An unprecedented public argument between a national Member of Parliament (MP) and Mpumalanga’s Health MEC – both ANC members – has finally dragged the province’s dysfunctional health service on to the national stage.
It has also opened a can of worms about the poor performance of many provinces in implementing national health policy, which is one of the biggest obstacles to effective health service delivery.
Dr Makhosi Khoza, the charismatic new chairperson of the parliamentary portfolio committee on Public Service and Administration, revealed last week that Mpumalanga Health MEC Gillion Mashego had threatened her in an angry phone call after she had released a media report about her oversight visit to the province.
‘I refuse to be silenced’
After their encounter, Khoza fumed on Facebook: “The MEC of Health in Mpumalanga had the audacity to threaten me for performing my oversight function…. Why should I not share with South Africans my disgust at those who are betraying our mission of liberating our people? I refuse to be silenced. The ANC I know does not tolerate mediocrity. The ANC I know wants us to serve the interest of South Africans.
“I’m not accountable to him. If he wants me to sugar coat the plight of the frail and voiceless, the service providers who are not paid within our 30-day turn around policy, the citizens who are ready to turn their backs on us because we are fulfilling our promises, he is wrong.”
It appears that the MEC, who has been in office since May 2014, wanted to be informed of the MPs’ visit in advance. According to Mpumalanga ANC spokesperson Sasekani Manzini: “The ANC in Mpumalanga would like to express it’s sincere disappointment on the conduct of comrade Makhosi Khoza, whom we expected to comradely inform the leadership of the ANC in the province or our deployees in the [health] department that the committee was overseeing.”
But the portfolio committee wanted to conduct a proper investigation instead of a publicity stunt. It had decided to visit Mpumalanga, focusing particularly on its health department, because it had identified a number of performance problems.
One was the department’s zero percent compliance with the Financial Disclosures Framework (FDF) Act, which compels senior public servants to disclose their registered assets in order to identify conflicts of interest. In comparison, other provincial health departments’ compliance is over 80 percent.
Describing this disclosure failure as providing “a breeding ground for corruption”, Khosa said her committee had found that the health department was in a “state of paralysis”, citing 12 581 unpaid invoices as one example of this.
But it is the MPs’ visit to Matikwana Hospital in Bushbuckridge that seems to have really enraged the province.
Although the visit was supposed to be unannounced, Khoza said that hospital officials had been tipped off and tried to stage-manage the visit, telling MPs that patients did not wait more than two hours to be attended to. But when the MPs finally managed to speak to patients, they found that some people had been waiting for two days and still not been given their files, let alone been attended to by a health professional.
Chillingly, in the early hours of the morning after the visit to Matikwana, Khoza received a phone call from a man who threatened to kill her. He was able to describe with precision her movements and even give her the room number of the hotel that she was staying in at the time of the call.
Mpumalanga is notorious for corruption and there have been a number of political assassinations, particularly of municipal level officials attempting to expose corruption. Surveillance of, and threats to kill, a national leader, is unknown territory.
Parliament has reported the death threat to the police. But it remains to be seen whether any action will be taken against MEC Mashego – either for overseeing a dysfunctional department or for his refusal to accept parliamentary oversight over his department.
Officials will be punished
Khoza is adamant that officials will be punished for poor service delivery. Speaking in a radio interview last week, she said: “We are going to make sure that accounting officers are charged for poor performance”, adding that the top health officials needed to sign performance agreements and be subjected to independent evaluations.
Khoza’s public exposure of the poor conditions in Mpumalanga is a refreshing intervention in a system where there is little accountability.
Mpumalanga’s hospitals are notorious for their lack of health workers, no ambulances and the long waits for patients to get more specialised services, particularly orthopaedic services.
Worst fatality rates
The province had the worst fatality rates for diarrhoea and pneumonia in the country for 2014/15, according to the Health System Trust’s District Health Barometer (DHB).
It’s Gert Sibande district had the highest deaths of malnourished toddlers in health facilities in the country. These statistics are an indication of both poor access to care and poor treatment once in facilities.
Little has changed for patients over the years. Yet there have never been any consequences for MECs or the top health officials because in a climate of factionalism, political loyalty has come to be more prized than efficient service delivery.
Khoza’s approach shows that Parliament is slowly finding its backbone and that some MPs are no longer prepared to tolerate poor treatment. This has to be good news for patients. – Health-e News.