- The Department continues to delay the delivery of an organogram
- workload had tripled
- I conclude with a question
- How much of this report qualifies as post-truth because of repetitive findings?”
Honourable Premier, Madam Speaker, colleagues and esteemed guests Molweni Nonke! It is a privilege to greet you and to wish you the happiest New Year yet!
Health affects every single one of us no matter who we are or where we live. It is, therefore, vital that our Provincial Department of Health adheres to global best practice to honour and cherish the lives and health of all our people irrespective of the circumstances of their birth.
One way of doing so is to adopt the principles of the World Health Organisation (WHO) and its definition of health as “… a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”. Such a principled stance requires that all our patients receive fair, equal and thorough treatment regardless of their disease, age, sex or status.
These principles should extend to include administrative justice, equality of access and service -regardless of rural or urban environments – and predictably healthy, clean, safe, well stocked and fully staffed facilities at all levels.
In this respect the performance of our Provincial Department of Health is embarrassing. As detailed in the report the Department continues to delay the delivery of an organogram! Such a failure makes a mockery of planning! It compromises service delivery and contributes to heavy workloads and understaffing in what would be the lower levels of our currently non-existent organogram – hence the shortage of lower band level staff such as Cleaners. These shortages increase the load borne by all our overworked Nurses, Doctors and Specialists and contribute to the Province’s already massive medico-legal costs.
The statement above is supported by research published in the Sunday Times of 29 01 17 (p6) in which staff shortages and conditions of service in our state hospitals include a workload that has tripled in the last few years and sees interns and registrars completely overburdened, exhausted and unable to perform optimally because they are completely overstretched. So much so that one intern who fell asleep at the wheel is known to have died after working extended hours.
The lack of an organogram also frustrates the decomplexing process because organisational structures remain centralised. The DA is encouraged by the demand that a time-bound plan should be submitted not later than 30 days after adoption of the report. It is vital that this Recommendation is adhered to and the DA looks forward to receiving the completed organogram within 30 days of its adoption.
It is a matter of concern that despite the many needs of our health facilities and our people that the Department of Health has underspent its budget by 79. 756 Billion Rand and that all Programmes posted under expenditure in the 2015/2016 financial year.
Although the Portfolio Committee is aware of some of the challenges in the NHI pilot programme it is alarming to note that the NHI Grant underspent its allocation by 28.8% or R 2.072 million of R7.204 million rand. It is even more troubling to note that an official is yet to be appointed to monitor and evaluate the success of the NHI project.
Such inactivity suggests that the Department does not place much importance on Programme 2 or that it lacks the capacity and means to fill posts and appoint staff to conduct performance appraisals.
The NHI Pilot programme appears seems to be neglected, failing, under-resourced and unable to deliver. In direct contrast to this scenario – On 19 September 2016 – the DA launched “Our Health Plan”. Our Health Plan recognises that state health services the vast majority of our country’s population, that our public health system is chronically mismanaged and understaffed and that the wealthiest 20% of the population who use the private system are far better served.
We propose therefore to introduce strategic reforms, to increase competition in the private sector and to encourage more private-public partnerships that will require no new taxes and to allocate a universal subsidy to all South Africans regardless of whether they are private or state patients.
Included in Our Health Plan are public and private standardisation of services, the provision of expanded Maternal and Child Health Programmes, an expanded Clinic Building Programme – especially in under-resourced areas, and a single number expanded national public-private Emergency Medical Service.
Because we care we will also establish a single a self-funded post-retirement programme and an unemployment protection regime for medical aid members. It is obvious that the Public Healthcare system is failing our people so we propose to restructure it and to introduce autonomous Public Hospitals and District Health Authorities that will have independent boards, wide operational discretion and Public Services will be free at the point of service for those with and without medical aid membership! In this way equal services will be provided to all patients regardless of whether they are – or – are not members of a medical aid. Unlike current government practice that hounds those with Medical Aids who use state health services and forces them to pay more if they belong to a Medical Aid Scheme!
Again it is disturbing to read that EMS Call Centres are not fully functional, that our Department has underperformed on all indicators related to turnaround times and that such failure is caused by staff and vehicle shortages. This is life threatening and requires swift action before lives are lost because of understaffing and poor turnaround times.
It is a sadly quite contradictory to claim that the Department aims to increase access to learning
by providing bursaries and to read down the line that there is a notable decrease in the number of
bursaries awarded to first year nursing and medical students!
Failure to finalise decomplexing has negatively impacted on service delivery in Programmes 1, 2, 4 and 5. This is 4 programmes too many and change is essential!
It is reported in Programme 8 that the Coega Development Company (CDC) summarily terminated contract number CDC 02 15 and – even worse – that the Department never concluded or signed a contract for this work.
Such action exposes the Department to risk and requires vigilant management.
General Findings in the report that all Departments underspent their budgets and that the budget for COE has shrunk because priorities changed to suggest that all is not well in the Eastern Cape Department of Health.
In conclusion, I introduce the concept of “post-truth” to this debate. “Post-Truth” is the Oxford English Dictionary word of the year and is defined as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than objective facts.”
So the question is how much of this report and its recommendations qualify as “post-truth” ??
The DA accepts the report.