Jack Bloom MPL
DA Gauteng Shadow Health MEC
Summary extract of speech by Jack Bloom MPL in debate on the Gauteng Health budget in the Gauteng Legislature on 29 July 2014
Madam Speaker, there have been eight changes in Health MEC since 1994, five of them in the last six years.
We keep hearing about a turnaround plan, but the same problems persist.
On 23 October 2009 the Star reported: “Gauteng health MEC Qedani Mahlangu has a plan of action for getting her financially disastrous department on track …(she) … committed herself to her turnaround plan.”
The first mention of a turnaround plan was in 2008 under MEC Brian Hlongwa. The company that was to execute this turnaround was 3P Consulting, and we all know what a disaster that was. They are currently subject to an asset forfeiture application, and all the allegations about bribes and corruption will be tested in a court of law.
I give MEC Mahlangu the credit for pulling the plug on 3P, and for instituting the investigation that got the Hawks and Special Investigating Unit involved.
But this department still suffers from the loosening of financial controls that happened during the Hlongwa years.
As I pointed out at the time, it was clearly irregular that a 3P employee was the acting Chief Financial Officer for an extended period of time.
The backlog in payments to suppliers also started at this time.
This was so bad that other departments had to surrender funds to keep the department afloat, but this has still not eliminated the arrears.
At the end of the last financial year, R1.488 billion was still outstanding to health suppliers.
The department now claims that 75% of suppliers are paid within 30 days, but this is still unsatisfactory.
Non-payments are a major reason for shortages in our hospitals, and breakdown of machines due to lack of maintenance.
Budgetary controls have been broken for a long time. There is an established trend of large underspends in certain programmes, and overspends in others.
I have little confidence that the budget before us will be adhered to.
Last year’s budget failed to spend a whopping R1.355 billion.
The underspend would have been higher but was partly offset by overspending of R357 million on the four academic hospitals.
The biggest failure was in capital spending, where R769 million for hospital building repair and machinery and equipment was unspent.
It is frankly unbelievable that the department was unable to spend this money when many of our hospitals are falling apart and desperately in need of repair.
Even worse, the department is happy that the infrastructure budget declines in the next three years, from R1.75 billion to R1.19 billion, because it is unable to spend a larger amount.
We have been told that infrastructure grants decline because the new approach to prevent underspending is to only apply for approved and ready projects.
What this means is that we lose out on money because of this department’s incompetence.
With all this turning around it seems that we have come full circle and are back where we started.
It is absolutely essential that we have a computerised Health Information System so that we can spend money most efficiently and streamline patient administration.
The sooner paper files are replaced with electronic records the better. This is another area where progress is stalled because of disputed contracts from the 3P era.
The department is currently in arbitration with the Baoki consortium after its R1.2 billion Health Information System contract was cancelled.
There is now an asset forfeiture application against Baoki. If it is proved that this was a corrupt contract, the department can then proceed with the Health Information System that we so desperately need, but this could still take years.
Madam Speaker, the budget this year is R31.5 billion, which is 12.6% larger than last year.
Key problem areas include:
- Emergency management remains a disgrace. We need 800 ambulances, but only have 428, and many of these are more in the workshop than on the road.
- We should have 944 000 HIV/Aids patients receiving ARV treatment, but there are only 592 000 registered. We have lost about 350 000 patients that we can’t track.
- The five state laundries operate at less than 40% capacity, and there are frequent linen shortages in hospitals.
- The Folateng wards should be closed as soon as possible. My estimate is that they have lost more than R500 million over the last ten years, including capital costs.
- Medicine shortages are still happening, including vital anti-cancer drugs.
- I am alarmed by the current contingent liability of a stupendous R5.78 billion due to 1458 medico-legal cases.
- We are not spending nearly enough on training skilled staff – the training budget decreases by 2.4%, which is very disturbing.
Madam Speaker, the DA will oppose the transfer of our four academic hospitals to the national health ministry.
The better idea is to turn these hospitals into non-profit organisations free of stifling civil service regulations. They should be given a budget and have to perform to specific outcomes in providing quality treatment.
I am very much in favour of the lean management approach which has had a successful trial at the Kalafong hospital in reducing medicine queues and waiting times.
We need smart management and innovation so as to do more with less.
It is with a heavy heart that we will once again oppose the health budget as it will not meet the health needs of the people of this province.
I hope that there is better news next year, as the failed promises cause misery, pain and shortened lives.