Worst ever Gauteng health budget will run out by December

27 June 2017

This year’s health budget is R40.2 billion, which is more than four times the health budget in 2005 which was only R9.2 billion. In real terms it has more than doubled, even taking into account the higher rate of medical inflation.

But what value are we getting with this huge amount of money? With great regret, I have to say that this is the worst health budget ever tabled in this House.

This is because R11 billion of the R40.2 billion budget is not available in this budgetary year for the delivery of health services. Accruals of R4.2 billion have to be settled, and there are contractual commitments of R3 billion, and possible payments of R3.8 billion for medical negligence this year.

This means that only 73% of this budget is actually available and we will run out of budget after 9 months in December of this year. It’s a budget nightmare. The budget has previously been crippled by payments for the previous year, but this is the worst ever.

Financial management has never recovered from the disaster unleashed by Honourable Brian Hlongwa who took over as Health MEC from Honourable Ramokgopa in early 2006. The lack of consequence for corruption and mismanagement continues in this department.

This is why only 77 out of 166 service delivery targets were achieved last year, which is a 54% failure rate.

The capital budget is 18% down from last year because National Treasury withheld R860 million for hospital infrastructure "pending submission and approvals of plans by the department". This department is incapable of building anything in reasonable time and vaguely near budget.

Another continuing failure is the Folateng private wards that lost R12.6 million last year. These wards were started by Ramokgopa in 2002, and since then an astounding total of R569 million has been written off. But instead of closing them, the MEC wants to expand the services offered.

Other areas of concern are the following:

- The revenue collection target is down R110 million from last year.

- Long queues for patients at hospitals and clinics and long waiting lists for operations, particularly cataracts and knee and hip operations.

- Poor emergency ambulance response times, will 100 ambulances out of action every day.

- Too much spending on the Cuban Doctors programme instead of local training of doctors.

- Medical negligence cases continue to rise, particularly brain-damaged babies.

- There are not enough beds in specialized wards for psychiatric patients, who are often placed in ordinary wards in hospitals.

- Medicine shortages still occur.

- 160 NGOs who look after thousands of mental health patients have not been licensed and have not been paid by the department for three months.

I hope that the promised deadlines are met for the scanning of all patient files by next year. Electronic files should be part of a comprehensive health information system to improve efficiency and cut down waiting times.

The MEC took over in difficult circumstances following the monstrous treatment of Esidimeni patients that led to more than 100 deaths. I am concerned that disciplinary action is still not concluded in this matter - we don’t even know exactly how many people died.

I am disappointed that the MEC has been so weak in handling the three week illegal strike by mortuary workers which has caused so much distress to families. A court order barring the strike should have been obtained right from the beginning.

On a positive note, the department can be proud in areas like vaccinations where more than 100% of target is regularly obtained. In 2005 the TB cure rate was 58%, and has risen to 87%. More than 800 000 people receive ARVs, and less than 2% of HIV-positive mothers give birth to HIV-positive babies.

I wish I could see more rays of light, but this budget is inescapably going to require a financial bailout, otherwise health services will come to halt in December.

Madam MEC, you need to clear out the rot in this department and appoint capable new people.

Efficiency and compassion in all areas is needed in order to serve the health needs of the people of this province.

Issued by Jack Bloom, DA Gauteng Shadow MEC for Health, 27 June 2017