Gaut­eng Health in ICU

Ur­gent shake-up needed

The Star Early Edition - - FRONT PAGE - TEBOGO MONAMA

GAUT­ENG Pre­mier David Makhura has a ma­jor headache: what to do with the prov­ince’s trou­bled Health Depart­ment, which had a “chaotic” ad­min­is­tra­tion and needed a “big shake-up” ur­gently.

Makhura con­ceded yes­ter­day that a lot wasn’t well in the depart­ment, still reel­ing from the deaths of more than 100 psy­chi­atric pa­tients moved from Life Esidi­meni and the re­cent mor­tu­ary work­ers’ strike that lasted three weeks, plung­ing the prov­ince’s health-de­liv­ery sys­tem into chaos.

The re­cent col­lapse of a roof at Char­lotte Max­eke Aca­demic Hospi­tal is also among is­sues the depart­ment has had to grap­ple with.

Makhura blamed ad­min­is­tra­tors for the poor run­ning of the depart­ment. “The clin­i­cians are do­ing well, but it is of­fi­cials at pro­vin­cial level who are fail­ing the sys­tem.

“Those in charge of the in­sti­tu­tions of health, whether it is pro­vin­cial or re­gional or the hos­pi­tals, them­selves need a big shake-up,” the pre­mier said, speak­ing at the tabling of the pro­vin­cial bud­get in the Gaut­eng leg­is­la­ture.

He said an ur­gent over­haul had to hap­pen be­fore 2019, when his term of of­fice ends. “We are mon­i­tor­ing care­fully the work be­ing done to fix public health in our prov­ince. We will not rest un­til all the prob­lems in our health sys­tem are ad­dressed fully.”

The Esidi­meni tragedy, as well as the mor­tu­ary strike and the Char­lotte Max­eke roof col­lapse, were the lat­est in a string of prob­lems that have hit the depart­ment.

Var­i­ous hos­pi­tals and clin­ics have had to deal with is­sues such as de­lays in op­er­a­tions due to the short­age of anaes­thetic drugs, bro­ken equip­ment, in­ad­e­quate staff, and mis­use and mis­al­lo­ca­tion of funds, all of which has led to a sharp de­te­ri­o­ra­tion in health­care. Other prob­lems in­clude a short­age of key staff such as doc­tors, moon­light­ing and doc­tors us­ing state fa­cil­i­ties for pri­vate work, as well as theft of medicines and equip­ment.

The cri­sis-rid­den depart­ment has over the years seen its key po­si­tions chang­ing hands sev­eral times with­out any last­ing so­lu­tions. Former Tsh­wane mayor and ex-deputy min­is­ter of health Dr Gwen Ramok­gopa re­cently re­turned to the po­si­tion as health MEC, tak­ing over from Qedani Mahlangu, who re­signed in the wake of the Esidi­meni scan­dal. Ramok­gopa was pre­vi­ously Gaut­eng’s health MEC, from 1999 to 2006.

In a bold ad­mis­sion that in­com­pe­tence was at the heart of some of the prob­lems, Makhura said the is­sue was not that the depart­ment didn’t have money.

“One part… re­lates to the ad­min­is­tra­tive chaos in the Depart­ment of Health. It is some­thing we are on top of,” he said.

The pre­mier an­nounced that all NGOs would be paid by to­mor­row, but stressed that se­nior man­age­ment in the depart­ment needed to “shape up”.

He said the pro­vin­cial govern­ment and the Health Depart­ment were im­ple­ment­ing the rec­om­men­da­tions of Health Om­buds­man Pro­fes­sor Male­ga­puru Mak­goba’s re­port into the Life Esidi­meni deaths.

The re­port found that more than 100 pa­tients died af­ter the ir­reg­u­lar re­movals from the Life Esidi­meni fa­cil­ity to un­reg­is­tered NGOs. Mak­goba rec­om­mended that all the NGOs that looked af­ter the pa­tients be shut down and in­ves­ti­gated by the po­lice.

The pa­tients were moved from the un­reg­is­tered NGOs to dif­fer­ent ones, but it emerged this week that 160 of them have not been paid for three months.

The pre­mier said the prob­lem was not only the depart­ment, but new NGO reg­u­la­tions that have been in­tro­duced, which had re­sulted in or­gan­i­sa­tions strug­gling to ad­here to them.

Makhura said the prov­ince was con­cerned about the Health Depart­ment’s per­for­mance, which was why he has es­tab­lished a spe­cial cabi­net com­mit­tee to as­sist Ramok­gopa. “Non-pay­ment im­pacts neg­a­tively on small busi­nesses, but this ad­min­is­tra­tion has done well.”

But the DA’s Jack Bloom blamed the depart­ment and Makhura for de­stroy­ing small busi­nesses in the prov­ince by not pay­ing ser­vice providers on time.

“Their pay­ment av­er­age is 66 days, some­times very much longer. Other big-bud­get de­part­ments also fail to pay on time. This shows wide­spread poor fi­nan­cial man­age­ment that your of­fice seems pow­er­less to fix.”

Makhura said that in the next few weeks, he would, as in­structed by the Health Om­bud’s re­port, an­nounce a re­tired judge and a com­mit­tee to probe the Life Esidi­meni mat­ter.


FAC­ING MA­JOR CHAL­LENGES: Pre­mier David Makhura ad­mit­ted a lot was not well in Gaut­eng’s public health­care sys­tem.

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