Despite numerous complaints regarding poor treatment at Gauteng hospitals – including the latest, widely distributed patient video about Helen Joseph Hospital – the Health Department, in its recently released annual report, says 86% of patients reported they were satisfied with the care received, a figure disputed by the Auditor-General.
The AG said this could not be confirmed as correct as “adequate supporting evidence was not provided for auditing”, reports News24.
The document was submitted by Health MEC Nomantu Nkomo-Ralehoko and tabled in the Gauteng legislature, coming hard on the heels of recent headlines relating to poor service delivery at Helen Joseph.
The footage led to Health Minister Aaron Motsoaledi calling on Health Ombud Professor Taole Mokoena to investigate the allegations, ranging from disrespectful hospital staff to infrastructural issues, which left patients without access to clean toilets and running water.
Despite a litany of complaints that this is the norm at Helen Joseph, in the annual report, Nkomo-Ralehoko and her department said the majority of provincial patients – 86% – reported being satisfied with the care they received, while specialised hospitals reported an achievement of 91%.
The AG, however, had identified “material mis-statements” in the report, translating to false information being supplied.
In certain categories it was found that the supplied information did not correspond with audit evidence: this included the number of child pneumonia and diarrhoea fatalities as well as immunisation coverage.
The AG lambasted the department’s “inadequate” performance management system, saying health information systems and records were not being maintained.
This resulted in “unreliable information” as confirmed through its audits of the reported performance information on primary healthcare services since 2014/15.
The department also racked up R25bn in irregular expenditure over the past three years, while underspending on its budget by more than R6.4bn in the same period – leaving some hospitals unable to afford taps and toilet paper in bathrooms, reports TimesLIVE.
Irregular expenditure now stands at R2.7bn in the 2023/24 financial year, up by R400m from R2.3bn in 2022/23, according to the past three annual reports.
In the 2021/22 financial year, irregular expenditure amounted to a hefty R22bn, which included R2.3bn a month on the extension of security contracts that did not go through tender processes.
The department underspent by R1.1bn in the past financial year, R2.7bn in 2022/23 and R2.5bn in 2021/22.
The department said Treasury had “provisionally approved” the unspent R1.1bn in the past financial year to be carried over into the current financial year.
Spokesperson Motalatale Modiba said it was not always possible to spend every allocated cent, “due to various factors”.
“For instance, some of the money is committed to purchase orders or invoices that could not be processed within the previous financial year, leading to a rollover of funds.”
Modiba said those amounts would cover grants for human resource training, national tertiary services, district health programmes and the NHI.
The report also revealed that a programme with an allocated R154m budget for remedial work for fire and occupational compliance at Charlotte Maxeke Hospital in Parktown, which was planned for the past financial year, was not done, while another planned maintenance project at Helen Joseph Hospital, for which R29.6m had been set aside during the 2022/23 adjustment budget last year, was also not undertaken.
Health receives the province's second-biggest budget, after education. The department was allocated R64.8bn in the 2024/25 financial year, up from last year’s R60bn, making it the department with the biggest increase in budget.
Modiba said it was projecting “to overspend within the compensation of employees” due to the 7.5% public sector salary increases which were not fully covered through allocated budgets for the current financial year.
“However, the amount (to be overspent) has not yet been fully determined.”
The department’s salary bill has risen by about R300m in the past three years, from R59.6bn in 2021/22 to R62.5bn in 2023/24.
Modiba said R695m was spent on fighting litigation in court, which is the most in the past three years, with R507m spent in 2022/23 and R369m in 2021/2022.
‘Corruption’
Wits adjunct Professor Alex van den Heever said the department suffered from “institutionalised corruption at the highest levels”.
“This is evidenced by the extraordinary levels of irregular expenditure, repeated year after year. The accounting officers (heads of departments) are never held properly to account for these massive, and arguably wilful, infringements.”
He said the failure “to address the rampant theft of resources that (whistle-blower) Babita Deokaran identified, suggests …leadership problems”.
“Importantly, despite massive evidence of wrongdoing, the former CFO, to whom Deokaran reported was permitted to resign three years after her murder, with no action taken by the Department.”
DA health spokesperson in Gauteng Jack Bloom said the consistent underspending showed chronic poor financial management.
“How can it be that available budget is not spent to help treat patients? Last year, R250m set aside to cut the backlog for radiation cancer treatment was unspent, costing the lives of many patients.”
Human rights and social activist Mark Heywood said there was “no intention by the authorities to fix the crisis in Gauteng Health”.
“The department has a budget of R65bn in the current year and is served by three universities, with some of the best health professionals and health systems experts in the country. We’re a province with a developed, sophisticated private sector with all of its specialists willing to assist in a geographically small province that should be relatively easy to co-ordinate and manage as far as health promotion, disease prevention and treatment are concerned.”
The system’s collapse was due to “maladministration and corruption and the lack of political will to replace the implicated officials at the top”, and there was no strategy to rescue or revive the situation.
TimesLIVE article – Terminal disarray plagues Gauteng health (Restricted access)
See more from MedicalBrief archives:
Patient’s viral video highlights state of public healthcare
Gauteng hospitals deteriorate further after damning PP report
SAHRC to probe hundreds of complaints about public hospitals
‘Dysfunctional and an embarrassment’ – outgoing Ombudsman on health departments