The Democratic Alliance (DA) in the Northern Cape is not hopeful about the Premier’s cabinet reshuffle and is not expecting any significant improvements, least of all in the health sector.
Dr Zamani Saul is playing musical chairs through shifting MEC Nontobeko Vilakazi to Health, while transferring MEC Mase Manopole to Social Development, Youth Women and People living with disabilities and bringing in Lebogang Motlhaping MPL to Agriculture, Environmental Affairs, Rural Development and Land Reform. He is rearranging cabinet to fill the gap left by the resignation of former Health MEC Maruping Lekwene, without bringing in the type of specialised, determined and ethical leadership required to restore integrity and turn the ailing health department around.
This is essential, given the longstanding leadership gap caused by the ongoing HOD fiasco, that has seen Dr Dion Theys seconded to an alternate position while he battles a corruption conviction and additional charges. The prolonged absence of a fixed term accounting officer has seen the department being run by a string of acting appointees. A similar situation in relation to the Chief Financial Officer position, aggravates volatility within the department.
The resultant instability, and lack of ownership of this department, has caused significant degeneration across the health sector.
Finances are increasingly instable, with accruals and payables stated at over R500 million for the last financial year. The strain on available funding sees health professionals embroiled in recurring battles to receive salaries and overtime payments, threatening the very backbone of health care.
It has also affected the capacitation of health facilities. The province has a 21% vacancy rate with over 1 700 vacant posts, of which 333 vacancies are at the Robert Mangaliso Sobukwe Hospital (RMSH), the only tertiary facility in the province. Nursing shortages are especially debilitating, limiting RMSH to running between only one and three theatres a day, aggravating the longstanding surgery backlog. The emergency service continues to go backwards, with critical shortages of ambulances and emergency personnel.
Despite the fuss made over the collapse of the new mental hospital, and the damning findings of the Health Ombudman in relation to the deaths of patients, progress in addressing health care failures is minimal. You only have to drive past the Kimberley mental hospital precinct, to spot visible gaps in the perimeter fencing, to know that the risks flagged at this facility are still not being taken seriously.
The DA wishes all MECs well as they take over new portfolios. A long ranger, however, will not succeed in fixing the mess in health. We therefore call on Dr Saul to personally support Vilakazi, to reinstate his once touted health help desk, and to make the overhaul of the health department a premier priority.
The state of the health sector will be a reflection of Saul’s legacy, more than a reflection on the many MECs who have taken the reigns of this department during his tenure. Currently, he will be remembered for failing to address rampant corruption, deadly ambulance failures, lethal health care backlogs and the fatal mental hospital scandal. It is up to him, alongside Vilakazi, to change this.