A strike by National Health Laboratory Services workers has entered its second week. (Peter Nicholls)

Have provinces really paid outstanding billions to laboratory services?

Nelisiwe Msomi
The national health department says provinces have paid up but the head of lab services denies this.

Provinces have met a tight deadline to repay billions owed to the National Health Laboratory Services (NHLS), says the national health department. The influx of cash may help end the NHLS strike now in its second week .

“All the provinces that were owing the NHLS have paid. Gauteng has paid almost 50% and [are] making plans to pay the rest,” national health department spokesperson Popo Maja told Bhekisisa.

But the acting NHLS CEO Shabir Madhi has maintained that KwaZulu-Natal and Gauteng still owe the service more than R2-billion each.

In a media statement released by Madhi on Tuesday morning, he said: "Unfortunately, in the case of Gauteng province, the NHLS board notes with dismay the reluctance of this province to settle any of the outstanding debt...This is now being compounded by Gauteng health’s ongoing procurement of services valued at approximately R154 million per month, whilst their monthly payment since 1 April 2017 has only been two-thirds thereof. This will result in Gauteng provincial health department accruing a further debt of R600 million during the current financial year."

The NHLS operates about 300 laboratories nationwide that conduct tests — from cervical screenings to testing babies for HIV — for the public health sector. 

Gauteng health department spokesperson Prince Hamnca said he could not confirm whether Gauteng had paid almost 50% of what it owed the NHLS, but maintained that the department continues to make monthly payments to the body.

The KwaZulu-Natal health department had not responded to request for comment at the time of going to print.

NHLS workers went on  strike Wednesday after the national body said it could not meet employees’ demands for better benefits. This came after the NHLS agreed to a 7.3% wage increase following negotiations with unions the National Education, Health and Allied Workers’ Union (Nehawu) and the Public Servants Association of South Africa (PSA).

Speaking to Bhekisisa last week, Madhi said that the NHLS cannot meet demands for benefits unless provinces pay up.

He explained this week: “The NHLS is a public and national laboratory service that receives its income from the provincial departments of health for services rendered. Our income must and will continue coming from the provinces as per legislation. The issue of non-payment has to be sorted out because the organisation’s financial viability depends on this income.”

In his media statement, Madhi said: "The failure of some provinces to pay for their consumption is unfortunate considering that the NHLS costs are at least 25% cheaper than in the private sector for a basket of tests, including being more than 60-75% cheaper for priority tests such as HIV-PCR and tuberculosis tests."

PCR, or polymerase chain reaction, testing is the only way to diagnose babies born to HIV-positive mothers with the virus.

Previous strikes at the laboratories have shut down diagnostic services, such as cervical cancer screening and some types of tests for HIV-positive patients, creating huge backlogs.

Last week, Bloom alleged that the national strike had closed or nearly paralysed most major public laboratories in Gauteng. He said that the Gauteng health department had begun outsourcing some critical tests to private laboratories, a decision he said was likely to plunge the NHLS further into debt as it would have to pay for this. 

Meanwhile the HIV lobby group, the Treatment Action Campaign, and the social justice organisation, Section27, said while they support unions' "quest for a reasonable salary increase and working conditions", they appeal to them to not "conduct wage disputes in a manner which jeopardises people’s lives". In a statement released on Tuesday afternoon they said: "Seventy percent of all clinical decisions are based on a pathology result. That means that millions of people depend on these essential services."

This story was updated on Tuesday afternoon at 15:23 with a comment from Section27 and the Treatment Action Campaign.


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National Health Laboratory Service (NHLS)