We welcome the R49 billion budget allocated to the Department of Health for the 2022/23 financial year. However, we are concerned that six KwaZulu-Natal districts have borne the brunt of the damage to healthcare infrastructure due to floods. The damaged healthcare infrastructure included 23 hospitals, 34 clinics and community health centres. We believe that this will have a negative effect on the Budget. Siyafisa ukwazi kuMhlonishwa uNgqongqoshe ukuthi malini ezosetshenziselwa ukulungisa ingqalasizinda ezibhedlela ecekelwe phansi izikhukhula. Konke akubekwe obala asifuni ukuphinda sehlelwe isehlo lapho kwatanyuzwa khona imali kuthengwa izinsiza ze-Covid-19 nanamhlanje isamfoma amafutha imihlwehlwe kwabathile abahlomula ngokungemthetho kuloluhlelo. Sifuna ukwazi ukuthi imali yabakhokhi-ntela izogadwa kanjani.
It is a well-known fact that more still needs to be done to ensure that healthcare is improved in KwaZulu-Natal.
One of the many challenges facing our healthcare system is a lack of qualified doctors, nurses and competent administrative staff, which has led to the unresponsive and cumbersome bureaucracy in the health sector; lack of accountability; and poor decision-making.
Kodwake angeke ziphele izinkinga ezibhedlela uma uMnyango weZempilo KwaZulu-Natali usaphethwe uNgqongqoshe okhonze ukujayiva njengoba kwenzeka wabanjwa oqotshweni edansa emcimbini engasifakile isifonyo. Ngqongqoshe kufanele ukhethe okukudwa ukuthi ufuna ukuba ungqongqoshe noma uqhubeke nekhono lakho lokudansa. Awukwazi ukukwenza kokubili ngesikhathi esisodwa.
We constantly read reports of hospital staff, from administration, to nurses and doctors, who mistreat patients or are indifferent to people’s needs. If one asks community members about the staff of their local hospitals or clinics, they will complain about being mistreated or ignored when they need help.
The Budget that is being tabled today before this House must fulfil its intended purpose. As we speak about billions of rands, it is essential that the people – even those in rural areas – see a change when it comes to healthcare services. This Budget must be spent prudently. We want to see the Department getting a clean audit outcome, without findings.
From the outset, the IFP wants to see the Health Budget addressing the most pertinent issues that are affecting the proper functioning of hospitals and clinics. These issues are:
- Staff shortages in hospitals and clinics.
- Shortage of beds, as it has been the case with Northdale Hospital, where patients were allegedly sleeping on the floor.
- Ageing infrastructure.
- The need to provide hospitals with necessary resources.
- Improved security in hospitals and clinics.
- Building more clinics closer to the people.
The IFP welcomes the allocations directed to infrastructure, as the Department plans to spend R6.7 billion over the medium-term expenditure framework on infrastructure. This includes a number of projects, such as at Osindisweni Hospital, where R57 million has been budgeted for the construction of a new multidrug-resistant TB Unit. In the King Cetshwayo District, R41 million has been set aside for roof repairs and asbestos removal at clinics. At Greys Hospital, R29 million has been budgeted for roof repairs and upgrades to the accommodation facilities for doctors and nurses. At RK Khan Hospital in Chatsworth, R25 million has been budgeted for major electrical upgrades. At Northdale Hospital, an amount of R20 million has been set aside for roof repairs.
This is commendable but times frames must be met and funds must be spent on their intended purposes – with no losses to corruption. Further, we welcome the R11.736 million for the EPWP Integrated Grant for provinces to create jobs, as well as the R449.155 million to cater for the stipends of a further 9 859 community care-givers.
Further, the allocation of R1.5 billion to continue fighting the Covid-19 pandemic is welcomed. We, as politicians, must continue to encourage people to prevent the spread of Covid-19 by encouraging them to vaccinate.
Hon. MEC, the IFP wants to remind you that this Budget is not for the following:
- Corruption through the awarding of tenders that flout supply chain management procedures, as has been the case with PPE procurement.
- Medico-legal claims for hospitals, which take a large chunk of the budget. This unfunded mandate is a cause of serious concern. Medico-legal claims increased from R20.1 billion (2018/19) to R23.4 billion (2019/20). The MEC must address this elephant in the room. We want to see people contributing to the costs of medical negligence in hospitals and clinics be held accountable and made to pay those claims. These huge sums spent on claims clearly indicate that the Department is not implementing measures to prevent medico-legal claims.
- Irregular expenditure, as the Department incurred irregular expenditure of R9.92 billion during the 2019/20 financial year. The AG was unable to determine whether any further adjustments were necessary to the movable assets stated at R5.5 billion (2019: R.,74 billion), as well as minor assets stated at R944 million (2018: R1.07 billion) respectively.
- The Department incurred R1.43 billion in unauthorised, irregular and wasteful expenditure, without following the prescripts of the law in relation to non-compliance with legislation in ongoing multi-year contracts for cleaning services, security and medical waste removal. This must be addressed and those found responsible must be held accountable. The time for complacency is over.
- Paying contractors who have taken the Department to court for failure to honour its contractual obligations, as was the case with two security companies LK Security and Sharks Protection, which are suing the Department for R24 million over breach of a contract signed in 2014. Further, the Department is sued for R1 million by an e-hailing driver who was assaulted by Mafoko Security guards in RK Khan hospital in February this year.
When visiting hospitals and clinics, our people must feel that they are visiting places that will save their lives, not a ‘slaughter house’. In healthcare, the days of business as usual are over.
The IFP is concerned about the delay in opening the Dr Pixley Isaka Seme Hospital. We do not want any more excuses. This Hospital must be opened to the public immediately. Billions have been invested in this Hospital, yet it is not fully operational. The time for a phased opening has passed. People want to see the Hospital operating at full capacity. We do not know whether the delay in the recruitment process for staff is due to the fact that the Hon. MEC might be considering cadre deployment. We are aware that the ANC Provincial Elective Conference is scheduled for this year, therefore the MEC could be trying to allocate positions at Pixley KaIsaka Seme Hospital for ANC comrades participating in the Conference, to gain votes for those who are aligned with the MEC’s faction.
While the IFP commends the Department for its plans to increase the average number of daily operational ambulances from 185 to 225, it is concerned about the safety of paramedics. The Department of Health seems to fall short when it comes to protecting them. The IFP is waiting to hear from the Hon. MEC regarding what plans are in place to protect paramedics while on the job. It is useless for the Hon. MEC to consistently condemn the attacks and murder of paramedics, yet not provide tangible solutions to protect them. The IFP proposes that paramedics must be accompanied by police when going into dangerous areas. The Department must stop gambling with the lives of paramedics.
The IFP is doubtful of the excuse provided by the Hon. MEC that a shortage of funds is the reason that the Department is not filling vacant posts. Year after year we have been given the same excuse. If the MEC is concerned about a shortage of funds, what has she done to address this challenge? What is concerning, is that there are apparently no funds for the filling of vacant posts, yet there are millions available to settle medico-legal claims. The MEC must use the millions that are spent on medico-legal claims to hire staff. This is non-negotiable. This situation paints a picture of a Department struggling to deliver high-quality care consistently, due to a widespread lack of staff. The increasing pressure and unmanageable workloads are the greatest barriers to delivering high-quality care for patients.
Nurses are working excessive hours without rest and this pressure is causing stress and making staff unwell. State hospitals are already over-crowded and largely understaffed, and not filling vacancies will further exacerbate the problem and result in the poorest of the poor suffering the most. If this this situation is not addressed urgently, it will continue until service delivery collapses entirely at most facilities.
The IFP is against Circular G01/2022, which put a moratorium on the filling of posts, including critical personnel like nurses. This ill-advised Circular must be withdrawn.
ST FRANCIS HOSPITAL
The IFP is against the closure of St Francis Hospital in Mahlabathini. The MEC must tell the people of Mahlabathini why she is closing down St Francis Hospital, forcing people to travel many kilometres to access healthcare services in Nkonjeni, which is a significant distance from them.
According to information from local residents, if you are traveling with your own car from St Francis Hospital to Nkonjeni Hospital, it is about 14km. However, if you are using public transport, you have to travel from St Francis to Mashona Town, and then to Nkonjeni, which means people pay twice. Sometimes taxis are delayed, and they get there late, which causes great inconvenience. People are also forced to hitch-hike at times, which is unsafe.
Although we understand that the MEC is not happy that the IFP exposes failures in KZN healthcare facilities, we caution MEC Simelane-Zulu that the time for spin-doctoring and defending her failures is over. She must humble herself and communicate with the people. Being untouchable will not solve healthcare issues in KZN.
The IFP Supports the Budget in the hope that all outstanding projects delayed due to the Covid-19 pandemic – including those hospitals that were affected by storms last year, with an additional R138 million in funding allocated by National Treasury for the Provincial Disaster Relief Grant – will be completed on time. Further, we trust that funds for these projects will be spent accordingly and not lost to corruption.
Sengiphetha. Mhlonishwa Ngqongqoshe ake unyuse amasokisi ekuletheni ushintsho ekutheni lomnyango uthole umbiko wezimali omuhle ongenagcono kumncwaningi mabhuku. Abahlulekayo ukwenza umsebenzi wabo ngendlela efanele abayidede inkundla badedele abantu abazokwenza kangcono. The Department received a qualified audit outcome with findings, due to flouting of Supply Chain Management procedures.
The IFP supports the Budget.
I thank you.