Debate on Health

By
Hon. N.J. Nkwanyana, MPL
KZN Legislature
June, 2020

Hon. Speaker,

The IFP supports the 2020/21 Budget.

BUDGET ALLOCATION FOR 2020/21

We welcome the R48.1 billion budget allocated to the Department of Health during the 2020/21 financial year. It is completely unacceptable that the Department’s Budget was cut with 4.5% below the normal government 5.5%. Equitable Share budget cuts of R285.117 million against Compensation of Employees is a huge concern, since it affects critical services of the Department. We welcome the R467 million to address pressures in security, electricity, sewage and water costs, however this allocation should not affect the filling of posts such as Medical Officers, Pathologists, Nurses, administration support, cleaners and Security staff. The IFP is of the view that these are crucial services that make the Provincial Health Facilities fully operational. We are deeply concerned that there is a R98.266 million budget cut against District Hospitals as a result of prioritisation of Dr Pixley ka Isaka Seme. This budget cut will directly leave the District Hospitals with serious issues. The IFP urges that the MEC of Health should liaise with Treasury about this huge concern of budget cuts below acceptable levels.

A good example is the St Francis Hospital in Mahlabathini. The IFP demands answers from the KZN MEC of Health, Nomagugu Simelane-Zulu, on why the St Francis Hospital is empty, with 33 nurses looking after six mentally-ill patients. We urge the Hon. MEC to come clean about what is really happening at the St Francis Hospital.

2018/2019 PERFORMANCE – AG REPORT

Looking back at the previous financial year, we can conclude that the Department has been failing to use its budget accordingly. The budget allocated to the Department must be fully utilised to improve people’s lives and nothing else. But this Department has received poor audit reports for three consecutive years. Hon. MEC, as the IFP we want to hear from you – what are you going to do to ensure that the Department of Health gets a clean audit in this current financial year? We want to hear you presenting a detailed plan, with clear strategies and time frames, to ensure that the culture of getting poor audit outcomes comes to an end.

IRREGULAR EXPENDITURE

The increasing irregular expenditure in this Department is of huge concern to us. The irregular expenditure increased from R8.9 billion in 2017/18, to R13.44 billion in 2018/19, as stated by the Auditor-General. The Auditor-General further stated that he was unable to obtain sufficient appropriate evidence for communicated overtime allowances, to the tune of R984.89 million. This is completely unacceptable. Causes of irregular expenditure, such as use of expired contracts for cleaners and security, are a cause for concern.

WASTEFUL AND FRUITLESS EXPENDITURE

The wasteful expenditure increased from R8.9 million in 2017/18 financial year, to R9.0 million in 2018/19. Hon. MEC, this tells you that there is something wrong in your Department. You must stand up from the plate and ensure that all those found to be contributing to the wasteful and irregular expenditure are held accountable. You must be tough on transgressors. These monies should be recovered, Hon. MEC.

COVID-19

I would like to take this moment and applaud both the National and Provincial Government, for spearheading some issues that need serious attention from the Hon. MEC of Health.

We applaud the efforts of our government to identify hospitals where coronavirus patients are treated. However, we are concerned that they might not be have adequate capacity for patients from all corners of this Province, should the demand become out of hand.

There has been an outcry for our government to increase the supply of protective gear such as masks, gloves and sanitisers in every community urgently. We are also concerned the KwaZulu-Natal Health Department has a shortfall of R6.3 billion, which it needs to fight COVID-19. We are also concerned that eThekwini and iLembe districts contribute to more than 80% of total cases provincially. Though eThekwini District has the highest number of cases, iLembe District has the highest infection rate. The IFP is concerned about the disregard for social distancing regulations amid the COVID-19 pandemic by the eMakhempini residents in Mandeni, iLembe District.

We, as Members of the KZN Legislature, participated in the Speaker’s Workers’ Outreach Programme in iLembe District, distributing masks and sanitisers. I was shocked when we arrived in the eMakhempini Area, to see overloaded taxis and vans, with passengers not adhering to the social distancing rules and obligatory mask-wearing. When we questioned people boarding these overloaded vehicles, their excuse was that they were rushing to work. This totally outrageous. What is happening at eMakhempini is a recipe for disaster and it calls for urgent intervention from the relevant authorities.

NO BUDGET PROVISION FOR PURCHASING MORE VEHICLES

We are shocked to see that there is no provision for procurement of vehicles in 2020/2021, including Ambulances in the Department of Health, yet the ambulance shortage is a matter of death and life. Our people wait hours and hours for ambulances when they urgently need medical attention and they continue to lose their lives while waiting.

Yet in 2015 the IFP wrote to the former Public Protector, Advocate Thuli Madonsela, asking her investigate the controversial R61 million tender that saw the KwaZulu-Natal Health Department lease a mobile clinic unit for R52.5 million, after the former KwaZulu-Natal Health Department Head, Dr S. Zungu, signed off on the lease improperly. The tender was for four mobile clinics in KwaZulu-Natal, which ended up costing taxpayers a whopping R61 million for units that were never delivered. A few months back, the Public Protector released a report which verified that the purchase of the mobile units was improper. In her investigation report, the Public Protector, Advocate Busisiwe Mkhwebane, stated that the process followed by the Department to both lease and purchase the mobile units was improper and not in accordance with a system that is fair, transparent, competitive and cost-effective, and amounts to maladministration.

We want to know from the Hon. MEC whether she has implemented all the remedial actions raised in the Public Protector’s report, such as taking disciplinary action against the officials of the Department of Health in respect of their conduct.

STATE OF MORTUARIES

The IFP is concerned about the closure of Magwaza Maphalala (Gale) Street Mortuary, which has left Park Rynie Mortuary with an excess of bodies and nowhere to store them. We urge the Hon. MEC to address this matter urgently. We propose that the Health Portfolio Committee conduct an oversight to Park Rynie Mortuary.

MEDICAL NEGLIGENCE

Medical malpractice continues to be an area of grave concern for this Province and is costing the department millions of Rands. In 2018/19, the Department spent R429 093 621.12 on medical negligence. This is concerning because the money that is supposed to go to the provision of healthcare services, it goes to medical negligence cases. This must be addressed.

CONDITIONAL GRANTS

We note that HPV Vaccine Grant has been absorbed into the HIV, TB, Malaria Community Outreach and HPV Vaccine Grant, but we are gravely concerned with the Grant decreasing by R16.217 million in this financial year. It is clear that this Grant was not fully utilised and Treasury reduced it. As the IFP we demand an explanation as to why the Department failed to spend this Grant fully? The Department is fully aware that if Grants remain unspent, they are bound to be sent back to national coffers. This is unacceptable.

EPWP GRANT

We note the funding of R10.903 million provided for 2021, which is meant to create equivalent jobs through intensive infrastructure programmes. However, our biggest worry is that there is no provision for the later years. Why is this? This is a very important Grant that helps our Province fight unemployment, which is rising every day in this Province. We urge the MEC to ensure that this Grant is provided for the coming years.

I thank you.