JOHANNESBURG, Gauteng — The Democratic Nursing Organization of South Africa (DENOSA) has issued a stark warning over critical staff shortages crippling the Gauteng public healthcare system, with union leaders demanding immediate government intervention to fill vacant posts and restructure the department. Speaking at an urgent press briefing, DENOSA Gauteng Chairperson Bongani Banda highlighted that the ongoing workforce deficit is directly causing long queues, delayed treatments, and compromised patient care across the province.
Banda emphasized that the provincial health department’s organizational structure has not been reviewed since 2006, despite a significant increase in population demand. This surge includes patients migrating from other provinces like Limpopo and Mpumalanga, individuals from SADC regions, and undocumented foreign nationals, all of whom place immense strain on existing healthcare budgets and infrastructure.
The union is demanding two primary actions: a comprehensive review of the organizational structure and the immediate filling of all vacant, funded posts. Banda argued that discussing legally binding minimum nurse-to-patient ratios is futile without first securing the necessary staff. He cited alarming current conditions, such as general wards at night where four professional nurses and one enrolled assistant nurse are expected to care for up to 40 patients, including mixed acuity cases like mental health and diabetic patients sharing the same unit.
Addressing the government’s frequent citation of fiscal constraints and budget freezes, Banda countered that the money is available but mismanaged. He pointed to consistent budget underspending by March each year due to unfilled posts, which subsequently leads the Treasury to reduce future budget allocations under the assumption that the funds are not required. He criticized political promises to build new hospitals or open 24-hour clinics without first securing the human resources required to operate them, warning that expanding services without capacity is unsustainable, especially with the impending implementation of the National Health Insurance (NHI).
If these demands are not met, DENOSA plans to escalate its actions. The union will soon embark on hospital listening campaigns to mobilize workers and the broader community. Banda confirmed that if the government remains unresponsive, DENOSA will take healthcare workers and society to the streets in October to force accountability, strategically bypassing “essential services” strike limitations by garnering broad public support.
When questioned about DENOSA’s position within the COSATU and broader political alliance, Banda clarified that the union will hold all public servants and governance structures accountable, regardless of political affiliation. He stressed that the alliance is strategic, but governance failures must be challenged without apology to advance the national democratic revolution.
The briefing also highlighted a direct correlation between operational failures and the instability of executive management in hospitals. Banda criticized the prevalence of acting positions, noting that the Head of Department (HOD) of Health is currently in an acting capacity and based in Kokstad, making remote management of the province’s health system unfeasible. Furthermore, key roles such as the Deputy Director-General (DDG) of Corporate Services, the Chief Director in Supply Chain Management, the Chief Director in Health Economics, and the Chief Financial Officer (CFO) are all filled by acting appointees.
Banda warned that month-to-month acting appointments strip leaders of the authority to make critical financial and operational decisions, as they fear jeopardizing their future permanent appointments. This chaos, he argued, leads to arbitrary removals of staff and a severe lack of monitoring and evaluation.
Additionally, DENOSA is fighting to keep the hospital CEO appointment process at the provincial level. The union recently agreed with the Member of the Executive Council (MEC) to appoint CEOs permanently through provincial work streams, but the process was abruptly shifted to the national minister’s office. DENOSA is demanding the process be returned to the province, arguing there is no legislation mandating ministerial appointments for provincial posts and that local capacity is being ignored in favor of political favoritism.
Finally, Banda addressed ongoing medication stock issues linked to recent facility relocations, such as in Ekurhuleni, where previous buildings were deemed non-compliant with Occupational Health and Safety (OHS) standards. The uncoordinated movement has disrupted supply chains, leaving clinics and hospitals without adequate medication. This lack of coordination frustrates service providers and places healthcare workers on the front lines, bearing the brunt of patient anger when essential treatments, such as antipsychotics, are unavailable due to systemic supply failures.
