DEBATE ON HEALTH

BY HON N.J. NKWANYANA, MPL

KZN LEGISLATURE

21 May, 2021

 

Hon Chairperson,

The IFP supports the R48.4 billion budget allocated to the Department of Health for the 2021/22 financial year. It is unfortunate that this Budget was also affected by the cuts which emanates from no salary increase for public servants.

The IFP is concerned about the cuts under Compensation of Employees for this department in particular because of the heroism and commitment displayed by the front-line workers since the beginning of the pandemic. Most are lowest-paid and undervalued and these include housekeepers, care givers, security and administration. All these heroes have been holding it down with pride since 2019 and never had options to work from home like many of us. Many of them lost their lives to the virus along the way. They deserve recognition and salary raise.

We are also concerned that these cuts on compensation of workers will impact on the ability of the Department to fill critical vacant posts mainly in hospitals as the delay in the filling of a position like that of the CFO has been long overdue. The appointments of senior managers take months for the executive council to approve. One cannot help but wonder if the delay is caused by jobs being reserved for the politically connected, instead of qualified individuals or if the delay is caused by sheer incompetence?

It is also worrying to note that there is a significant cut in the HIV, TB, Malaria, Community Outreach and HPV Vaccine grant which decreases by R184.202 million, R456.242 million and R615.009 million over the MTEF. This decrease alongside the R7 million decrease on national health insurance grant might have disastrous impact for the department should it experience a shortfall in ARVs which will impede progress towards epidemic control, as well as the affordability of existing staff funded from the grant.

2019/2020 Perfomance -AG REPORT

The 2019/20 Auditor-General audit findings against the Department of health in KZN are deeply worrying to say the least. The Department has received poor audit outcomes for many consecutive years. We can conclude that the Department has been failing to use its budget accordingly as it uses large parts of it on medico legal claims in 2019/20 medical claims increased from R20,1 billion to R23,4 billion, placing further pressure on the department’s finances when these claims become payable. The Department spent R429 million on medical claims in previous year alone.

What is concerning is that not a single member of staff has been held liable, and what adds salt to the wound, is the fact that there is no strategy in place to deal with officials who are found guilty of negligence. This has a negative effect in the Budget as there is no specific budget for litigations.

The AG’s Report further revealed that the Department incurred irregular expenditure amounting to R9.92 billion for 2019/2020 financial year due to disregard of SCM processes. The Department incurred R1.43 billion in unauthorised and wasteful expenditure on ongoing multi-year contracts awarded in prior years 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.

Therefore, to bring much needed change in the Department of Health the IFP demands the following:

1. 1. That the budget allocated to the Department must be fully and effectively utilised to improve people’s lives and nothing else.
   2. The Department of Health gets a clean audit in this current financial year.
   3. That steps must be taken against the officials who had permitted irregular expenditure and the money must be recovered.
   4. MEC must implement and present progress on all her plans to mitigate medico-legal claims that she presented to the Health committee in the previous years. The department can’t afford to further spend billions on payable claims.

There is no excuse for the lapses in governance and administration which featured prominently in the report. Some of these are administrative and control issues addressing issues of management, administration and control through the system, so at the one level it’s a fundamentally political task about oversight and leadership with regards to what needs to happen.

COVID-19

We welcome the allocation of R302.271 million towards Covid-19 vaccine programme. But we are concerned about the slow pace in which this programme is moving. The process of vaccinating people and medical staff must be fast-tracked. All information about the progress in the vaccination programme must be made public every week. There must be no secrecy on that. The slow progress on vaccinating the masses makes us wonder whether the department is prepared for a 3^rd wave of Covid-19.

We welcome the allocation of R233.5 million for Covid-19 related activities but funds should not be squandered on unnecessary spending such as payment for private expensive hotels and quarantine sites. Every cent matter as we operate under tight budget.

This allocation should be spent on campaigns and communication updates with the public. This will assist as many people to stay updated about the progress and new action to take. People will easily adhere to calls by health authorities to be vaccinated with the COVID-19 vaccine if they are fully aware about it and its intended benefits.

We urge people to ensure that the elderly (60 years and above) of age and those with comorbidities are vaccinated.

Hon Chairperson, the IFP is concerned about the abuse of funds and alleged corruption in relation to the procurement on PPE. The KZN Department of Health 2019/2020 Audit Outcome by the AG under Covid-19 findings revealed the following:

1. 1. Procurement for 9 infrastructure projects valued at R472.54 million had no evidence provided to indicate that the bid committee system applied in the making the awards.
   2. That a contract was entered to between the Department and a service provider at a price exceeding the price quoted by the service provider of a contract valued at R10.36 million but the payments were made amounted to R24.28 million without any evidence to justify the overpayment.
   3. Transaction from 15 orders which entered to with non-tax compliant service providers amounting to R39.9 million
   4. Discrepancies on the procurement of items on an existing contract which the Department incurred a financial loss amounting to R15.69 million.These areas point towards poor financial management and non-compliance with the PFMA on the parts of very specific officials and we recommend corrective action. This points to the lack of monitoring and evaluation of procurement services.

      As long as the institutions and people in authority who have the power to execute and oversee their Departments and further fail to take action against individuals for misconduct, irregular expenditure and corruption will continue to be rampant and get worse every year.

      The IFP wants to know how many officials and service providers who were contracted by the KZN Department of Health have been held accountable for their involvement in the alleged corrupt procurement of goods and services for Covid-19? When will the funds be recovered?

Infrastructure

Hon speaker, the R60 million budget cut against Health Facility Revitalisation grant poses a great concern to us as the IFP, as this will result in the delay of some major maintenance projects funded from this grant especially the projects that were delayed due to Covid-19, we urge the MEC to fast track them.

Many people still have no clinics in their areas and dilapidated hospitals like St Mary’s KwaMagwaza Hospital. This hospital needs to be demolished and a new hospital must be built.

The IFP welcomes a budget of R26.6 million which will be used to replace 43 lifts in various facilities. But what is concerning is that the KZN Department has already spent almost R2.5 million fixing faulty lifts at Adlington Hospital to service providers. For how long will the department continue to spend on these companies for the same problematic lifts?

We further welcome the amount of R66 million to be used towards the eradication of asbestos roofs in all provincial clinics and community health centres. Our health care facilities in the rural areas have always been lacking in proper facilities. All these millions must be utilised for their intended purposes not for the benefit of incompetent contractors.

In conclusion

Hon. Speaker, actions speak louder than words! The IFP urges the Hon. MEC of Health, Nomagugu Simelane-Zulu, to ensure that the funding is used sparingly to fulfil its intended purpose. The Department must prove us wrong by ensuring that this budget is fully utilised and that no corruption is involved. That medico-legal claims are dealt with effectively without splashing current budget paying them.

The IFP echoes the calls for Covid-19 awareness to continue. It is concerning that the third wave is upon us, we urge the department to get going with vaccinating the people while also preparing for the third wave.

I thank you