E CAPE HEALTH IS R3bn IN THE RED
‘Embarrassing’ incidents of seeing its assets at tached to settle debt
The Eastern Cape health department is R3.1bn in the red.
The troubled department’s bad debt was laid bare before a virtual standing committee on public accounts (Scopa) meeting on Thursday.
As at November 2019, the department faced medico-legal claims reportedly worth about R29bn but, curiously, the exact figure was left out of last week’s discussions and no updated amount was given.
A health department delegation led by superintendentgeneral Thobile Mbengashe reported to the committee that it had faced “embarrassing” incidents of seeing its assets — mostly vehicles and furniture — attached by the sheriff of the court to settle debt.
Responding to a question from MPLs, Mbengashe said: “Our total liabilities and unpaid bills are about R3.1bn.”
Mbengashe said the medicolegal negligence claims represented a contingent liability for government, meaning the department would be liable as soon as the claim was proved.
DA Scopa member Bobby Stevenson said on Sunday that the department’s unpaid debt accruals would cripple it, unless it was resolved urgently.
“The only way to resolve this is for treasury to become involved to settle the historic debt and for dramatic changes to be made to the way in which the health department delivers health services so that the medico-legal claims for negligence do not continue.
“They need to appoint the right number of staff and ensure there is good management in the hospitals.”
Dispatch reports on high court proceedings regularly highlight the department’s woeful record in respect of negligence by healthcare workers which result in medico-legal claims by patients running into tens of millions.
Many claims date back over a decade because of the department’s cashflow problems and delays in settling claims.
Thursday’s presentation by Mbengashe’s team provided no insight into the impact on the department’s finances of responding to the Covid-19 pandemic.
Mbengashe told Scopa a court order enforced a R477m debit order deduction from the department’s bank account. He did not give details about which court gave the order, when this happened or who the creditor was.
MPLs grilled the department about why it failed to pay service providers within the legislated 31-day period.
Health CFO Msulwa Daca said the accumulated medicolegal claims over the last five years “affects the ability of the department” to pay within the stipulated deadline.
Daca said: “There is always an attempt to pay the smaller suppliers first and try and keep them within reasonable time [of] 45 days and lean a little bit more on the bigger suppliers and the suppliers that are state entities — such as NHLS, state attorney.
“To try and close that gap, treasury towards the end of the year provided some [R459m] overdraft facility to assist the department to make sure some of the entities are paid.”
He said the overdraft facility was to ensure the department could pay some of its creditors.
UDM MPL Mncedisi Filtane asked why the department was surprised when a court-sanctioned debit order was presented for payments.
Responding to Filtane, Daca said: “From a cash flow perspective, it’s the same outcome whether we voluntarily pay them out or they are deducted from the bank account ... It takes cash out of our system. That cash is now unavailable to pay service providers.”
Mbengashe said the provincial executive council had asked the provincial department to expand the team working on medico-legal claims.
Provincial health spokesperson Siyanda Manana told the Dispatch the debit order related to medico-legal payments.
Manana said the figures debited were staggered and stood at R490m, of which R277m was from last year. The rest is from the current year.
He said the figures were not a once-off transaction.
“The court issues an order and that order is taken to treasury and Standard Bank and it is set aside until we reconcile our account — which normally takes 30 days,” Manana said.
He said the debit orders negatively affected the department’s capabilities for service delivery, particularly with medication.
Stevenson said on Sunday the delays in paying suppliers had a crippling impact on small businesses.
The only way to resolve this is for treasury to become involved
Eastern Cape health MEC Sindiswa Gomba has broken her silence on calls to have her removed from her executive position in the provincial government because of alleged underperformance.
Fielding questions during a media briefing at St Barnabas Hospital in Ntlaza near Libode on Friday, Gomba laughed off the claims allegedly justifying the calls for her removal.
She hinted in her responses that the criticism was driven by people who were unhappy with her for reasons unrelated to her performance.
The MEC noted that, historically, the post of MEC for health had been occupied variously by politicians who were health professionals, while others were not.
Some commentators have said the absence of medical experience in the MEC ’ s background leaves her ill-equipped to lead the health department’s fight against the Covid-19 pandemic.
Problems within the department are not new, but the coronavirus onslaught has meant intense scrutiny of the MEC’s missteps, and problems in hospitals in respect of staff and resource shortages, and unhygienic conditions, have been directed at her.
National health minister Dr Zweli Mkhize has previously put out flames around the province’s management of the crisis, saying in July that there were no plans to place the EC health department under national administration, and that the government was “still comfortable” with provincial leadership.
Mkhize was caught flat-footed when provincial leaders, including Gomba, launched a scooter ambulance transport system that was a non-starter with the public.
A more chilling oversight came with the admission that an official in Nelson Mandela Bay had not submitted daily tallies of deaths in that metro.
But on Friday, Gomba was nonchalant when she said: “You really make me laugh. I doubt if a barometer for any person to be performing at work should be on an issue that is not known — the Covid-19.
“When there was no Covid19, everybody was appreciating the fact that we are starting to get into hospitals and address challenges.
“Somewhere someone was saying they have never seen where an MEC will visit hospitals and clinics.
“But when it came to Covid19, there are many reasons that I would not like to speak. One of them is that you will be engaged by certain people on certain issues and when you do not agree, of course those people will not be happy with you at all.
“To say that, on the basis of Covid-19, you are not fit to be what you are, I don’t think that is right.
“There have been doctors, there have been no doctors, who have led the department of health.
“My view is that if you are a politician, you are not guided by a stethoscope or an injection. But you are guided by what is in your manifesto, what is your deliverable.
“In the Freedom Charter, it says health must be available even for the poor people who cannot afford it and that is exactly what I am doing.
“I am not the best person to judge my own performance, but I believe that we are just on the right track.
“But if you want to do that even in this Covid-19, we are taking a curve that we do not want to boast about because one is not too sure about how things are projected into September. We are doing relatively well,” said Gomba.
Gomba was applauded at the hospital as she delivered PPE and addressed some problems within the hospital.
You are guided by what is in your manifesto, what is your deliverable