Gauteng Health has halted the procurement of all new equipment with immediate effect, further crippling state hospitals already constrained by various shortages, including staff.
A circular issued earlier this month by HoD Lesiba Malotana to all hospital CEOs said the department “has incurred overspending with machinery and equipment on equitable share due to accruals payment as at end August 2024 and commitments …during the current financial year”.
The DA, which described this as “bad news for hospitals”, has called for a complete overhaul of the department’s top management, reports News24.
“This should include the removal of Mr Malotana, who was recently appointed, despite an SIU investigation into allegations he shared a R8m bribe with two other officials,” the party’s Jack Bloom said.
Last month, the chairperson of Parliament’s Portfolio Committee on Public Service & Administration, Jan de Villiers, asked the Public Service Commission to investigate whether correct procedures were followed in Malotana’s appointment.
The probe was to focus on him being appointed despite an investigation into a tender-rigging scheme involving the bribery claim, as well as “possible irregularities” relating to his application and declared qualifications, to determine whether he had the required Master's degree for the job.
Gauteng Health did not comment on the allegations against Malotana, but on the budget, spokesperson Motalatale Modiba said proactive steps would be taken to ensure it met its obligations while exercising tight financial controls.
The equipment purchase freeze comes after the department had confirmed it would “prioritise the filling of critical posts” amid the constraints.
Bloom said hospital CEOs had told doctors there would be no new hiring, while posts already advertised would not be filled because of a R1.5bn shortfall “due to endemic poor management and corruption”.
As at 31 July, Gauteng had a vacancy rate of 8.1% for medical doctors, 7.9% for nurses, and 5% for senior management.
Critical posts
However, it is not just Gauteng that is taking strain from unfilled vacancies. The budget cuts meant at least a quarter of all national posts were unable to be filled in 2023/24, including dozens it considered critical to delivering on its mandate, MPs were told last week.
“It really has had an impact on how we function,” Gealth Director-General Sandile Buthelezi said during a presentation in Parliament on the department’s 2023/24 annual report.
BusinessLIVE reports that the unprecedented in-year budget cuts imposed in the medium-term budget policy statement last November were only partially reversed in this year’s February budget, leaving the sector’s budget set to shrink in real terms over the medium term.
The Treasury set aside a revised estimate of R267.3bn for consolidated health expenditure this year, rising to R271.9bn in 2024/25.
The consolidated Health budget then increases to R281.1bn in 2025/26 and R295.2bn in the outer year.
This represents a nominal increase of 3.4% compared with the Treasury’s forecast inflation of 4.7% over the period.
Health Department officials told the Portfolio Committee on Health that the cuts had affected hiring at both national and provincial level, with far-reaching effects.
The national Department had 1 122 posts in the year under review, of which 24.1% were empty. It was able to fill only 60 of the 101 posts it had identified as priority positions, said Buthelezi.
At the provincial level, thousands of community health workers had not been replaced after their contracts ended or they resigned, hampering the provinces’ efforts to provide community outreach services, said the department’s chief director for monitoring and evaluation, Thulile Zondi.
The reduced funding also hobbled polio surveillance programmes, which ran in just eight of the 42 health districts that had originally been planned, she added, with the cash crunch resulting in a shortage of surveillance staff and limiting their ability to travel.
Budget constraints had led to the loss of about 18 000 posts over the past two to three years, said CFO Phaswa Mamogale.
Vacancy rates for doctors ranged from 22.4% in the Free State to 5.5% in the Western Cape, while those for nurses ranged from 28% in the Free State to 5% in the Eastern Cape. There were extensive vacancies at senior managerial level.
See more from MedicalBrief archives:
Gauteng Health fails to spend budget millions – again
Overtime cuts impact on hospital services
Health budget fails to hit the mark – SAMRC researchers