Motsoaledi denied that the national health system was collapsing, but admitted that it was “very distressed”.

“Provinces don’t always listen to national,” he admitted at a press conference in Tshwane on Tuesday, referring to the limited powers the NDoH has to intervene in provincial health crises.

But, after the collapse of health services in the North West the provincial health department was placed under national administration.

Motsoaledi said that he needs the power to intervene, and announced that the dire staff shortages in the province will be addressed immediately. He said that 222 critical health worker positions will be filled in the North West by the end of June at a cost of R150 million.

But Gauteng is another province in crisis. Strike action at Charlotte Maxeke Academic Hospital last week, the rising financial burden of medico-legal claims and the recent Life Esidimeni mental health tragedy have prompted calls for the province to be placed under administration.

National administration, as provided for in Section 100 of the Constitution, allows the national government and NDoH to take over processes under the control of provinces including in human resources, procurement, equipment maintenance and financial management.

“Gauteng will be filling a substantial amount of vacant posts and [Gauteng health MEC] Dr Gwen Ramokgopa will announce details on that in the next few days,” he said.

No authority to intervene

But he admits that “we don’t have the legal authority over those functions” and that, although the province has agreed to fill vacant posts, “at the moment I can only plead with them”.

“It will be disastrous for Gauteng not to fill in essential vacant posts,” he said.

According to Motsoaledi, should the province fail to fill these posts as well as implement other recommendations including decreasing its cancer treatment backlog, “I will have no option other than to put them under administration”.

But this is not a long-term solution and Motsoaledi announced that he has proposed substantial changes to the law contained within the National Health Insurance Bill that will be presented to cabinet this week.

He said that the limited powers of the national government in procurement and human resources specifically has caused many of the current on-going “grievances”.

“This is what we are going to be changing with the National Health Insurance so that the hiring of posts is no longer done by provinces… We can’t deal adequately with the present arrangement so it needs to change,” he said. – Health-e News.

An edited version of this story was published by Health24.com