Speech Notes: Recruitment by the Eastern Cape department of Health during the COVID-19 pandemic

Issued by Jane Cowley, MPL
Shadow MEC for Health

Madam Speaker, Honourable Premier, Honourable members of the House, officials and guests, I greet you all.

Madam Speaker, a year ago we had not even heard the word Covid-19. A viral pandemic was something one read about in a good book, or watched in a scary movie. Little did we know that in a few short months, the world as we knew it would have changed forever.

Entire new vocabularies have been invented around this pandemic, such as social distancing, the new normal, business unusual and virtual meetings, to name but a few. There are new ways to greet, new ways to shop safely and new ways of attending school. So much has changed since last year and we have had to adapt on a global scale.

Sadly, though, some things have stayed exactly the same. Things that, had they changed, would have made a positive impact on our response as a province to the Covid-19 pandemic. The first is the rampant corruption which needs no introduction.

First we had the pop –up PPE companies that wanted a slice of the Covid-19 slush fund, and who charged exorbitant rates for masks, sanitisers and other PPE items, and which the SIU is now investigating. I cannot wait to see whose bank account details are revealed when the investigation is over.

If that was not bad enough, we then had pop-up communications companies, who charged R4,8 million rand to do a door to door Covid-19 awareness campaign in OR Tambo district, which never even happened!

The cherry on the corruption cake, and the all-time lowest of the low, was the theft of food parcels from indigent people, by ANC councillors. Of course, none of these corrupt practises were revealed by the ANC themselves, but rather by opposition parties practising due diligence.

Another thing that has not changed, is the state of understaffing in our hospitals and clinics. According to Dr John Black, a leading epidemiologist in the province who briefed the legislature on the 3rd of March this year, the biggest challenge that was facing our beleaguered Health Department in the province with the advent of Covid-19, was the severe and ongoing staff shortages in facilities across the province.

So there was a sense of relief when it was announced by the Department of Health in May that they were to employ a total of 7642 healthcare workers on contract, from 1 July 2020 until 31 March 2021. While the virus had already taken its toll on hundreds of frontline workers, some of whom had tragically already succumbed to the disease, it was certainly a case of better late than never.

It was for this reason that I put a motion to the House to resolve that the Department keep the House abreast of the recruitment process, including the time frames for recruitment and the cost of the recruitment, so that the Health Portfolio Committee could conduct the requisite oversight over the recruitment process.

In a report to the Health Portfolio Committee dated the 12th of June, it was stated that recruitment had begun and of the 7642 positions, 2923 had already been filled. However, the vast majority of these were community health workers. While they are certainly able to assist, they could not fill the gaps created by the surge in Covid-19 cases among the professional nurses and enrolled nurses. So there was little to no relief in the Covid – 19 wards.

A full month later, on the 13th of July, it was revealed that 3459 positions had been filled – a mere 42% of the total required. Shockingly, this only included seven doctors. So in 30 days, only a further 536 people were recruited by the Health Department. Bear in mind that the contracts were from the 1st of July.

Fast forward two more weeks to the 26th of July, and in the Premier’s Executive summary in his extended Provincial Command Council, his first observation after his virtual visits to assess the rollout of the Covid-19 campaign, was that, and I quote, “areas requiring close attention include the following: 1) Healthcare staff shortages which are exacerbated by the increasing infections and deaths”. End quote.

Fast forward again to the 16th of August. While most, but not yet all, of the posts have now been filled, only 435 professional nurses and 38 social workers have been employed. But the part of the update that really caught my eye, was that 8 critical senior management posts have been filled, while further 17 had been advertised. Advertised.

So a full five months after the warning bells were rung very loudly and very clearly by Dr Black in the House for all to hear on the 3rd of March, the department finally got their act together and advertised some critical posts. Five months later. The mind boggles.

Now while the weekly JOC reports and the Premier’s command council talk about the great strides that the province has made in responding to the pandemic, it made no sense to me that despite repeated requests by the Health Portfolio Committee to be allowed to conduct oversight at health facilities across the province, this request was declined every time.

Madam Speaker, I do not speak on behalf of the Health Portfolio Committee. I speak as an individual that could not for the life of me understand why, in the midst of a global HEALTH pandemic, the HEALTH committee was denied their request to perform oversight at health facilities, which is their constitutional mandate. Once again I speak as an individual when I say that that made me highly suspicious.

And so, I climbed into my faithful Toyota bakkie and went travelling around the province to visit hospitals.

The sights I saw, and the tragic stories of our healthcare workers and doctors on the frontline, Madam Speaker, were enough to break my heart. It is my considered opinion that all the plans, interventions, recruitments, extensions and secondments found very little expression on the ground.

In other words, weekly reports did not reflect on what was happening in our hospitals at all. The reports were, and continue to be, a grand exercise in paper compliance, while in the real world, the desperate challenges facing our frontline forces have for the most part, not been addressed.

By June, Livingstone hospital had 30% less frontline healthcare workers than they had in March. Dr Black stated clearly that this was because the Department had failed to fill vacant funded posts.

Uitenhage Hospital, Fort England Hospital, Cradock Hospital, Frontier Hospital and The Premier’s flagship hospital, St Patricks Hospital in Mbizana, all have empty wards which could have been converted into Covid -19 wards, but there’s just one small snag. They don’t have enough nurses and doctors to man them.

St Patrick’s, despite being open for four years already, has NEVER been able to open their gynaecology ward, their high care ward or their 30 bed step down ward, because this flagship hospital was never ever given any beds or nurses for these wards. It seems the flagship has sprung a leak.

When speaking to the doctors and nurses, I had to hold back tears when they described their exhaustion, their emotional distress and the sheer hopelessness they continue to endure daily. They all tell the same story – a story of gross negligence on the part of the health department, despite ongoing and urgent please for more doctors, more nurses and more beds.

When asked about all the extra staff that have been recruited to assist in the response to Covid-19, they explain that community health workers can assist with laundry and food. They are not able to relieve any of the immense pressure on the Professional nurses and enrolled nurses and doctors who are so thinly spread that they have to work in non-Covid and Covid wards on the same shift, massively increasing their risk and the risk of other patients, because there is nobody else to do the job.

They have had minimal psycho-social support, and more often than not have to wait for the Department of Social Development to send a social worker, who must then try to attend to the needs of 100 staff members.

The situation in the EMS programme is no better. In Alfred Nzo district, ambulances are parked in a row at the hospital, but there are no EMS personnel to use them. This, while we face the biggest global health pandemic known to mankind. People are dying at home because there are not enough paramedics or ambulances in the province.

In Uitenhage, the EMS service is housed in a condemned building. There is no regular access to water, so paramedics must try to fill an old bath when there is water, so that they can use that water to flush their toilet and wash themselves when they come off duty. This, while we face the biggest global health pandemic known to mankind.

In Cradock and Whittlesea, which fall under the Chris Hani district municipality, ambulances must be booked from eKomani. Four to five hours is the average waiting time. This, while we face the biggest global health pandemic known to mankind. One wonders just how many preventable deaths have occurred as a result of ambulance and EMS personnel shortages.

The Hewu hospital in Whittlesea only has access to water for three hours every day, but on Thursdays there is no water at all. How can it be that a hospital does not have access to running water? How do they cope with infection control and prevention protocols without running water? It is no wonder that so many healthcare workers at that hospital were infected with the Covid-19 virus. Furthermore, their staff organogram has got so many gaps in it that it resembles a cheese grater. I am surprised the hospital is even able to function.

Having travelled around the province from east to west and north to south, it became crystal clear to me why the Department of Health did not want any oversight to be conducted. They knew that their continued maladministration, which has left the Health department rudderless at both an institutional and provincial level, would be exposed.

And exposed it was. Not only nationally, but internationally too. Only after the BBC and Sky News had told the stories of our broken health system and our broken and devastated frontline workers, did we at last see some tentative steps being taken to improve cleanliness in hospitals, improve PPE supply and improve psycho-social support for our angels working in Hell.

In stark contrast, the Democratic Alliance – led Western Cape government has been lauded internationally for their professional, focussed and diligent response to the Covid-19 pandemic, and their forward planning and forward thinking in establishing field hospitals well before the peak of the pandemic was reached.

This is because as the Democratic Alliance, we have earned our place as an efficient and honest government and DA led municipalities across the country obtain clean audit reports. We do not tolerate any form of corruption, which is why we are able to deliver basic services, including healthcare, to all our citizens where we govern. This is why we are able to create more jobs than the rest of the country put together. This is also why, allegedly, so many of your family members live in the Western Cape now.

Political patronage, jobs for friends, and a Mafia-like control of senior positions within the Department of Health, have taken their toll and rendered the Department almost useless. I am not surprised at the high rate of resignations of highly qualified doctors and specialist nurses from the Department of Health – according to them this is mostly due to discrimination and victimisation. If you do a good job, you will get worked out of the system.

It is indeed a sad day that a Member of the House has to put a motion which essentially is just asking the department of Health to do their work properly. But if it has the desired effect, then I will continue to put motions to the House every time we have a sitting.

Until such time that the recruitment of personnel to the Department of Health is based on merit only, instead of how well you can throw a chair at a congress or how many votes you can secure the Premier candidate, this department will remain in deep, deep trouble. And the longer this department remains in deep, deep trouble, the more citizens will die unnecessary deaths.