SPEECH NOTES: 2021/22 Appropriation Budget – Vote 3 Health

SPEECH NOTES: 2021/22 Appropriation Budget – Vote 3 Health

Madam Speaker, Hon Premier, Hon Members, officials and guests, I greet you all.

Madam Speaker, the Department of Health in the Eastern Cape remains beset with administrative, human resource and financial challenges. It is fair to say that these have been exacerbated by the Covid-19 pandemic, but this is true for all departments.

The greatest challenges in the Health Department are longstanding and have simply not been addressed adequately, because those in positions of authority have failed to make the difficult but necessary decisions to clean up the administration.

How many years, Madam Speaker, has the Portfolio Committee been warning that drastic measures must be put in place in order to curb the ever-spiralling contingent liability against the Department?

At least a decade and counting. Three years ago, the Hon Premier started setting up a litigation unit to deal decisively with medico-legal claims against the department. Sadly it is not even fully functional yet, and since its inception, claims have soared even higher. Where is the commitment to tackling the fiscal crisis?

In response to a recent parliamentary question on the budget breakdown, the department revealed that of the R26,5 billion allocation, only R22,3 billion is in play. The rest has settled accruals and medico-legal claims.

This remaining budget is allocated as follows:

  • R14,3 billion on medical and allied personnel
  • R3,54 Billion on administrative staff
  • R1,56 billion on Goods and Services
  • R1,56 billion on Capital Assets
  • R1,34 billion on Transfers and Subsidies.

So admin staff use up more than double the budget that has been allocated for Goods and Services, which are the critical components that keep hospitals and clinics running. The Goods and Services budget for this financial year is likely to last until the end of July. And then what?

What contingency plans are in place to provide health facilities with medication, Oxygen, medical equipment, theatre equipment and soft services such as food, linen, laundry services and security? When Goods and Services run out, fatcat administrators will still be earning their salaries. This begs the question – who is the Health department really looking after?

Madam Speaker, the Health budget is unfunded and nothing is being done about it.

The administration remains bloated and incapable, while medical personnel posts remain vacant.

Nurses and doctors are stretched beyond their physical and emotional limits while they work double and even triple shifts to care for patients. Again I ask, who is the health department really looking after?
Madam Speaker, our dire financial status as a country and a province requires that we rationalise our operations. The rationalisation of facilities at district level must be properly planned and effective for three reasons:

Firstly, rationalisation must in no way impact on Goods and Services to our citizens, but rather it must streamline administrative roles in order to cut back on costs.

Secondly, this process must not deny our citizens access to the medical care that they require. Our people are indigent or elderly and they cannot afford to travel distances to reach healthcare facilities.

Thirdly, we need a full revision on the policy of sessional work by doctors. Many rural facilities depend heavily on such sessional work and it cannot be that doctors who are willing to take on such duties are prevented from doing so by a policy that does not address the needs of the people.

Our track record with regard to Mental Health in the province is an indictment on the department of Health. The fact that two full years after the very strong recommendations made by the late Professor Mkhize have not yet been implemented, shows a distinct disrespect for those who are most vulnerable in our society. And what are the consequences of this inaction? Absolutely nothing. Who is held to account? Nobody.

And then …. the scooter scandal. The contempt of top leadership for due process with regard to supply chain regulations is disgraceful.

The Public Protector has called for disciplinary action against the former MEC and former HOD – now an “advisor” to the Premier. Let us see if the premier puts his money where his mouth is regarding his desire to reside over a clean administration.

Madam Speaker, our province has 447 ambulances. Only 301 of these are currently on the road. In response to a question I set regarding Government Fleet Management Services, I learnt the following: It takes 10 business days – two full weeks – to have an ambulance serviced. My bakkie has a service in two hours.

Minor repairs take five to six weeks and major repairs take 12 weeks. Ships are built faster than that. This is pathetic. People living in rural areas are deprived of mobile medical services while this goes on.

Who will account for this dysfunctionality? Nobody. Will there be consequences? Not a chance.

If this department is serious about surviving and improving, then a good starting point would be to get rid of the Health Education Programme and the Infrastructure Programme. Neither of them are core mandates of the Department of Health. They are simply cash cows and historically produce nothing but documented acts of maladministration and corruption. Any consequences so far? None. Anyone held to account? Not a chance. The money wasted on these two programmes would be far better spent on Goods and Services and medical personnel.

In the DA – led Kouga Municipality, the remarkable turnaround of the municipality in the last five years is attributable to three key factors: Firstly, meritocracy. People are employed because they are fit for purpose and get the job done properly. Secondly: accountability. Their zero tolerance for corruption has seen officials suspended for fraudulent activities. Thirdly: decentralisation. By collaborating with community groups and the business sector, they are enabling ordinary South Africans to get stuff done.

No big talk – just hard work and getting stuff done.

So Madam Speaker, if this department has even the slightest chance of turning the ship around and surviving another financial year, then the time for talking is over and the time for meritocracy, accountability, decentralisation and getting stuff done must start.

The Democratic Alliance supports an excellent report but, unfortunately, we cannot support the budget as it is largely unfunded.