The DA in the Eastern Cape has called for the provincial department of health to be placed under administration to prevent its imminent collapse and deaths related to the third wave of the Covid-19 pandemic.
About 80% of the department’s total budget goes to employee costs and soaring medico-legal claims, while little goes to the actual business of saving lives.
Jane Cowley, the DA’s health spokesperson in the province, has since written to acting Health Minister Mmamoloko Kubayi-Ngubane, urging her to place the troubled department under “immediate administration”, charging that its financial status is no longer sustainable and that its total collapse is inevitable.
Cowley claimed that contingent liability, made up almost entirely of medico-legal claims against the department, had soared to more than R37 billion, while accruals of more than R4 billion from the previous financial year had almost entirely drained the goods and services budget.
She claimed that critical vacant funded medical posts had been left unfilled in some hospitals.
“Newborns in the Dora Nginza neonatal unit are dying because there are not enough specialist intensive care unit nurses to [look after] them. In such intensive care units, the ratio of nurses to babies should be 1:2, but instead, one nurse cares for more than 20 newborns. In rural areas, patients die while waiting for an ambulance. Instead of the 650 ambulances required for our population as per national norms, we have half of that number in working condition.”
In her written reply to a parliamentary question from Cowley, health MEC Nomakhosazana Meth said most of the province’s budget went to personnel costs and medico-legal claims, while only 7% went to goods and services.
“Of the total budget for the department for the 2021/22 financial year of R26.5 billion, it is estimated that, in real terms, the department has R22.3 billion to function in the current financial year, primarily as a result of projected payables and accruals of R4.4 billion vesting at year end, as well as unfunded and unbudgeted medico-legal settlements. Of the remaining budget, the department anticipates spending 80% on personnel costs,” wrote Meth.
The department had already paid about R1 billion for medico-legal claims in the 2020/21 financial year as at March 31, according to Meth.
Cowley said that, due to the fact that the department’s finances were already in a mess when it was struck by the third wave of Covid-19, coupled with other challenges it faced and its limitations in providing quality healthcare in the province, she was forced to seek urgent intervention from national government to save lives.
“I’ve written to the acting minister of health urging that national government place the Eastern Cape department of health under administration in accordance with section 100(1)(b)(i) of the Constitution, to ensure that established minimum standards for rendering health services in the province are maintained,” she said.
Sizwe Kupelo, provincial health spokesperson, said that asking for the department to be placed under administration was tantamount to grossly exaggerating its challenges, and that the issues facing it should not be politicised.
“We must all agree that we’re facing serious challenges of corruption, collusion and genuine medico-legal claims, which are the subject of multidisciplinary investigations by the Special Investigating Unit, the Hawks and other law enforcement agencies, with cases that are already before the courts. “Section 100, which is being touted by the DA, won’t come up with the money. We should be judged by our ability to deal with the situation,” said Kupelo.
“We’re also prioritising the issue of service delivery in the circumstances, including extending Covid-19 contract posts for nursing staff for us to be in a better position to deal with the virus confronting us,” he added.
He said the issue of medico-legal claims was not unique to the Eastern Cape: “The Gauteng department of health was also in the red by a whopping R3 billion due to medico-legal claims. The same happened in KwaZulu-Natal. This is a national issue because all provinces, including the Western Cape, are facing similar challenges of being targeted by medico-legal claims,” he said.
Kupelo said the department was working hard behind the scenes to turn things around, adding that it was unfair of people to politicise issues by calling for section 100.
“Judge us by what we’re doing in response to all these challenges that are man-made as far as medico-legal claims are concerned, because the money that’s supposed to serve our people is going towards them,” he said.