Speech notes: Vote 3 – Health Annual & Half Year Financial Oversight Reports

Issued by Jane Cowley, MPL
Shadow MEC for Health

Madam Speaker, Hon Premier, Hon Members of the Legislature; officials and guests, I greet you all.

Madam Speaker, I would like to begin by acknowledging the incredible work done by our Eastern Cape Healthcare workforce over the past year as they have been at the forefront of the fight against the dreadful Covid-19 pandemic, which has devastated so many lives across our province, and indeed across the globe. They are in my prayers daily.

Madam Speaker, we are all aware that the Department of Health has many challenges, most of which have been haunting the Department for several years already. Sadly, despite many attempts at rectifying these challenges, they continue to haunt the Department and impact negatively on its performance.

The wonderful actor Octavia Spencer says, and I quote, “Only when you find the courage to say something to someone that might influence a change in behaviour, does that behaviour change”.

We will never see the change we want to see in the Department until we change our tactics because we need to acknowledge that most of the strategies that have been applied to deal with the serious issues facing the Department have failed dismally.

Let us look firstly at the financial status of the Department. Contingent liability now stands at R36 billion and accruals at almost R4 billion. We know the root of all the financial evil is medico-legal claims against the Department of health, but these will never disappear completely – it’s the nature of the practice of medicine.

What needs to change is how we deal with them. All the fancy law firms and financial institutions haven’t helped – they have simply added their cost to the problem. So we need to change how we approach the claims. We need to budget for them so that the rest of the Department is not continuously hamstrung by overspends which cripple their performance.

Madam Speaker, when I hear the word organogram, I have heart palpitations. The finalisation process is clearly not working, so tactics must change. Currently, the organogram is a dog’s breakfast of unqualified but well-connected people holding positions that they don’t deserve, or the other extreme, operational managers and senior staff who have proven their worth over many years but do not even have a letter acknowledging their acting capacity.

The resentment and division at district level is tangible, and is a direct result of disastrous cadre deployment.

So fix it. Employ people who are competent to do the job and employ them legitimately. Get rid of those who don’t deserve to be there. Politics has no place in health.

The Emergency Medical Services programme, so vital to our province, continues to limp along without having implemented any strategies discussed at its now forgotten summit; turn- around times remain dismal, decentralisation of the service remains a pipe dream; the number of vehicles on the road remain way below the required norm of 670 for the population of the province because there is no money for more ambulances, but… miraculously, a whopping R60,7 million rand was paid out to EMS employees for overtime NOT WORKED.

Madam Speaker, where in the world does anyone get paid overtime for doing absolutely nothing? This behaviour must change immediately. It only takes one leader with enough Chutzpah to say – enough is enough.

The mental health reputation of the Eastern Cape is in tatters and has been for some years now. An administrator, Professor Mkhize, was brought to investigate matters after the horrendous revelations of abuse, theft, fraud and mismanagement at Tower Hospital. More than 18 months after he completed his recommendations, the committee had still not received his report. Madam Speaker, as a committee we are dedicated to conducting oversight in our various communities, and I can assure you that all is not well at most of the mental hospitals in the province.

This clearly shows a lack of commitment on the part of the Department to implement the administrator’s recommendations. How are patients with mental health issues ever to live lives of value, if those who are in place to ensure their care don’t even bother to do so? And what are the consequences for programme managers who fail to implement these recommendations? Their behaviour won’t change until the actions against them change.

Madam Speaker, we have the ongoing challenge of poor rural infrastructure for doctors, which impacts very negatively on the attraction of such to our rural areas. Last year I proposed a model whereby doctors and specialists rotate between rural and urban facilities, firstly to bring better services to the rural communities, but also to protect doctors from feeling as though they are committing medical suicide by being confined to rural facilities.

Doctors upskill at tertiary institutions in one cycle and practice their improved qualifications in the rural facilities for the next cycle. This innovation has been successful in several African countries and contributes to rural communities feeling more valued. Of course, the first step would be to ensure that they have acceptable accommodation and facilities.

Let’s talk more about infrastructure. It has no place in a health department – Qha.

For the past several years, the Department has had the approach of Sakhiwo – vul’igate! They have sucked this Department dry and have left very little of value behind.

We have a Department of Public Works who did us so proud over the past 12 months under extreme duress. They must take back the responsibility of health infrastructure. It will save our province a fortune.

In the DA-led Western Province, health infrastructure has been strategically built so that more than 91,5% 0f households live within 30 minutes if their closest health facility – by far the highest in the country.

My sentiments are similar with regard to the Health Science and Training programme. We have many excellent tertiary facilities in the country that offer health education. When a sister department takes over this competency, corruption and mismanagement become the norm.

Jobs, bursaries and positions for family and friends are common in the Lilitha system in the Eastern Cape. So change it. Once again, we will save a fortune.
Madam Speaker I am very concerned at our Cost of Employment which currently stands at 79% – way above the national norm, and yet our performance as a department has regressed.

We seem to employ more and more people, who do less and less work. At this rate, we will soon have a COE of 100% and not a single Disprin to dispense.

This does not require months and years to reverse – it simply requires a strong leader to make a strong decision and stick to it. In the absence of strong leadership, you will continue to regress.

Madam Speaker, let us find the courage to say what needs to be said, and more importantly do what needs to be done, in order to bring real and sustainable improvements to health services in our province.

Our people deserve a life of value and a caring and functional health care system will contribute significantly to bringing this vision to life.

The DA accepts the report.