[ad_1]
- In the recent elections, ANC support in Gauteng fell below 40% and a minority ANC-led government is currently in power.
- Prime Minister Paniaza Lesufi’s new cabinet includes Nomantu Nkomo-Ralehoko.
- Her reappointment as MEC for health was welcomed by some but derided by others.
Nomantu Nkomo-Ralehoko was first appointed as Gauteng MEC for Health and Wellness in October 2022.
A long-time ANC member, she has served as MEC for finance and e-government and has been a member of the provincial legislature since 1999.
Her return to this critical post comes as the province’s health department remains mired in a long cycle of administrative and service delivery dysfunction, according to extensive reporting in Spotlight and other publications.
The department collected just under R65 billion in revenue this financial year, making up a large portion of Gauteng’s provincial budget.
While the national Ministry of Health is responsible for formulating health policy, the day-to-day operation of public health services is managed by provincial health departments.
There are a number of vacancies in the Gauteng Health Department. On the administrative side, this includes the key position of Chief Financial Officer (CFO).
Former CFO Lerato Madyo was suspended in August 2022. Her case is still pending.
Research A survey last year by community health monitoring group Ritshidze found that most health facility workers and public health users they surveyed believed health facilities were understaffed.
Madio’s case is linked to the Special Investigations Unit’s ongoing investigation into corruption at Tembisa Hospital.
This was also the question that whistleblower Babita Deokaran was investigating before she was killed in August 2021.
Deokarran was serving as acting chief financial officer before his murder.
Since her death, it has been confirmed that there was corruption to the tune of R1 billion at Tembisa Hospital.
When Nkomo-Ralehoko replied 10 Questions in Spotlight Soon after taking up the post in 2022, she said: “One of my current focus areas is to ensure that the department’s systems in areas of delivery such as finance, human resources, monitoring and evaluation, risk management etc. are strengthened so that processes are not reliant on human frailty but have clear checks and balances.
“An environment without consequence management breeds indiscipline and a culture of disregard for the processes and procedures set out in the legislative framework.”
Gauteng also faces a growing backlog of surgical and oncology treatments.
Its cumbersome supply chain and procurement systems often result in suppliers being unable to be paid, leaving medical institutions short of basic medical consumables and even unable to procure large equipment when needed.
Explainer | Why we should expect more instability from a minority government in Gauteng
There have been periods in some hospitals when patients have had to fast.
Questions remain about the department’s governance capacity.
Notable examples of Nkomo-Larehoko’s tenure so far include the failure to take action to utilise R784 million allocated by Gauteng provincial finances in March 2023 for outsourcing radiation oncology services.
These earmarked funds were secured following sustained pressure and protests from activists and civil society.
As of now, the money has not been spent.
The department will also continue to implement the memorandum of agreement signed in June 2022 with the University of the Witwatersrand.
The agreement sets out a framework for the department and the university to work together to address many of the challenges in the province’s health sector while ensuring academic training for the next generation of physicians takes place.
Another key challenge facing Nkomo-Larehoko is how to navigate the changes in the Gauteng legislature in the seventh government.
Also read | Frere Hospital crisis: Eastern Cape MEC makes surprise visit after pregnant woman complains
The country did not have an outright majority, nor did it reach an agreement on a coalition government that would include the largest opposition party, the Democratic Alliance.
This would pose a clear obstacle to passing the budget or gaining enough votes to approve it in the House.
Despite those challenges, the re-election of Nkomo-Lalejoko, 58, was welcomed by some.
They said she brought stability to a portfolio that had been plagued by instability and short tenures at the top, adding that she had a flexible leadership style and was willing to work with many different stakeholders.
But her critics accuse Nkomo-Larejoko of being unable to deliver the reforms the sector needs and that she has not been tough enough in her crackdown on corruption.
“The situation is largely the same”
DA Gauteng health spokesperson Jack Bloom said: “I don’t think the current MEC deserves to be re-elected but it’s up to the ruling party to decide.
“We are going to see more of the same going forward. There needs to be a radical change in the Gauteng Department of Health but that is not going to happen in the current situation.”
Blum added that Nkomo-Larehoko’s return was “cadre deployment and political protection”.
“I’m worried that corruption will spread across the board and looting will continue.”
Read more | Panyaza Lesufi opens door to DA, but ANCYL warns against ‘silent coup’
He said the MEC had been slow to take disciplinary action against many suspended senior staff and had failed to strengthen measures such as pre-employment checks on potential employees, leading to less capable candidates being appointed.
The Economic Freedom Fighters (EFF) is the third largest party in the Gauteng provincial legislature.
We contacted Nkululeko Dunga to weigh in on Nkomo-Ralehoko’s re-election, but he declined to take our calls and did not respond to written questions.
‘Delays cost lives’
In a brief speech to the eNCA news channel on July 3 after signing her oath of office, Nkomo-Lalejoko mentioned oncology and radiology services as one of her focus areas.
She specifically mentioned the construction of a fort-like facility to house specialized cancer treatment equipment procured for the Chris Hani Baragawanas Hospital and the George Mukhari Hospital.
However, for Salome Meyer of the Cancer Alliance, the fact that the equipment had been procured but was sitting in a warehouse amounted to delays and cost lives.
She said there are currently 3,000 patients waiting for cancer treatment in the province.
Meyer added: “Our facilities are operational but not at full capacity because the equipment is not being used or we don’t have the staff to operate the equipment.”
she says:
We’re seeing radiation therapists quitting because their pay scales aren’t what they need, so even if we do get the equipment, we don’t have enough people to operate it.
“The MEC has to start taking care of its own people – the people who work in our clinics and hospitals.”
Meyer also pointed out the lack of communication between the Cancer Alliance and Nkomo-Larejoko and her department.
“There is no relationship between the MEC and the Cancer Alliance. We had set up a dedicated task force to ensure open communication with the Gauteng Department of Health, but communication has come to a standstill,” she said.
“Ensuring stability”
However, for the Democratic Nursing Organisation of South Africa (Denosa) in Gauteng, Nkomo-Ralehoko has used her 20 months in the MEC position so far to start bringing about the right transformation in the health sector.
Bongani Mazibuko of the Nursing Association said: “We believe that this welcome appointment of the MEC will go a long way in ensuring stability in the sector, something Denosa has long called for.”
Lack of stability has been a feature of the health situation in Gauteng for more than a decade.
In 2022, Nkomo-Larehoko was appointed as the new president, replacing Nomathemba Mokgeti, who had served in office for less than two years. Before Mokgeti, Bandile Masuku also served in the position for less than two years.
Read more | From union leader to MEC: Free State’s new health minister Monyatso Mahlatsi makes big promises
Gwen Ramokgopa took over for more than two years, after Qedani Mahlangu was forced to resign following the Life Esidemeni tragedy.
Gauteng’s Denosa also called for the appointment of a chief executive officer to be finalised and senior management positions to be filled.
It was vital to repair the infrastructure “so that the sector can function better,” the statement said.
Mazibuko added: “We need to ensure that nurses are appointed as a priority because they are the backbone of the system. But we believe that we can continue to work together to ensure that the people of Gauteng get the health they deserve.”
Right direction, but corruption needs to be tackled
Treatment Action Campaign (TAC) Gauteng chairperson Monwabisi Mbasa also backed Nkomo-Ralehoko’s re-election, saying she was so far someone the group felt it could work with compared to her predecessor.
“We’ve seen the MEC work hard over the last almost two years to address some of the issues plaguing public health care at the provincial, regional and clinic levels. She’s very hands-on and very flexible, so we continue to have confidence in her.”
But Mbasa added that she must take responsibility for not taking “tough action against corruption”.
He added that 26 of Gauteng’s 37 public hospitals had recently experienced food shortages, but Nkomo-Ralehoko’s interventions included using suppliers and service providers who were not properly registered.
Mbasa said this was a red flag and the TAC would continue to hold the MEC accountable.
He added that boosting health in the province now requires coordination between the health sector and the infrastructure, development and finance sectors.
Mbasa said:
Our medical infrastructure is in a state of emergency. We are also calling for improved supply chain management and procurement of goods and services, and the need to improve human resources.
“There have been challenges and weaknesses in the cabinet but it is a good thing that we are not working with completely new people in those positions. Now is the time to step up and make sure we use this seventh government to improve public health services,” he added.
After long and intense negotiations, Negotiations with the Democratic Alliance to form a provincial administration have reached an impasse.
As a result, Prime Minister Panyaza Lesufi appointed a cabinet with seven MEC posts for the African National Congress (ANC) and one each for the Palestinian Authority (PA), the Influence Freedom Party (IFP) and the Rise Mzansi Party.
*this article First published on spotlight – Covering health news in the public interest. Sign up Spotlight Newsletter.
[ad_2]
Source link
