SPEECH NOTES, PINE PIENAAR, MPL, FOR DEBATE ON ANNUAL REPORT OF DEPARTMENT OF HEALTH, 2 DECEMBER 2010

I don’t think I have ever had so many negative things to say about the management, administration and utter incompetence in any department as I was forced to say during the past year.

The situation in the Eastern Cape Department of Health is so far beyond control that I’m afraid that I have no hope.

Earlier this year I pleaded with the national government to assist in the running of health in this province. I pointed out that services are horrible; medicines are not being delivered at clinics; hospital departments are closing because of a lack of staff; and poor people are dying because of administrative incompetence and the lack of financial control.

It is a cop-out to repeatedly have assistance for national government in departments. These “task teams” come here, do their intervention and when they leave, the same problems crop up again.

This happens because the root of the problem is “problem people”. What is needed is decisive leadership to remove these people so that obstacles to service delivery can be eliminated.

The ruling party must be held accountable for the suffering of the poor in the Eastern Cape that cannot afford private medical health care.

Not one person can, on the grounds of what is happening at grassroots level in hospitals, clinics and emergency services, deny that bad management and administration has led to numerous deaths over the past few months.

You cannot allow an MEC to lose all control over his R13,6-billion budget.

How can you allow this if the AG says he cannot obtain appropriate audit evidence to provide a basis for an audit opinion about the department?

It’s a complete horror story. The department:

* failed to maintain adequate records of outstanding payments for goods and services or provide supporting documents;

* did not give supporting documents for the amounts of R858.5 million payments as employee benefits;

* overstated R8.8million in Occupation Specific Dispensation and Human Resource accruals;

* could not provide evidence of backdated and arrear salaries of R404 million relating to Human Resource Operating Project Team payments and of R219 million in allowances and bonuses; and

* overstated salaries by R30.5million and staff dept by R5.9million.

And nothing is being done. We need to take action to retrieve fruitless and wasteful expenditure and put management control systems in place. But, nothing.

We are sitting here waiting for an Christmas bonus while people — mostly children – are dying.

The findings of the AG confirm what I have been saying for the last couple of years.

This province has no chance what-so-ever to meet the Millennium Development Goals we have set ourselves.

We have also learnt from this report that a mere 26% of the province’s budget was allocated to health work itself. A gross 63% of the health budget is allocated to the cost of employment. Overspending on employment is making it impossible for us to invest in infrastructure and resources we need for quality healthcare.

The lack of control, over-spending and blatant corruption indicates that poor monitoring by the government could impact on mortality rates and specifically on child deaths.

The department admits that in many instances they do not know what happens to drugs when it leaves depots. I know! It’s being stolen and sold on the black market.

Nurses have been arrested, but it’s worse than that. It is institutional! Because of the lack of control and the bad administration, it has become easy and the norm to be corrupt in an environment where you have a pathetic administration and inadequate

monitoring mechanisms.

Mr. Speaker.

The department of health is in debt. It owes money not only to the bank and on its current budget, but it also owes the people. It owes the people in lack of service delivery and in lack of the hardware it needs to serve the sick, the elderly and the poor.

Private public partnerships creates the opportunity for successful entrepreneurs and businesses to team up with government projects to achieve specific goals.

Achieving these goals can be measured by all the parties involved, thus creating the mechanism so that partnerships which do not reach their goals in terms of cost and efficiency, can be discontinued immediately. It creates the further opportunity of training, skills transfers, job creation and empowerment. Off course, successful projects will also achieve real service delivery.

We need strong leadership where the MEC and the Premier — ¬and I have written letters to request this over and over — ¬call on the SA Defense Force to make its ambulances and services available until we have rectified the backlogs and sorted out our bad deals and lack of hardware to deliver proper services.

We need to take real and touch decisions. Cometh the hour, cometh the man or the women that can make the tough decisions.

The new Superintendent-General in the Health Department has already started making some headway, trying to rid the department of corruption, but how long will he be allowed to do so?

The moment anybody is successful at fighting corruption, they are the ones who get the axe. Look at what happened to the Scorpions. When you start shaking the tree and the bigwigs start feeling uncomfortable, that is when your own head is about to roll.

It is indeed a sad day when a government cannot provide basic healthcare to its citizens. Without radical change, the situation will only become worse.