More than a financial Band-Aid needed to heal the NHLS

More than a financial Band-Aid needed to heal the NHLS
10th November 2014 | Spotlight

Health Minister Dr Aaron Motsoaledi has announced plans to ‘fix’ the National Health Laboratory Service (NHLS) – one of the country’s most important health assets, which is on the verge of collapse.

The role of the NHLS cannot be overstated. It is at the heart of the country’s response to HIV and TB and plays a vital role in for example cervical cancer screening. Without tests there can be no diagnosis, there can be no monitoring, and there can be no viral load programme for the largest HIV epidemic in the world. Without the NHLS, health care for the poor will virtually grind to a halt.

The NHLS is one of the few public services that has functioned well. It provides high quality tests at affordable prices. It’s not flawless – no laboratory is – but it has provided a competent and reliable testing service for many years and often against great odds. In addition to the testing, it has also produced high quality research and has trained key pathologists, as well as technicians and technologists.

There are many theories why such an important asset been allowed to become bankrupt, but what is common cause is that two provinces are a big part of the mess – KwaZulu-Natal and Gauteng – neither of which has paid what they owe for services rendered.

As a starting point, we call on provinces to do the right thing and pay their bills. Put quite simply they need to pay for services which they requested and received.

Also, we need to ensure that going forward the NHLS is protected and insulated from political interference. It is trickly and complex to understand the real reason why for example KwaZulu-Natal is not paying its bills, but there is no doubt that there have been political considerations.

Losing the NHLS is simply not an option and will be a disaster this country cannot afford.

We also call on the Parliamentary Portfolio Committee on Health to urgently hold a public hearing to investigate what has happened to the NHLS and how it got to the point described in the main article carried in this publication.

Those who currently work at the NHLS and former employees would like to see the NHLS function optimally, but they are too fearful or terrified to speak on the record. Several spoke to the NSP Review, but only after they were offered absolute confidentiality and protection. This cannot continue.

Another urgent intervention is for the NHLS Board to take the lead in formulating a plan to retain existing staff and to attract back staff that left.

A key reform announced by Minister Motsoaledi in Parliament in September is that, from the next financial year, Treasury will pay the NHLS a global lump sum and cut out the provinces altogether. This will go a long way to ensuring the Service doesn’t sink deeper into a bottomless pit of debt. In the meantime, though, it still owes creditors R5- billion – and won’t be able to function effectively if this debt isn’t settled. So, while we welcome the plan announced by Minister Motsoaledi it has not been debated or interogated in Parliament. We would like to see this plan tabled at the Committee and debated properly with stakeholders able to give input.

We are also concerned by the silence from the NHLS Board. They are a critical cog in the wheel and have been appointed to ensure they this key asset it protected and able to function independently. A public statement from the NHLS Board is long overdue and must be published urgently. This statement will have to assure the public that it is actively working to protect the services of the NHLS.

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3 Responses to “More than a financial Band-Aid needed to heal the NHLS”

  1. Sagie pillay

    Excellent article . It is absolutely right that loosing the NHLS is not an option. the current reimbursement model is unsustainable and must be replaced with an altenative that is simpler and guaranteed .

    Reply

  2. Terry Elans

    losing?

    Reply

  3. Anonymous

    From my perspective, there were multiple problems within the NHLS. The external problem was financial and appears to have been politically motivated.

    The internal problem has to do with the culture of the organisation. The exodus of technical staff is not entirely due to the financial problem. The lack of leadership, empty promises, unfairness, victimisation, absence of planning, an executive and board with no pathology experience, senior management without exposure to pathology, the bloating of the organisation with unnecessary administrative staff over the last 5-6 years, the absence of clear career progression, management’s apparent inability to reconcile financial statements with either healthcare on the ground or the maintenance of human resources and skills, and the perception that executive appointments are political rather than based on ability and relevant experience have all demoralised and demotivated the staff.

    One could argue that the financial woes constrained the executive’s ability to invest in sustaining and maintaining the organisation’s human capital or creating systems that cater for career progression. I think that the NHLS has converted a financial problem into a financial, human resource and infrastructure problem — there is nothing left from which to build. The strings holding the organisation together are about to retire. I therefore agree with the commentator who says “it has already collapsed, it has already crumbled”.

    I should argue that the financial problem is the straw that has broken the camel’s back.

    Reply