Jack Bloom, Summary extract of speech in the Gauteng Legislature on the Annual Report of the Gauteng Health and Social Development Department, December 1 2010
I have thought about what advice I could offer you in your new job.
You must be very firm with officials. Hold them to account and get rid of the rotten ones.
Your number one priority is to put in proper budgeting systems.
For two years in a row this department has received a disclaimer by the Auditor-General. This means that he couldn't even form an opinion because he had no reliable financial information. If the Auditor-General can't form an opinion, then neither can you.
You must be ruthless on corruption. Get the auditors in if you suspect anything, and lay charges. These people are killers because the money that they steal should go to saving lives of people in this province.
You should also concentrate on billing. It is absolutely incredible that the department has written off R535 million owed from private medical aids, mostly because bills were submitted after the 120 day prescribed period.
Hospitals are also owed R230 million from the Road Accident Fund and more than R200 million from the health departments of North West, Mpumalanga and Limpopo.
If you collect these debts you will go a long way to reducing the projected overspend this year of R1.7 billion.
The next big problem you should look at is filling staff vacancies at our hospitals and clinics. There are about 4700 vacant posts in critical occupations, including 2100 nurses, 1930 doctors, 370 specialists and 277 pharmacists. One in three doctor posts (33%) are vacant, as are 41% of pharmacist posts.
You need to lobby the national health ministry for the removal of unnecessary restrictions on private sector training. We should encourage private medical schools and private hospitals should be allowed to train registrars to become specialists. The staff shortage is one of the reasons for the dreadfully long queues in our hospitals.
The creative way to solve long pharmacy queues is either with home deliveries of chronic medicines or a partnership with private pharmacies so patients can collect it there.
Please also give special attention to emergency ambulance services in this province which are a disgrace. According to the latest figures of mid-year performance, only 12% of critical patients were responded to in 15 minutes in urban areas. This is the worst that it has ever been. It is an absolute scandal that the three metro cities in this province don't even supply ambulance response times to the department.
This includes Ekurhuleni when you were mayor there. I hope you will kick butt and insist on accurate figures so that you can demand accountability for the gross failure to provide a decent ambulance service.
You need to probe why according to the Annual Report only 194 out of 450 ambulances are on the road at any one time. The official reason given is down-time due to repairs and maintenance. We buy lots of ambulances but they are badly driven and badly managed. More than half, 55%, have more than 200 000 kilometers on the clock and need to be replaced.
Yet only 42% of the EMS budget has been spent after six months with the well-worn excuse of "cash flow problems". In your busy days ahead please find time for the following:
1. Release the full report on the deaths of babies at the Charlotte Maxeke hospital
2. Make progress on a decent computerized health information system
3. Find a use for the Kempton Park Hospital that has been empty for 13 years now and costs R1 million a year in maintenance and security
4. Ensure proper follow-up so that all rape victims finish their preventive course of anti-retrovirals rather than just 50%
5. Make more female condoms available so we don't get extraordinary stories of people washing and reusing them
Finally, you should consider separating Social Development from Health. It is very clear that the merger is not working.
The NGOs all complain about it and it is even admitted in the Department's Second Quarterly Report that "Health Department payments (are) crowding out those of the Social Development Branch due to the limited availability of funds."
I suggest that the Honourable Premier follow the Eastern Cape and have a new Department of Social Development, Women, Youth and People with Disabilities.
This makes a lot of sense and will enable a proper focus on this important area in our province.
Statement issued by Jack Bloom MPL, DA Gauteng Health Spokesman, December 1 2010
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