conditions in the private sector
Shortage of staff resulted in overworked and demoralised staff
Poor training of staff
Patient unhappiness due to poor attendance
Patient backlog
The lack of ambulances and personnel in Emergency Medical Services (EMS) had a huge bearing on the compliance to the National Norm of response times
Shortage of EMS staff resulted in poor response times, poor discipline and low morale of the staff

Mr Wheeler explained that the shortage of specialists affected the admission of patients and lack of appropriate specialised care. At academic hospitals the non-availability of critical staff impacted directly on the quantity and quality of the training service offered. The implementation of Occupation Specific Dispensation (OSD) resulted in the overspending of compensation which was placing a limitation on the filling of vacant positions. He said that inadequate Human Resources training and budgeting constraints resulted in a lack of posts for critical skills and bursary recipients.

Mr Wheeler gave an outline of factors impacting on support programmes. The impact on the supply chain management environment had a direct impact on poor procurement processes, fleet management and asset management. He said that because of this, the Gauteng Health Department had recently been in a situation where hospitals were left without food and basic services. The shortage of personnel in the infrastructure unit resulted in projects not being finalised in time, poor quality of work not detected early and unnecessary expenditure in correcting poor workmanship. In addition, newly built facilities were not being utilised due to a shortage of staff.

Social Development sector: presentation
Mr Wheeler said that overall vacancies in the social development sector were 11 595 (37%). He then gave a breakdown of vacancies per province. Overall, the biggest change was noted in KwaZulu-Natal as for the period 2009/10 the vacancy rate was at 69% and had improved to 4% in 2010/11. He said that this was as a result of massive efforts to address the vacancy rate in the province. The vacancy rate had increased in the provinces of the Eastern Cape, Western Cape and Gauteng with a decrease in the Free State, Limpopo, Mpumalanga and Northern Cape.

Mr Wheeler gave a breakdown of vacancies per programme. Programme One, Administration, had a vacancy rate of 36%, and Programme Two had a rate of 35%. Programme Three, Development and Research had the highest number of vacancies at 53%. He then presented the vacancies versus posts filled for Programme One (see slide 6). Vacancies for critical posts such as social work and related permanent professionals were at 33% and at 55% for other critical posts. He then gave an outline of critical occupation vacancies per province. The North West province had the highest number of vacancies for social work and related professionals and Limpopo had the biggest shortage of other critical posts.

Mr Wheeler said that there were insufficient social service professionals available to communities in the provinces as most of the provinces had a vacancy rate of more than 10% in the social service programmes within the departments. He said that other factors impacting on service delivery was that departments did not have proper measures in place to monitor Non-Profit Organisations (NPOs) regarding expenditure incurred and progress made on service delivery. Departments did not have proper measures to monitor the actual service delivery of NPOs regarding care and service to older persons, child care and protection services as well as have a community base for HIV/AIDS. The department complained about inadequate office space and financial constraints to implement organisational structures.

Home Affairs: presentation 
Mr Wheeler presented the vacancy rate by programme for 2009/10 which was at a total of 17.5%. This rate dropped to 7.4% in 2010/11. He presented the vacancies per programme for 2010/11 and 2009/10 (see slides 4 and 5). He then gave an outline of vacancy rates by salary band with the highest rate of vacancies at senior management level.

Mr Wheeler noted that the Department of Home Affairs had really improved a lot with regards to its functioning. It had improved its processes also taking into consideration that this Department had a critical mandate to fulfil. Its annual report of 2010/11 showed all the steps taken to bring about this change. He said that vacancy rates by critical occupation was at 21.0% in 2009/10 and had come down to 6.7% in 2010/11. One of the reasons why it had come down by such a huge margin was because one of the critical vacant post categories (computer system designers and analysts) had been removed. Mr Wheeler noted that vacancies in critical posts existed for information technology-related professionals and regulatory inspectors. 

Discussion

Mr T Mashamaite (ANC, Limpopo) wanted to know who was responsible for the poor training which was impacting on service delivery in the health sector, as he felt this was unacceptable.

Mr Wheeler agreed that this was an issue that needed to be addressed. Continuance was required because insufficient was attention given to the needs of the Department resulting in skills being unavailable. The Department was experiencing a skills gap especially in core skills, soft skills, development and leadership. The problem with training was that it was not thoroughly assessed. A framework in the Department had to be created whereby the quality of training had to be assessed once it had been provided.

Mr S Plaatjie (COPE, North West) said that since the information on vacancies was not audited, would there be a huge variation if current statistics were used?

Mr Wheeler replied that that these presentations were based on performance information submitted to the AG by the departments. This performance information was indeed audited and was available in the annual report framework. Members could request the most recent information from the Department of Public Service and Administration.

Mr W Faber (DA, Northern Cape) noted that the Western Cape had only a 4% vacancy rate in 2010/11 for health. All other provinces had a rate above 10% which was impacting negatively on service delivery. This was extremely worrying. He wanted to know if the national or provincial department took responsibility for this.

Mr Wheeler replied that it was a political responsibility. The Head of Departments (HODs) had to take responsibility, not Human Resources. The HODs should be responsible to know what was happening in their departments.

Mr M de Villiers (DA, Western Cape) was worried that if the departments could only provide vacancy statistics for 2010/11 now, then they had no idea what was happening in the department. If the provinces and the Minister had the right information then maybe they could figure out better more effective action plans.

Mr Wheeler apologised that the most recent information was not ready to be used for this meeting. 

Ms M Moshodi (ANC, Free State) said that an NPO was supposed to be an organisation that had to assist the Department in outreach to communities. The AG had to give this information to the Department. The inadequate office space as a factor did not make sense as officials had to be out in the field helping communities.

Ms M Makgate (ANC, North West) said that she was concerned about the state of District Health Services as people should have access to use these basic services. The Department had to figure out a way to attract young people into these posts and get the empty buildings operational.

Mr Wheeler replied that it all depended on working conditions as young people preferred to work in academic hospitals or centres of excellence as they were called. 

Ms B Mncube (ANC, Gauteng) suggested that to fill the scarce and critical skills shortage, each department had to figure out its own strategy to create skills development programmes.

The Chairperson noted the over-allocation of posts in the Eastern Cape in the Department  of Health. She wanted to know whether the national Department was aware of this and what assistance had been provided.

Mr Wheeler replied that he could not comment fully around this but knew that some of those posts were subsequently removed. It was also a problem with database registers where an employee would leave but the systemwould not then register that the post was then vacant.

Mr Mashamaite said that Mr Wheeler had tried to explain the reasons for the vacancy rates but he wanted to know what caused these delays. Was it because of ineffective norms and standards?

Mr Wheeler replied that the AG had visited the HODs and Members of the Executive Councils MECs of provinces, and also held meetings with the chairpersons of the portfolio committees and it was agreed that controls had to be updated. Human Resources in the Department of Health was not working as there was no set process for the filling of vacancies but the Department was trying to correct this.

Mr De Villiers referred to the vacancy posts per programme in the health sector and from this information he could see that there was a problem. If the administration was problematic or understaffed, then all other programmes would fail.

Ms Moshodi asked whether it was the Department of Social Development or the South African Social Security Agency (SASSA) which did not have enough funds.

Ms Virginia Petersen, Chief Executive Officer (CEO), SASSA, replied that currently SASSA was operating with only 50% of its mandate funded. It was working on recreating its structure to make it more automated, where beneficiaries could now collect their grants at automated telling machines (ATMs), for example. They had started a huge re-registration operation due to the high number of fraud and identity theft cases reported.

Ms Makgate was concerned whether the Department of Home Affairs could control illegal immigrants crossing over the borders.

Ms Charlotte Mocke, Chief Director: People Management, Department of Home Affairs, replied that the Department had projections of positions needed to control the border posts. Currently 118 positions were projected for port of entry points along the border. A pilot project would be rolled out at OR Tambo International Airport focusing specifically on immigration.

Mr Plaatjie thanked the Department of Home Affairs for the good work and huge improvements it had achieved.

Mr Mashamaite agreed that the Department of Home Affairs had shown great improvement. He said that some offices in Mokopane were not open and asked the Department to look into why this was the case.

Ms Mocke replied that she would look into this.

The meeting was adjourned.