NC health problems can be solved with accountability

Karen de Kock, MPL

DA Provincial Spokesperson of Health

Following a visit by Public Protector, Thuli Madonsela, to the Kimberley Hospital Complex today, the Democratic Alliance is more convinced than ever that the heart of the health care problem in the Northern Cape lies at the primary and secondary health care levels and that this problem is predominantly fueled by the provincial health department’s unaccountability and its inability to effectively utilize financial resources at its disposal.

Madonsela’s thorough oversight visit exposed the fact that the bed shortages at KHC are in fact not a reflection of poor services at the hospital but rather a poor reflection of services being provided at clinics and district hospitals across the province.

It emerged that clinics and district hospitals across the Northern Cape are experiencing severe shortages of doctors and nurses and that there is also a high turnover of medical personnel at these facilities. This is largely due to the significant work pressure faced by medical staff, who are expected to perform miracles without the necessary equipment and infrastructure in place. In effect, patients are being referred to KHC from all over the province for basic medical procedures. At the same time, patients themselves are sidestepping primary health care institutions, instead opting to go straight to KHC for the necessary care. This is placing an undue workload on KHC which, under normal circumstances is coping but also has its own problems to face, namely a shortage of nurses, the expanded package of care service, and old infrastructure.

The current dilemma has serious consequences for the province. This especially affects preventative healthcare in the form of regular check-ups and behavioral modification at clinics. Perhaps the most distressing of these consequences is the negative impact on the maternal and infant mortality rates. This is partly due to fatal, yet preventable conditions, such as low birth weight, not being addressed at primary health care level. It is also largely due to delays in treatment due to patients having to be transported long distances to KHC.

The DA is of the view that the solution to the province’s health problems is not as complex as the provincial department would have us believe. Instead, the answer simply lies in political accountability and the cascading quality and professionalism from that point through the entire system. This would in turn see the department cutting out all wasteful and irregular expenditure, especially regarding bloated contracts, as well as under-expenditure and

unnecessary legal claims, and instead diverting these funds towards upgrading the infrastructure and equipment of primary and secondary care systems. Also, by putting proper management systems in place at these levels, and by coming up with creative solutions such as accommodation and salary incentives, the department would be in a position attract the required medical staff to these largely rural facilities.

The DA’s answer is not about making sweeping policy changes but rather about getting the provincial health department working adequately. We only hope that the provincial government will also wake up to the simplicity of the solution and the fact that the fundamental problem in healthcare is that financial resources are mismanaged at a provincial level.