Speech notes by Celeste Barker MPL, on oversight visits by the Portfolio Committee on Health to facilities in Alfred Nzo District Municipalities. 3 October 2017

Honourable Premier, Madam Speaker, Colleagues and Guests, the DA is grateful for the opportunity to debate the findings of pre-visits to health facilities in the Alfred Nzo District.

On a personal level, I must say that it was a treat to drive through what is surely one of the most beautiful rural areas in our country and to see unspoilt terrain on our travels.  Those of us who call this province “home” are truly blessed to live in the Eastern Cape.

Our team conducted oversight at the Siphethu Hospital, the Madzikane kaZulu Hospital, the Khotsong Hospital, the Mount Ayliff Hospital, the Taylor Bequest Hospital and at the EMS station of the Matatiele Hospital. We also received reports and presentations from 15 Clinics and the Maluti Community Health Care Centre.

Findings indicate that our rural hospitals continue to be forgotten and neglected. They are marginalised, underserved, under-equipped and seriously short staffed.  The provincial government should hang its head in shame and be brought to book for making it possible for the disgraceful legacy of unequal services in our past to continue and for indulging a situation in which rural facilities are disproportionately provided for and in which the suffering and marginalisation of our rural people continues unabated.

I say this because findings in the report highlight major inequalities in service delivery at rural Hospitals and Clinics in the Alfred Nzo District.

Such inequalities include – but are not limited to – staff shortages manifest at:  the Sebeni Clinic which has no appointed staff of its own and relies entirely on “borrowed” staff, unfilled positions and staff shortages at the Thsungwana, Thabachicha and Afsondering Clinics, failure to appoint a CEO at the Siphethu Hospital for a year during which time the Assistant Manager has acted for the full year and the non-appointment of an Operational Manager at the Maluti Community Health Care Centre. One wonders which overworked members of staff have been obliged to do double jobs and whether they – and other hapless staff who assume double responsibilities – have been acknowledged, thanked, remunerated or given time off for doing two jobs simultaneously.

Staff shortages are compounded by equipment and infrastructure challenges.  These include dysfunctional solar systems at the Dungu Clinic, an unreliable solar system at the Sebeni and Madlangala Clinics, no fridge for drug storage at the Mhlotsheni Clinic and a solar system at the Thabachicha Clinic that has not worked since 2016!  As these Clinics rely on solar power to generate electricity and to keep fridges cool, dysfunctional or semi-functional solar systems pose a threat to our people’s health. They render very important dates such as those for baby immunisation and the regular visits of the ill, aged and infirm who require prescription drugs a hit and miss affair in which there is no reliable, guaranteed service because the four solar systems highlighted above are either fully dysfunctional or semi-dysfunctional.   As recommended in the report a 30 day period has been provided for the submission of plans for rectification.  The   DA looks forward to receiving these plans because our patients are entitled to the Health Rights enshrined in our country’s constitution.

Currently, there is no fridge at the Mhlotsheni Clinic and no generator at the Matatiele Clinic.  Patient well-being and safety is compromised by unfenced premises at the Sebeni Clinic, and at the Siphethu Hospital. There are poor roads leading to the Dungu Clinic which has also has a leaking roof.

Equipment challenges at the Afsondering Clinic include no thermometer to maintain a consistent temperature in the Resuscitation Room and a shortage of sterilization materials for dressing packs. Both are vital and we look forward to receiving feedback that a thermometer and dressing packs have been provided to the Afsondering Clinic. The DA is appalled by the lack of proper, reliable ablution facilities at the Sipethu Hospital and urges the Department to attend to such basic patient needs as recommended in the report.

The consequences of this Departmental failure to manage and maintain rural Health facilities has led to years of unnecessary suffering in much the same way that the failure to maintain access to roads that lead to rural Health facilities has compromised patients in need of medical attention and has negatively impacted on maternal and infant mortality rates which in turn impact on the Department of Health’s medico-legal debt.

As the Department spent R1.7 Billion of its funds on medico-legal claims in the last financial year it is imperative that it fulfils its recommendation to “… address all infrastructure and capital equipment challenges” at the Taylor Bequest and Mount Ayliff Hospitals.

Poor file management at the Madzikane kaZulu and Mount Ayliff Hospitals, a shortage of infrastructure at the EMS base in Matatiele,  a dearth of response vehicles at Mzamba, Mount Frere, Greenville, Isipethu and Tabankulu pose a major risk to our patients and expose the Department to increased medico-legal expenses as does the shocking  fact that eight ambulances are currently under repair.

The novel, “Things fall apart” by Chinua Achebe underscores the tragic fall of Okonkwo – originally a respected and influential leader in the Igbo community of Eastern Nigeria.  We cannot indulge a similar process in our province or in our Department of Health.

The DA, therefore, proposes that Healthcare in the Eastern Cape should be based on the following World Health Organisation (WHO) building blocks:

  1. Good Health Services to those that need them with minimal wastage
  2. A well-performing workforce that works fairly and efficiently to achieve the best possible outcomes (ie: sufficient staff, fairly distributed staff that is competent, responsive and productive).
  3. A well-functioning information system for all health facilities that ensure the production, analysis, dissemination and use of reliable, timely information on health determinants, health systems performance and health status.
  4. A well-functioning health system that ensures equitable access to essential medical products, vaccines and technologies of assured quality, safety, efficacy and cost-effectiveness.
  5. A good Health Financing system that raises adequate funds for health, in ways that ensure that people can use needed services and are protected from financial catastrophe or poverty associated with having to pay for them and
  6. Leadership and governance that ensures that the existence of strategic policy frameworks is combined with effective oversight, attention to system design and accountability.

The adoption of this plan would enable our Health Department to rise above its current circumstances and to aim for the success rate achieved in the Western Cape.

The DA supports the report.