The beleaguered Eastern Cape health department, serving one of the poorest communities in the country, has reported massive underspending on services, amounting to a whopping R328,4-million – a large amount being funds earmarked for the primary school nutrition programme.

Provincial health officials reported that they were unable to admit patients at some hospitals unless they were critically ill and that they were unable to meet their commitments with the present budget allocation.  

 The province shared its woes this week with Parliament’s health committee, which has called all the provinces and the national health department to report on budgetary issues.

In submissions earlier this week both the National Treasury and the National Department of Health expressed concern over the massive underspending of the Eastern Cape’s health budget.

Dr Mark Blecher of National Treasury said that overall the performance of the provincial health departments had been exceptional in the area of health expenditure, but added that the biggest problem was in the Eastern Cape.  

He said there were problems in several areas including the global allocation, stores and livestock (drugs), personnel and the ability to comply with ringfenced conditional grant increases.  

He indicated that treasury was communicating with the province in this regard.

The key source of increase in the Eastern Cape’s health budget is likely to come from large adjustments paid to the province late in the year to supplement its shortfall and the province’s under-expenditure of R341-million by end of February which is likely to be rolled over into the present financial year. Blecher said the current budget increase is only 0,9%.

Gerrit Muller, chief financial officer at the National Department of Health, agreed that there should be concern over the “massive underspending” by the Eastern Cape.

“I think we should be worried about the Eastern Cape, Northern Province (Limpopo) and Mpumalanga, in that order,” Muller said.  

Mike Fraser, Chief Financial Officer in the Eastern Cape told the committee that the department was severely underfunded, that services had been reduced, that there was no room for expansion and that they were experiencing difficulty in addressing backlogs, especially in disadvantaged areas.

“We do not have sufficient funds to fund existing services until the end of the financial year,” Fraser warned.  

He said the new budgets for departments were yet to be approved by the legislature and that the health department was unable to fund existing financial commitments or address inequities.

Dr Siphiwo Stamper, health of the province’s health department, acknowledged that his department had experienced difficulties in spending money, especially on capital projects.

“This is also due to poor management across all departments, including Public Works and Treasury,” Stamper said.  

Dr Vincent Shaw, Director of District Hospitals in the province told the committee that the Eastern Cape health department was using its limited budget to fund drugs, surgical supplies and food at the hospitals.  

“Equipment is being compromised as we are unable to replace or maintain equipment,” he said.

Shaw said patients were showing a lack of confidence in the health system. He said that Umtata Hospital was unable to admit patients unless they were critically ill.

“Even if confidence was restored at this stage and patient numbers increased, we would be unable to treat them,” he said.  

James Ngculu, chairperson of the standing committee, commented that the situation in the Eastern Cape was abominable and that it was clear that confidence in the public health system was going down.

“The Eastern Cape is underspending in almost everything. What better life are we talking about in the Eastern Cape, if this better life is being undermined and compromised,” Ngculu asked.  

“We need a bold intervention from our side.”

For more information click here: Underspending threatens provinces’ health care