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DENOSA’s response to the freezing of nursing positions in government as exposed by South African Health Review 2017 Study 

Media statement 

Thursday, 24 August 2017 

The Democratic Nursing Organisation of South Africa (DENOSA) notes the South African Health Review 2017 Study by Health Systems Trust that was released yesterday which, among others, paints a bleak picture of potential compromise of quality healthcare service due to unfilled critical clinical positions in provincial departments of health. 

DENOSA’s interest and take about the study is from a perspective of advocating for the welfare of the population in as far as adequate healthcare service provision to the vulnerable, majority of whom are indigent and rely of public healthcare. 

The Study confirmed what we have always been saying that there is a silent moratorium in provincial departments on the appointment of even nurses despite assurances that critical clinical categories were exempted from such. While we understand the current financial situation the country and government find themselves in as after-effects of the 2008 financial meltdown, DENOSA is of the strong view that the shortage of staff in health facilities is becoming a ticking time-bomb that has the potential to regress the country’s achievement of positive health outcomes in the years behind us. This is owing to the increase in the disease burden in the country, and the increasing South African population figures. 

DENOSA is happy that the Study also makes this point clearly and we would like to add that the population of immigrants into South Africa also needs to be accounted for so that budgetary planning for health is informed by relevant numbers. We already know, thanks to the study, that our health budgets have often underestimated the population growth. What adds salt to the wound for us as nurses is that despite the underestimation of population figures in the budget processes, the austerity measures in relation to control of personnel figures wades off even the few nurses that are qualified and sitting at home while they are greatly needed by facilities. Vacancy rates are a serious challenge that create new norms in different critical units in our health facilities.   

Speedy implementation of acceptable staffing norms in the country is a matter that should be given priority by government before we see ourselves back to where we were 10 years ago.   

The study also touches on another critical area for us as nurses, that of neglected capital infrastructure spending (i.e. building and reconstruction of clinics and hospitals) which has been shelved off as a way to save costs. This, too, is equal to merely delaying your day of reckoning because more and more infrastructure in our health facilities is decaying and falling on top of patients and health workers. Maintenance of the existing old infrastructure, which was said to be the substitute for capital infrastructure spending, is not being carried out. The one fresh example of this was the sudden collapse of the ceiling at the maternity section at Tembisa Hospital last month. The roof fell on top of nurses and patients. There are more examples like this. 

“DENOSA believes that efficiency is the key word that government is looking for as a way to address the current crisis,” says DENOSA General Secretary, Oscar Phaka. 

“This means proper prioritization in the form of employing relevant personnel. It is well-known that nursing is the backbone of healthcare, and even Minister of Health acknowledges that. To have nurses sitting at home when there are vacancies that are not filled is counter-productive to the very goals SA seeks to achieve in the end.” 

Occupation-Specific Dispensation for nurses, which is cited in the study as having had a great impact in driving costs towards remuneration, was a staff retention strategy used by government at the time when the country was experiencing mass exodus of experienced and specialized nurses who were leaving the country for greener pastures like the UK, Australia, UAE and others. 

When OSD was implemented in July 2007, by December of the same year, not less than 10 000 nurses had returned back to South Africa to render quality healthcare services to South Africans. And this brought about 80% drop in job application by South African nurses to the UK alone a year later. While this OSD strategy should have been reviewed by 2012 already, it has not yet been reviewed five years later. Nurses are becoming edgy and some have, once again, already taken their flights for greener pastures in the developing countries where working conditions are far better off than they are locally.  


Issued by the Democratic Nursing Organisation of South Africa (DENOSA) 

For more information, contact:

DENOSA General Secretary, Oscar Phaka.

Mobile: 082 328 9771 


DENOSA Communications Manager, Sibongiseni Delihlazo 

Mobile: 072 584 4175 



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