Eastern Cape health staff owe department more than R3m

The Eastern Cape department of health is scrambling to recover more than R3m in salary overpayments made to its own staff, including doctors and nurses, due to a string of administrative and payroll blunders.

The irregular payments, some dating back months, include cases where employees continued to receive commuted overtime, nodal allowances, or salaries, even after exiting the department. The department has so far clawed back more than R1m, but officials say the recovery process is far from over.

Provincial health department spokesperson Siyanda Manana confirmed that human resources and processing errors led to the overpayments, which affected dozens of staff across various categories.

“Some employees continued receiving nodal allowances after moving to non-nodal areas, while others were paid salaries after leaving the department,” Manana said.

R3.1m still owed and counting

To date, the department has recovered:

• R1.016m from commuted overtime; and
• R299,013 from nodal allowances

However, there is still R3.165m outstanding, linked to commuted overtime, grade progression errors and post-termination salary payments.

Manana said the final recoverable amount will be confirmed as part of the 2024/25 financial year-end reconciliation.

Unpaid debts and legal tangles

The department has begun issuing debt notifications and many employees have signed acknowledgement of debt agreements. In the case of 15 doctors who were wrongly paid grade progression allowances while working as registrars, repayments have been stalled due to a Labour Court interdict.

Manana said the department received a Labour Court order interdicting the department from initiating the recovery.

“The matter is now being attended to by the finance and legal units of the department, as well as the chief audit officer,” Manana said.

Meanwhile:

• 47 employees were affected by commuted overtime irregularities;
• 17 have fully repaid their debt;
• for the 65 nodal allowance cases, nine have paid in full;
• 12 have repaid via leave gratuities;
• the remaining debts have been handed over for legal recovery.

‘Austerity measures’ amid doctor shortages

This salary saga comes as the department faces mounting pressure over critical doctor shortages and reduced overtime hours. In April, the Eastern Cape legislature adopted a motion summoning health MEC Ntandokazi Capa and head of department Dr Rolene Wagner to appear before the standing committee on public accounts.

The backlash followed a decision to reduce commuted overtime from 16 to 12 hours per month, despite hospitals already being short-staffed.

Dr Mpumelelo Melamane, provincial chairperson of the South African Medical Association Trade Union, said the decision was made without consulting unions and is placing immense strain on healthcare workers.

“Commuted overtime is a contractual part of doctors’ working conditions. Now it’s being treated like normal overtime,” said Melamane.

He warned that the move not only affected doctors’ livelihoods, but was driving skilled professionals out of the province, and in some cases, the country.

“Doctors are losing nearly half their income. Some have financial obligations. Others are leaving for better opportunities and that leaves an even greater burden on those who remain,” he said.

Democratic Nursing Organisation of South Africa provincial secretary in the Eastern Cape, Veli Sinqana, said they have members who are affected especially those dealing with nodal allowances.

“The manner in which it has been handled leads to financial stress. Some were notified and some just received letters of demand without proper consultation,” he said.

He said the union is concerned about this approach as it is against Section 34 of the Basic Conditions of Employment Act which regulates deductions from employee remuneration.

“There is a written consent required for most deductions and outlining specific conditions under which deductions can occur. The impact of this will lead to more burden to health workers due to maladministration,” Sinqana said.

He said the organisation has engaged with the department. “Unfortunately the department does not engage in good faith,” he said.

Discipline and accountability

Manana confirmed that staff who allowed or facilitated the salary irregularities have been disciplined, with some receiving written warnings and others facing ongoing disciplinary action.

Despite the scandal, the department has highlighted its unqualified audit opinion as proof of its commitment to financial responsibility.

“We are committed to clean governance. That is why we are taking all necessary steps to ensure money paid in error is fully recovered,” he said.