The Human Rights Commission has ordered the beleaguered Eastern Cape Health Department to explain why it failed to address 27 public complaints – some dating back two years – which highlight the many stark crises and issues of the flailing department.
The provincial accounting officer and seasoned healthcare administrator Dr Rolene Wagner appeared before the commission in East London this week, where she was given two weeks to respond to the HRC, reports News24.
Wagner was subpoenaed as part of the commission’s ongoing investigation into “systemic failures” in healthcare service delivery across the province, and numerous complaints received by the Chapter 9 institution.
Among these were that a community in Willowvale was forced to build its own clinic in a bid to access primary healthcare services, that a senior staffer at Frere Hospital was calling employees “monkeys”, and that there were crucial shortages of essential medicines and treatment in some hospitals, said HRC provincial manager Dr Eileen Carter.
She told Daily Dispatch that there were also complaints about unsafe and dilapidated infrastructure, staff shortages, prolonged water shortages at some facilities and clinic closures without adequate interim arrangements.
Carter said the commission was also investigating allegations of procedural unfairness affecting vulnerable patients.
However, in second Daily Dispatch says despite its staff and equipment shortages and medico-legal debt, among other issues,the provincial department was making some headway in transforming some of its notoriously shoddy facilities and correct decades of under-investment in critical infrastructure (see details below).
However, among the complaints heard by the HRC, was one in April 2024 from Willowvale residents saying access to primary healthcare around Lurhwayizo was an uphill battle, that five villages were dependent on just one clinic, the commission’s senior legal services officer Advocate Loyiso Mpondo said.
“And the distances between the villages and the clinic is 40km to 50km. We were in those villages. I can tell you, HOD (Wagner), that the road infrastructure is very bad.
“So there were times that they would travel these long distances only to return… without being attended to.”
Frustrated, the community was forced to build its own clinic in the area.
Mpondo said the villagers’ letter to the department about the matter, which had a deadline of 17 May 2024 for response, was never replied to.
Racism
In October 2024, a Frere Hospital employee wrote to the commission complaining about a manager allegedly calling black staff monkeys.
“We are told the department has done nothing (about the allegation). Instead, the (manager) tried to take action against the person who reported the matter,” said Mpondo, adding that the numerous complaints received by the commission were assessed before being escalated to the department.
“We addressed several letters to the Department of Health requesting information and responses to the issues in the complaints. However, we received no responses.”
Wagner apologised to the commission on behalf of her officials who had failed to respond.
“We recognise the impact …. I want to unequivocally apologise on behalf of the department and our officials,” she said, adding that while the department recognised there was an increase in accountability reports that the department needed to provide to institutions, her team “has really been grappling with trying to respond to these because they come in on a weekly basis”.
“The responses we rely on come from our district managers and our CEOs (of hospitals), who are busy trying to just maintain services in the wake of having lost staff.
“That being said, it does not excuse non-responsibility, non-submission or such late submission. And so, we want to unequivocally apologise for that.”
She promised consequences would follow for officials who failed to submit reports to the complaints from the commission.
“I have already initiated consequences … for late and or non-submission.”
On the Frere allegations, Wagner said the feedback provided to her by the officials at the facility was not adequate, and undertook to investigate the matter thoroughly.
“It seemed the suspect’s name was misspelt, so we will find more concrete information,” she said.
Wagner said the Lurhwayizo facility was a health post donated to the department by a Good Samaritan, along with community members.
The department has employed two professional nurses – since December – to provide services at the clinic, she added, and they were also partnering with Doctors Without Borders to provide healthcare services to the Lurhwayizo community.
Distances
She noted that the Lurwayizo health post fell under the Mbhashe sub-district, which covers a rural part of the province comprising traditional residences.
“The two nurses whom the department employed drove between the Ngquthu and Lurwayizo health posts – services for Lurwayizo are on Tuesdays and Thursdays.”
However, she acknowledged the costs of travelling long distances to seek primary healthcare services, and said the “out of pocket by communities sums up the need for the provision of health services in the area”.
On the complaints about the condition of the Sada Clinic, she added that this had been included in the department’s repairs, renovation and revamping programme.
“Sada was prioritised as part of the 2025/2026 repairs, renovation and revamping (RRR) projects to bring the facility’s infrastructure to compliance, a R1m project.”
The project had passed the design stage and was in the procurement process to appoint a contractor.
In March 2025, Indwe residents had submitted a petition demanding that the local hospital remain a fully functioning facility rather than being downgraded to a community health centre.
Wagner said no final decision had been taken on the future of Indwe Provincial Hospital, but any decision about closing or repurposing it would follow a consultative process led by Health MEC Ntandokazi Capa.
Time for administration?
An opinion piece in the Daily Dispatch said Wagner urgently needed support to turn around the failing department, which it described as being in a constant state of crisis.
“It faces judgment debts amounting to hundreds of millions of rands and judgment creditors are lining up to seize its assets. Suppliers who are owed money have no choice but to stop providing essential life-saving equipment and medication to this serial offender,” it read.
Even oxygen is in short supply in hospitals.
Sister publication The Herald reported this week that some of the province’s state-run adult and paediatric oncology units are short of chemotherapy drugs because of the department’s alleged failure to pay its suppliers, while striking nurses, demanding overtime pay at Dora Nginza Hospital, have brought patient care to a standstill at this once world-class institution – which is now a shell of its former self.
“And, of course, there is the never-ending stream of medical negligence litigation cases which annually deplete its healthcare budget by billions of rands.”
In August 2024, the department acknowledged its contingent liability for such claims stood at about R22bn.
The editorial slammed the continual inaction by the department, saying “nothing is ever done … to change it except, arguably, for the worse”.
It said it boiled down to the constant leadership crisis.
“Dr Rolene Wagner returned as head of department in August after inexplicably being seconded for a year to some ‘crack’ support unit created by Premier Oscar Mabuyane.
“It seemed to be a unit of HoDs who had fallen out with their political heads.
“To this day no one knows exactly what that crack unit achieved but Wagner’s removal, just as she had made some headway in addressing the systemic challenges faced by the department, set it back even further.”
Provincial healthcare institutions, including hospitals and clinics, consistently deteriorate as does the healthcare they are supposed to offer, it said.
The department reportedly started its current financial year with almost R5bn in unpaid bills, including for municipal services, medical supplies, hospital and fleet services.
It is also a repeat offender in qualification of its audit outcomes.
The editorial said that in 2024, Mabuyane described the department as one that gave him nightmares. He has promised to give it better support to improve its performance as well as balancing its budget.
“One can only hope that Wagner will, with Mabuyane’s support, be given the opportunity to steady this unwieldy ship. If not, the province should seriously consider putting it under administration,” said the editorial.
But there were some positive moves, with several new projects. Health MEC Ntandokazi Capa, who recently led an extensive infrastructure oversight drive across Alfred Nzo and OR Tambo Districts, said that among the most significant projects is the construction of the new 100-bed Greenville District Hospital in Mpandinini, the Daily Dispatch reports.
The R168m investment – completion date scheduled for 2028 – is expected to change healthcare access for surrounding communities, who for years, have had to travel more than 250km for higher-level care, while the redevelopment of Bambisana Hospital is another project modernising a critical district hospital serving thousands of residents in the OR Tambo District.
New wards, improved clinical spaces, and upgraded staff accommodation are already improving working conditions for staff and enhancing patient care.
The MEC said these projects form part of a broader infrastructure plan that includes the redevelopment of Zithulele and Madwaleni hospitals, which will further expand clinical capacity and strengthen referral systems.
Last month, 50 new healthcare professionals were appointed at Frere Tertiary Hospital – specialists, doctors, nurses, and senior clinical leaders – while through the Ministerial Intervention Programme, the department has secured funding to recruit more than 429 additional staff, reinforcing the province’s clinical backbone.
Additionally, 248 Emergency Care Officers and paramedics have been hired, enabling the activation of 31 additional ambulances.
Last month’s launch of the Walter Sisulu University Rural Clinical School at St Elizabeth Regional Hospital marked a turning point in rural healthcare training, with 10 intern doctors already up and running in their duties.
Backed by a budget of R7.1bn, there have also been improvements in maternal and child health, with early antenatal bookings having improved to 67.5%, above the 65% target.
The maternal mortality rate also improved, dropping to 78 per 100 000 from 139 per 100 000.
The programme for delivering medication for chronic conditions like high blood pressure is being boosted, benefitting 534 000 patients in the province, while other noteworthy progress is the new renal dialysis unit at St Elizabeth Regional Hospital in Ingquza Hill Municipality, meaning patients from the far northeastern part of the province will no longer travel to Mthatha Regional Hospital for these services.
More renal dialysis units will be launched in Chris Hani and Sarah Baartman districts in the next financial year.
Also on the cards for this year is the completion of upgrades at Cecilia Makiwane and Dora Nginza Hospitals to accommodate Cerebral Palsy Centres of Excellence with specialised clinical, therapeutic, and family support spaces.
Daily Dispatch – Eastern Cape accelerates health infrastructure and specialist care expansion
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Eastern Cape patients risk lives in local clinics, report finds
Villagers build own clinic after years with no healthcare