Evaluating public sector service delivery at KwaZulu-Natal provincial hospitals : a case study of the Durban Metropolitan and Ilembe region.

Abstract

The Constitution of the Republic of South Africa,1996 (Act 108 of 1996) and the Patients’ Rights Charter (Patients’ Rights Charter: Online) guarantee all citizens the right to basic health care services (South Africa, 1996: chapter 3). Furthermore, the White Paper on the Transformation of the Public Service (South Africa, 1997) states that the delivery of healthcare should be guided by the principles contained in the framework of Batho Pele, a Sotho term meaning “People First”. Hospitals play an important role in delivering healthcare. However, strong allegations have been made about the inability of various provincial hospitals to provide health care in line with the Constitution and the Patients’ Rights Charter. Customer satisfactionis a vital measure of performance for firms, industries and national economies (Anderson et al., 1994).The growing health care literature suggests that patient satisfaction should motivate strategic decisions in the healthcare sector (Andaleeb, 2001). Research has indicated that the services provided by a company or institution can be measured by determining the inconsistency between what the customer wants (expectations) and how the customer experiences the service (perceptions). Little research has been conducted to date in KwaZulu-Natal provincial hospitals to evaluate the progress made in improving service delivery of healthcare; the healthcare system and the administration thereof, which is a major cause of poor service delivery in the provincial hospitals. This research study aims to contribute towards the identification of health care requirements by articulating the expectations of patients. Following a literature review which provided insight into the conceptual and contextual framework of public administration and the role of knowledge management in enhancing public sector service delivery, empirical data were gathered by means of questionnaires administered to patients, nurses and doctors at three hospitals in iLembe region and eThekwini Metropolitan Municipality in KwaZulu-Natal – Addington, King Edward VIII and Stanger Hospitals – that serve urban, rural and semirural communities. The study’s findings revealed that there is indeed, reason for concern with regard to the identified service delivery goals and with regard to improving the health care system in general. The findings show that there is a weak, non-significant, negative linear relationship between the services offered at the three provincial hospitals compared with the expectations of patients who were admitted to these hospitals during the time the research was conducted. There is a need for further research regarding the interface between public sector provincial hospital services and service delivery, and the quality of services offered by hospitals in order to comply with Batho Pele Principles. It is anticipated that the study’s recommendations will assist hospitals in the eThekwini Metro and iLembe region in dealing with the challenges they face with regard to hospital service delivery and the monitoring and evaluating of Batho Pele Principles in the quest for a more efficient and effective delivery mandate.