Hon. NJ Nkwanyana, IFP MPL
19 April 2023
Kuyadumaza ukuthi namhlanje sizolalela inkulumo ezokwethulwa uNgqongqoshe kaKhongolose obhekene nezinsolo eshaqisayo ezaphuma kwelinye laphaphendaba iThe Witness ngomhlaka 2 March 2023 ngaphansi kwesihloko esithi “Health MEC accused of approving questionable employee claims”. The article stated that, and I quote “KwaZulu-Natal Health MEC, Nomagugu Simelane, breached the separation of powers doctrine meant to curtail the abuse of power in government by approving relocation allowance payments to several department employees, some of whom were already dead when the payments were made. This is according to a report, compiled by lawyers contracted by the Department to give a legal opinion on the Department’s decision to pay about 90 employees’ costs related to the workers’ relocation from Ulundi to Pietermaritzburg almost two decades ago”.
Akwethusi nokho ukuthi uNgqongqoshe kaKhongolose angenza lomkhuba ngoba vele isisho sithi Inkonyane yomgakla yeqa lapho kweqe khona unina inkohlakalo isiphenduke usiko kuKhongolose. Kushiya ungabazane lokhuthi sonke isabelozimali somnyango sizokwenza konke yini okufanele noma uNgqongqoshe uzovusa abasebenzi bomnyango asebeshona athi bayaphila ukuze kudliwe imali. Mhlonishwa Ndunankulu udaba lolu oludinga ukuthi uMhlonishwa uSimelane-Zulu aphendule ngalo.
Okwesibili ngiyathanda ukudlulisa lomyalezo kuMhlonishwa uNgqongqoshe uSimelane-Zulu mayelana nendlela aziphatha ngayo uma kunemihlangano yeKomiti lomnyango aphathiswe wona nokuyinto asuke eyibhekise kithina njengamaLungu eSishayamthetho uma simhloma ngemibuzo.
Therefore, I urge Hon. MEC Simelane-Zulu, don’t let your ego hijack your leadership effectiveness. When people get caught up in their egos, it erodes their effectiveness. I wonder what made you, MEC, get agitated by my questions. What was the need that drove you to act egotistically? Ehlisa ukuzithwala ngoba wavuma ukusebenzela abantu.
2023/2024 BUDGET ALLOCATION
We welcome the R50.7 billion budget allocated to the Department of Health for the 2023/2024 financial year. Akuyona ibhajethi yokhetho luka 2024 lena.
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. Okunye siyakwamukela ukufakwa kwamagenerator ezibhedlela njengoba ugesi uhlupha ngenxa kahulumeni kaKhongolose osuhluleke wancama ukuxazulula inkinga kagesi.
It is an undisputed fact that in KZN, a staggering 81.9 percent of households rely on the public health service. In addition, the KZN Dept of Health is experiencing a shortage of medical staff in relation to the increasing size of the population. The 2022/23 APP shows that the number of professional nurses per the population of 100 000 is 152.5. This proportion represents 17 816 professional nurses and medical practitioners per 100 000 people, servicing a population of 11 583 million. The total population in KZN is serviced by an average of 3 234 medical doctors. This number represents approximately 27.4 percent of the required proportion of required health professionals.
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 is concerned about non filling of vacant posts. According to the Department, there is also an estimated funding gap to fill critical vacant posts amounting to R2.5 billion (7 004 per latest HR Plan). The above includes Various (Clinical and non-Clinical): 1 563; Medical Officers (for absorption-Cuban Prog.): 209; Professions allied to Medicine (Bursary Holders for absorption): 30; Covid-19 contractors: 5 232. Further, Goods and Services also shows a negative growth, at -3.5 %, as a result of budget cuts. This will impact on the Department’s ability to sustain the current level of services as medicine, medical supplies, fuel cost and property related payment are still underfunded. These cuts will have a negative effect on the people.
The IFP welcomes the allocations directed to infrastructure, as the Department plans to spend R6.8 billion over the medium-term expenditure framework on infrastructure. During the 2022/23 Financial Year, an amount of R258.057 million within the Health Facility Revitalisation Grant for flood damage caused by April 2022 floods had challenges with SCM. As the IFP, we are saying all projects that were delayed by Covid -19 and the April 2022 floods must be completed. We also want to know from the Hon. MEC how much from the R258.057 million within the Health Facility Revitalisation Grant for flood damage caused by April 2022 floods has been spent so far? Further, how much is the total budget allocation for 11 clinics that are going to be built, including Cwaka in Msinga and Ofafa Clinic in Ixobho?
We welcome the redirection of funds from the National Health Insurance (NHI) Grant from other provinces, which brings the total for the NHI Grant for Vote 7: Health in KwaZulu-Natal to R104.092 million. These funds must be spent wisely. The EPWP Grant must not be used as an ANC tool to garner votes for the 2024 General Elections.
PUBLIC PRIVATE PARTNERSHIP
The IFP is concerned about the unending contract between the Department of Health and Impilo Consortium Pty Ltd. This contracted started in 2002/2003. The contract ended in 2016/17 and was renegotiated in 2019/20, when it was extended for 18 months. Again, it was terminated in 2021, then it was extended again for a further 24 months. The current contract ends on 31 July 2023. Surprisingly, the Department has stated that it is experiencing challenges in appointing another private partner and is exploring other means, or requesting for a further 12 month’s agreement. Mhlonishwa Ngqongqoshe kungani lesivumelwano silokhu njalo sinqanyulwa sibuye sivuselelwe? Kwenza sisole ukuthi kukhona odlayo lapha.
HIV & AIDS
The IFP is concerned about the ongoing ignorance about how HIV/AIDS is transmitted in our society. According to 2021 figures from Statistics South Africa, the total number of people living with HIV countrywide is estimated at approximately 8.2 million. KwaZulu-Natal accounts for 2.02 million or 18.23 percent of that, which is the highest. Among adults aged 15-49 years, an estimated 19.5 percent of the population is HIV positive, with about 1 300 adolescent girls and young women aged 10-19 getting infected with HIV in the country every week. We are concerned that the Department is lagging in implementing ARV programmes for men and children.
Since the 2021/22 Financial Year, the Department has been telling us about addressing medico-legal claims, but nothing has happened. Medico-legal claims for hospitals take a large chunk of the budget. This unfunded mandate is a cause for 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 and 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. This is similar to where the Department has to pay 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 AG, during an audit – which is normally done in a form of sampling – stumbled upon information about a R7.3 million tender which was awarded to Thobza Security to secure the provincial pharmacy supply depot in Mobeni, south of Durban. We want to know from the Hon MEC what progress has been made thus far on this issue?
We implore the KZN Department of Health to address the elephant in the room – irregular expenditure – as the Department incurred irregular expenditure of R9.92 billion during the 2019/20 Financial Year.
PIXLEY KASEME HOSPITAL
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. The time for a phased opening has passed. Further, we were expecting the Hon. MEC to tell us how much the total budget allocation for the proposed hospital to be built in Umhlathuze is. Kade sasitshelwa ngalesibhedlela kodwa akukho okuphathekayo ngodaba lwemali yokusakha. Hlambe uNgqongqoshe ulinde ukukhankasela u2024 ngokwakhiwa kwalesibhedlela.
Nakuba sikwamukela ukwenyuswa kwesibalo sama-ambulensi ukuthi azosuka ku-179 aye ku-200 ngo-31 March 2024 kodwa lesibalo asanele ngoba abantu abaningi ikakhulukazi emakhaya basalinda umlibe i-ambulensi ingafiki. The IFP calls upon the Department to ensure that ambulance response time is quick and efficient. The IFP reiterates its call for the protection of paramedics. The IFP proposes that paramedics be accompanied by police when going into dangerous areas. The Department must stop gambling with the lives of paramedics.
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.
I thank you.