PUBLIC SERVICE COMMISSION

1. PUBLIC SERVICE COMMISSION REPORT ON REMUNERATIVE WORK OUTSIDE THE PUBLIC SERVICE (RWOPS) PRESENTATION TO THE PORTFOLIO COMMITTEE ON PUBLIC SERVICE AND ADMINISTRATION 14 OCTOBER 2004

2. Structure of Presentation • Introduction and Background • Project objectives • Unpacking RWOPS • Findings • Recommendations • Conclusion

3. Introduction • In terms of section 195 of the Constitution, 1996, the PSC is empowered to promote a high standard of professional ethics in the public service. • In terms of section 196 (4) (b) of the Constitution, 1996, the PSC is empowered to investigate , monitor and evaluate the organization and administration, and personnel practices of the Public Service. • Principals -Stakeholders are Parliament, Legislatures Executive, National and Provincial Departments.

4. Background to the project • The investigation was initiated due to a complaint received from Gauteng nurses concerning the non- compliance with the Code of Conduct with respect to RWOPS: - health professionals perform RWOPS without prior approval. • - abuse of sick leave (fraudulent) to undertake • RWOPS. • - theft of state assets for private use.

5. Background - • Investigation was conducted at Johannesburg and Pretoria Academic Hospitals. Interviews (with questionnaires) were held with health professionals: - Nurses, doctors and allied health professionals - HR Staff. - Chief Executive Officers. - Hospital health advisory committees. - Health Professions Council of South Africa . - South African Nursing Council. - Senior managers in the Gauteng Health Department.

6. Project Objectives • To assess the level of compliance with COC, with specific reference to RWOPS. • To identify the key ethical issues and problems related to moonlighting . • To determine some of the general working conditions in hospitals and the possible negative effect thereof on personnel.

7. Knowledge of the Public Service Regulations • 51 officials out of a sample of 200 indicated that they were fairly acquainted with the COC whilst 7 staff stated that they were unaware of it. • 58 officials out of a sample of 200 indicated they were aware of the departmental policy which regulates RWOPS. • Others respondents did not answer the question Only 12 % of all respondents indicated that employees comply with the provisions of the COC • 88% of the respondents indicated that employees and senior management do not adhere to the COC.

8. Reasons given for moonlighting by nurses and doctors • Non-recognition of performance by senior management • Common justifications are that everyone else is doing it, and public officials are poorly paid and deserve an extra reward. • Working conditions at state hospitals. • Some specialists are invited by private hospitals to offer their skills and knowledge. • Delays in processing RWOPS application forms by management.

9. Findings • There is abuse of official working hours and scapegoats are often sought to cover up. • Sick leave is abused. • Approved leave with full pay is misused for work in other state hospitals. • Moonlighting activities occur during the day and night (24hours). • A person who works a 24-hours day becomes exhausted and stressed. This puts patients at risk.

10. Findings • 50% of Specialists doctors own private clinics and often abuse official time and sick leave to moonlight at their clinics. • Health officials believe their salaries are not competitive e.g. Medical officer receives R115 575 and Nursing Assistants receive R31 695 per annum (2002 – 2003). • In 2002 the majority of nurses and doctors who moonlight at Gauteng hospitals (Public and Private)came mainly from: • Eastern Cape • KwaZulu-Natal • Limpopo • Mpumalanga • Free State

11. RECOMMENDATIONS • There is a need to investigate the current salary structure of health professionals • Other conditions of service: - Some doctors be required to work only five-hour shifts per day (5/8 hours), as opposed to the normal eight-hour shifts that currently apply - Such doctors be remunerated pro rata for working shorter shifts • This should apply to a percentage of posts depending on the workload or type of service required.

12. RECOMMENDATIONS • The Department of Health should review the conditions of employment of full-time health professionals doing moonlighting through private agencies within the public service. • A clocking system should be implemented to control: • absenteeism • unauthorized leave • and to ensure that officials are remunerated for actual hours worked.

13. RECOMMENDATIONS • There is a need to improve the RWOPS policy according to international best practice: • create measures that will address the conflict of interest • changing circumstances arising from approved RWOPS • the utilization of paid and unpaid leave as well as unpaid voluntary work. • Quarterly printouts of sick leave records captured on PERSAL should be made available to line managers so that the trends for each employee can be ascertained with regards to the following:

14. RECOMMENDATIONS (i) The day of the week on which sick leave commences. (ii) The duration of sick leave taken. (iii) The number of sick leave days utilized. (iv) Sick leave taken preceding and subsequent to public holidays. (v) The total salary cost of sick leave. • The nature of illness.

15. RECOMMENDATIONS • In order to improve the delays in processing RWOPS application forms: - A dedicated human resource component should be assigned the aforementioned task,and weekly reports should be submitted to the Chief Executive Officer.

16. RECOMMENDATIONS • Annual audits of RWOPS applications should be conducted by means of, among others, comparing the records kept by HR components with the corresponding records kept by doctors or nursing personnel.

17. CONCLUSION • Portfolio Committee should seriously consider the PSC recommendations. • PSC will monitor implementation of its recommendations on a six monthly basis.

18. THANK YOU