By Health Minister Aaron Motsoaledi’s own admission this week, the country’s healthcare system is “very distressed” and going through hard times.This was after a comment by Health Ombudsman Professor Malegapuru Makgoba – made during an eNCA interview last weekend – that “many Life Esidimenis are taking place throughout our country” and that the system was facing an impending collapse. The comments sparked widespread debate and condemnation of the department’s failings.The department has also been heavily criticised in different provinces – following the total collapse of services in North West last month, hospitals shut down as a result of violent labour-related strikes and patients were turned away from care; last week saw the trashing of Charlotte Maxeke Johannesburg Academic Hospital after a protest by members of the National Health and Allied Workers’ Union; and the KwaZulu-Natal oncology crisis is ongoing. The SA Human Rights Commission will be investigating the crisis in KwaZulu-Natal.Motsoaledi attributed the “distressed” state of the healthcare system to the exponential growth of the burden of disease as a result of a huge increase in noncommunicable diseases such as diabetes, high blood pressure and cancers. He outlined steps to address the many ills the department was facing.He said that, since Tuesday, 200 officials from the department’s head office had been sent to hospitals across the country to help with management issues.“We are painfully aware of the poor management skills in most of our hospitals. We are also aware of the negative attitudes of some staff members in quite a number of our facilities … While we have mentioned the long waiting times, brought on by the high demand for health services, we also believe that, with good management skills and planning, some of these waiting times can be markedly reduced,” he said.The minister also spoke about the department’s success in upscaling its TB and HIV programmes, saying these were among the biggest in the world. But he conceded that there were a plethora of problems, such as overcrowding and a chronic shortage of human resources.To address the understaffing issue, Motsoaledi announced that 223 vacancies would be filled this month in North West, at a cost of R150m. “Our other problem is Gauteng, which carries the burden of all former Transvaal provinces and even the whole of the Southern African Development Community. I’ve made it known to Gauteng that, no matter how tough it is, we cannot afford not to fill vacant posts in health,” he said.For the oncology crisis gripping KwaZulu-Natal and Gauteng, the minister has allocated R100m to deal with the backlogs.This week, Motsoaledi will brief the media on the National Health Insurance Bill. On Friday, Cabinet gave the green light for the bill to be published in the Government Gazette for public comment.