Health blames Public Works for hospitals’ state of neglect
THE Department of Health has put the blame on the doorstep of Minister Sihle Zikalala’s Public Works and Infrastructure Department for the lack of infrastructure development of healthcare facilities across the country.
The claim by the Health Department that Public Works is not carrying out its responsibility has been backed by the Democratic Nursing Organisation of SA (Denosa).
Public Works, which in Gauteng is known as the Department of Infrastructure Development (DID), is an infrastructure development implementing agent used by its sister departments to carry out the construction and maintenance of their facilities.
Both the DID and the national Public Works Department have yet to respond to questions sent to them.
Dr Nicholas Crisp, the Health Department’s deputy director-general in charge of the National Health Insurance (NHI), recently told the Sunday Independent that public clinics and hospitals were in a state of neglect because of “maintenance run by other non-health departments who are not motivated to do the work when it is necessary”.
Asked to elaborate, Health national spokesperson Foster Mohale said Crisp was referring to the Public Works departments of various provinces.
The issue of Public Works’ lack of motivation in doing their work came about when the Sunday Independent was making enquiries about health facilities’ state of readiness for the implementation of NHI, and established that much work needed to be done ahead of its implementation.
According to the NHI Bill, health institutions will have to meet a specific
health standard to be funded by NHI. Section 41(4) states that for a private or public institution to qualify to receive payment from NHI for services rendered, “the minister may make regulations to provide that payments may be made on condition that there has been compliance with quality standards of care or the achievement of specified levels of performance”.
It emerged that the majority of public health facilities might not meet the required standard because of their ageing or neglected infrastructure.
Mohale said it was hoped that the NHI would give the national Health Department autonomy to manage its own infrastructure development as opposed to the current situation where this was managed by provincial governments.
“The bulk of the infrastructure budgets are presently in direct conditional grants (so paid to the provinces to effect infrastructure contracts). The plan is to move these direct grants to indirect so that the NDOH (national
Department of Health) can manage the spending through more efficient implementing agents,” said Mohale.
Denosa Gauteng secretary Bongani Mazibuko said his union wanted the provincial government to do away with the DID and allow the health department to handle the work of repairing its health facilities.
“The problem is ongoing and still needs to be attended to, which we have previously raised as a concern.
“But the response is not satisfactory because it seems there is a challenge with the DID, who are the ones who are supposed to be doing the repairs but when the Department of Health puts a request nothing is happening.”
However, the Department of Basic Education does not have a problem with Public Works’ performance. Instead, education spokesperson Elijah Mhlanga blamed notorious business forums for the delay in developing school infrastructure.
“The Department of Basic Education and provinces have a huge portfolio in terms of its infrastructure projects and relying on the Department of Public Works alone would not be wise. So we utilise five other implementing agents,” said Mhlanga.
He said the department’s biggest headache was business forums “rather than the Department of Public Works”.
He said the forums would stop projects and delay the completion of much-needed infrastructure through violence and intimidation.
“They demand projects to be handed to them, they demand to be paid for projects to continue without interruption,” said Mhlanga.
“Many projects in KZN are affected, while in other provinces it’s not as prevalent. KZN is the biggest problem for the department where even some (workers) have been killed.”