DA has no faith in NC Health Department to manage its budget
by Dr Isak Fritz MPL – DA Northern Cape Spokesperson of Health
Date: 14 June 2017
Note to editors: This is a speech delivered by Dr Isak Fritz during the Health Budget Vote Debates of the Northern Cape Provincial Legislature at a House Sitting at the chambers of the Frances Baard District Municipality in Kimberley this morning.
Members of this House
Guests in the gallery
Hon. Speaker, the Constitution of South Africa is the supreme law of the country of South Africa. It provides the legal foundation for the existence of the Republic and sets out the rights and duties of its citizens, and defines the structure of the government.
The right to health is fundamental to the physical and mental wellbeing of all individuals and is a necessary condition for the exercise of other human rights.
The right to health care services is provided for in three sections of the South African Constitution. These provide for access to health care services, including reproductive health and emergency services, basic health care to children and medical services for detained persons and prisoners, and states that no one can be denied emergency medical treatment.
So my question is, Hon. Speaker, what kind of Health Department says that a head injury, with four fractures to the skull, bleeding on the brain and the onset of infection, is not serious?
What kind of Health Department thinks little of the fact that a patient, with a potentially life threatening condition, had to wait for several hours for an ambulance to travel over 400 kilometers from De Aar to transport him another 400 kilometers from Upington to Kimberley Hospital for emergency surgery?
What kind of Health Department shrugs its shoulders and drags its feet when an ambulance, transporting a patient in a very serious condition from Upington to Kimberley, breaks down due to a lack of maintenance?
And what kind of a Health Department accuses the opposition, who dares to expose the truth about the state of health care in the Northern Cape, of playing politics with people’s lives, when actually it is the department who is playing a dangerous game of Russian Roulette with patients’ lives?
The answer, Hon. Speaker, is an unaccountable, callous and out of touch Department. These may be strong words but they have unfortunately come to epitomise our very own Northern Cape Department of Health.
It is then not surprising that this poorly organised department, which claims to have 111 operational ambulances in the province, but did not have a single operational and available ambulance in Upington on Friday, 2 June 2017, is facing a barrage of medico legal claims to the value of over R1.2 billion.
In theory, this means that this Department owes more than a quarter of its annual budget to patients on whom it has inflicted injuries instead of having cured.
Yet, Hon. Speaker, this department:
• STILL chooses to defend itself;
• STILL refuses to accept responsibility and;
• STILL fails to set any money aside for potential medico-legal liability claims.
This paints a picture of a Department in denial.
Hon. Speaker, it is highly unlikely that errant doctors and nurses alone are responsible for the sharp increase in medical negligence cases in the Northern Cape.
Instead, the year on year increase in medico-legal claims is a symptom of a much broader problem. It speaks to a number of issues such as the lack of staff, overworked staff, improperly qualified staff, shortage of pharmaceuticals, the absence of critical equipment, not enough operational ambulances, issues pertaining to hygiene, failure to secure patient records, poor patient safety and so on, and so forth.
In essence, it highlights the urgency to raise the standard of health care in the Northern Cape and directly calls for the issue of quality management to be addressed.
Yet, this Department has in the 2017/2018 financial year decided to remove a number of performance indicators that directly addresses compliance of hospitals to the National Core Standards, from its APP.
Is this another attempt from this down-and-out Department to escape accountability? We can only wonder.
Hon. Speaker, this Department has been its own worst enemy. Over the years, it has bankrupted itself.
Millions of rands intended to improve health infrastructure across the province and to beef up its human resource capacity have been squandered on corruption, poorly managed contracts, dismally managed projects and uninformed decisions.
In the previous financial year, the Health Department received a bailout of R239 million from Treasury just to help it cover a portion of its outstanding debt. This money must now come off the Department’s already over-stretched budget for 2017/2018.
As a result, cost containment is implemented to such an extent that the department has no funding to appoint additional doctors, nurses and cleaners to improve the quality of care at facilities.
The Department also has a budgetary shortfall of more than R90 million to ensure adequate refurbishment of hospitals and clinics that are in desperate need of maintenance and repairs, as well as to enable the targeted number of clinics to reach ideal status and maintain those clinics that have already achieved this status.
So the question then: is this department addressing issues of quality management?
Unfortunately, the answer is NO:
• The majority of this province’s mortuaries still do not comply with health and safety standards, the mortuary fleet is on the verge of collapse, and the Department continues to face the risk of the possible discontinuation of Forensic Medical Services throughout the province;
• The Department is still R85 million away from meeting the legislated requirements of a 24 hour, two crew ambulance service and;
• Both the Nursing College and the EMS College risk losing accreditation due to issues relating to the curricula, lack of administrative and academic staff and lack of equipment.
At the same time, services under this Department are shrinking and not expanding.
One example is that Kimberley Hospital has been without a radiologist for almost a year now and continues to face the potential closure of certain services, such as radiology services, by external regulatory bodies.
Hon. Speaker there can be no denying that the Northern Cape Department of Health remains in crisis and on the verge of collapse.
If this Department cannot even manage what it has, due to self-inflicted financial pressures, how on earth are the up and coming facilities going to be operated?
• Dr Harry Surtie Hospital, which was opened more than three years ago, is still not fully operational due to budget pressures and staffing constraints.
• The full operation of De Aar Hospital, which was recently completed and handed over, hangs in the balance because of budget pressures, which necessitate more than R53 million.
• And then, Hon. Speaker, there is the new mental hospital, which according to the Department is due for completion in November this year but for which not even a cent is available for the operational costs.
It is clear that this Department has, on many occasions, put the horse before the cart without any foresight for the future implementation of health services in the Northern Cape.
This Department repeatedly tries to hide its own ineptitude and lack of planning by attempting to put blinkers on the health oversight committee – it talks in circles, avoids providing us with detailed answers, disputes the facts and hopes that we won’t see the truth through all of their lies.
But the DA has seen the darkness – this is a Department hounded by a dreaded lack of accountability:
• This is a Department that ignores orders of the High Court to pay claimants and actually has to be bullied into paying its dues via extreme measures, such as having the Sherriff of the Court attach assets and threaten to auction off life saving equipment.
• This is a Department that wants us to approve their budget but fails to provide a breakdown of the R119 million that it has allocated to NPO’s.
• And this is a Department that willfully tries to obscure the real story of the new mental hospital:
– Hon. Speaker, the mental hospital project started more than 11 years ago, not in 2011, as is mischievously misrepresented in the department’s APP.
– It also cannot be that only R1 million is allocated to the completion of the new mental hospital for 2017/2018, as is also indicated in the Department’s APP.
The DA has attempted to establish the true costs of the mental hospital for some time, but at each turn, the Department blindsides us. The Department doesn’t answer our questions relating to the costs and commitments and the Department fails to submit adequate reports to the committee.
The DA is fed up with this Department’s willful lack of openness and transparency.
The DA does not have faith in this Department to honestly and efficiently allocate, spend and account for the more than R4 billion entrusted to it.
The DA will not act as a rubber stamp for a Department that fails to tell the truth and fails to take responsibility for health care in the province.
Hon. Speaker, the DA will not support Budget Vote 10.
Dr Isak Fritz MPL
DA Northern Cape Spokesperson of Health
082 395 2737
Shelley De Witt
082 847 1387