Time to place NC Health Dept under administration is now

24 March 2022

Note to Editors: The following is a speech delivered at a press briefing attended by DA Provincial Leader, Harold McGluwa, and DA Provincial Spokesperson of Health, Dr Isak Fritz at the DA's legislature office in Kimberley today.

Voice clips are attached in English and Afrikaans. See pics  here and here. 

The Democratic Alliance (DA) wants the Northern Cape Department of Health placed under administration in accordance with Section 100 (1) (b) (i) of the Constitution.

While the Health Department has been on a steady decline for the last decade, matters have reached breaking point.

There have been no improvements in audit outcomes for the past five years, with the department stuck on a qualified opinion. Based on submissions by the Office of the Auditor-General, the department shows “no will” to try and recover. It has not even bothered to attempt to put together an audit action plan, to compile an asset register on a simple Excel spreadsheet or to investigate crippling irregular expenditure.

The department started the current financial year off on the back foot, already owing R590,186 million on the previous year’s debt while its bank overdraft was stated at R100,455 million, signifying financial unsustainability and once again casting doubt on the department’s ability to continue as a going concern.

Ironically, this debt laden department also managed to underspend by R78,418 million due to a combination of factors, including administrative delays in moving patients to the new mental hospital, which in effect sees state patients still being housed in prison despite this being a gross human rights violation.

The department failed to spend money earmarked for the procurement of emergency vehicles. In the meantime, the number of operational ambulances on our roads is declining with the latest figures suggesting that only 75 ambulances were operational, while 73 were waiting to be repaired.

Cancer patients can’t get from Springbok to Kimberley for treatment, while at the last known date, 28 Patient Transporters were operational and the other 28 were broken.

Out of a mortuary fleet of 31, only six mortuary vehicles are in a good working condition across the entire province.

The wheelchair backlog at last known date was said to be well over 1 000, but if other reported figures are anything to go by, its closer to a backlog of more than 5 000 already.

The state of clinics is on the decline, with only 23 facilities out of 159 achieving Ideal Clinic status compared with 101 achieving the status in 2018/19.

Claims against the department stand at R1,890 billion and continue to balloon, with medico-legal cases accounting for R1,624 billion, indicating an ongoing increase in adverse events taking place in health facilities.

Most hospitals and clinics suffer dire personnel shortages. In fact, Robert Mangaliso Sobukwe Hospital in Kimberley can, on a good day, only operationalise four out of nine theatres because of a lack of nursing staff. Smaller facilities, like the Community Health Centre in Warrenton has closed its emergency unit after 4pm due to staff shortages.

I must stop and highlight that these staff shortages are not because health professionals don’t want to work in the Northern Cape, as the department likes to claim. The real reason is that doctors and nurses, who desperately want to live and work in this province, don’t get the opportunity because of the destructive and delayed Human Resource (HR) practices employed by this department. By the time this department eventually decides to review job applications, or by the time submissions are signed by the acting HOD and the MEC, we have already lost valuable health staff to other provinces that do not take a tardy approach towards appointments of scarce skills.

The DA has repeatedly raised the decentralization of HR delegations, to no avail.

There are also cases where sexual assault victims could not be attended to due to shortage of available trained practitioners in Clinical Forensics. The health department’s failures in this regard are also impacting on the collection of high-quality evidence from victims or rape. In this regard, it’s shocking to note that, for the year under review, 848 sexual assault cases were reported at health facilities but there was only DNA testing done on a single perpetrator.

The total number of Neonatal deaths has increased steadily. Twenty-six deaths occurred in RMSH and 18 in Dr Harry Surtie hospital which can be attributed to a lack of neonatal units in all district hospitals.

Condom distribution underperformed again because of an outstanding license disk for the truck.

Despite the almost R2 billion state of the art mental health hospital, minors are being admitted to adult wards because the child and adolescent ward is not yet operationalised.

A large portion of the 50 ventilators procured during the peak of the Covid-19 pandemic for use in ICU’s in districts, remain locked up in hidden storerooms because of a lack of specialised skills in the districts to put the ventilators to good use.

Cumulative irregular expenditure now stands at R8,664 billion. It keeps on growing largely due to the awarding of tenders by implementing agents, followed by expired contracts that are extended on a month-to-month basis. This gets repeated time and again, without it being investigated.

We can only wonder why it is necessary for a cash-strapped department to insist upon using middlemen, to whom it must pay additional fees, to facilitate basic maintenance and the procurement of equipment, machinery and even furniture.

Big orders are split to avoid competitive bidding processes and to enable graft. Implicated company names are published in the Annual Report for all to see, and the internal audit committee advises the department to appoint a team of experts to investigate such irregularities. But a blind eye is turned. What is going on in this den of corruption? Why is it allowed to continue?

The DA has consistently called on the Premier to appoint a Head of Department to address the instability caused by a prolonged acting appointments to the position of Head of Department, and numerous other acting manager positions. We are still waiting. The moratorium on the appointment of staff was always the excuse, but what’s the excuse now?

The Premier himself, Dr Zamani Saul, has personally tried to intervene in this department with his Health Desk, that unfortunately was short-lived. He also declared health to be a provincial priority, but this has only accompanied the worsening health of this department.

If all of the above is not a clear enough warning that this department is completely overwhelmed and on the verge of collapse, then nothing ever will be.

The DA will take our concerns raised here today to the legislature portfolio committee. We hope to garner the committee’s support in our appeal to ask for a Section 100 intervention to be initiated.

If the committee chooses not to support us, we will anyway proceed to submit our own letter to the National Minister of Health, Dr Joe Phaahla, asking him to take this department under its wing while there is still something left to save from this dysfunctional and increasingly deadly department.

As much as 70% of the Northern Cape population depends on state health care, we owe it to them to stand up for universal access to quality healthcare for all!

Issued by Isak Fritz, DA Northern Cape Spokesperson of Health, 24 March 2022