Assessment of roles and responsibilities of hospital boards in a public hospital in the Limpopo Province

Introduction: This study sought to assess the roles and responsibilities performed by hospital boards in the public hospitals in the Limpopo Province since 2004. The rationale for embarking on the study is due to the fact that most public hospitals boards are characterized by role ambiguity resulting in squabbles and conflicts with health facility management, functionality crises or challenges, poor representation of communities being served, lack of personal commitment and will to the detriment of service delivery. Objectives: To determine the roles and responsibilities of the hospital boards in the Limpopo Province since 2004, to establish the main challenges that are experienced by public hospital board members which hinder good performance and to determine the qualification criteria for those appointed to be members of the hospital boards. Methodology: This is a qualitative study where the researcher interviewed board members of Tshilidzini Regional Hospital in the Vhembe District appointed in 2004 by the Provincial Member of Executive Council (MEC) for the Department of Health and Social Development in the Limpopo Province in terms of Northern Province Health Act of 1998. The study has been conducted from August to September 2008. Study Sample: The sample is a purposive one made up of 18 members from six district hospitals and 5 members from Tshilidzini Regional Hospital, all found in Vhembe district. The respondents were interviewed, using both open-ended and a closed-ended questionnaire. Data analysis and interpretation: As the study is a descriptive, the collected data was analyzed, taking into consideration the views and inputs as presented by different participants in the study. The researcher developed some themes or topics in accordance with the main focus areas of study and from what had been learnt via the literature reviews on the roles and responsibilities of hospital boards in the country and internationally. Results: The study found out that board members were not adequately performing the expected roles and responsibilities. Furthermore, the study shows numerous challenges and difficulties hindering board members in the execution of said roles and responsibilities that need to be addressed by the Department. The respondents also gave recommendations and inputs on the issue of criteria to consider when selecting community members interested to being hospital board members. Recommendations: A substantive recommendation is made for the Department of Health and Social Development in the Limpopo province including other provinces and the national Ministry of Health in South Africa to engage in a systematic review of the National Health Act, 61 of 2003. The study has evidence of the problems in the implementation of the Act which perhaps needs intervention through appropriate recruitment and appointment process, capacity building and clarification of roles and responsibilities. To address challenges pertaining to incentives for board members, it is further recommended that a policy needs to be developed. In order to enforce accountability, monitoring guidelines and reporting mechanisms should be developed in the form of regulations in the provinces. The appointed hospital board members should have background in financial management, financial accounting, strategic management, community development, human resource management, clinical matters, legal environment, quality assurance and risk management so that they can enhance good governance in a public hospital.