Gauteng Health failed to spend R504m set aside for equipment in the last financial year, while blowing its budget for hospitals and administration, a situation that highlights its weak financial management, reports Business Day. Despite improving its audit outcomes in recent years, it continues to struggle to stick to its spending plans.
Preliminary figures for the last quarter of the 2018/2019 financial year, to end-March, show the department under-spent its R46.8bn budget by R631m, or 1.4%. This is worse than the preliminary outcome for 2017/2018, which saw the department under-spend its R41.9bn budget by R204m, according to documents tabled in parliament in 2018.
“It’s quite disappointing. It’s fully down to (former health MEC) Gwen Ramokgopa and head of department Mkhululi Lukhele,” the Democratic Alliance’s Gauteng health spokesperson, Jack Bloom, is quoted in the report as saying. “The new MEC, Bandile Masuku, is starting off with a very poor base,” Bloom said, urging him to ensure this year’s R50.8bn budget is spent effectively to provide a high-quality health service.
The report says the latest figures are contained in documents tabled in the Gauteng legislature’s health committee. While the net under-spending for 2018/2019 appears to be relatively small compared to the scale of the budget, it masks the significant under- and overspending of specific budget allocations.
The documents show the department overspent its R1.07bn administration budget by R282m (26.3%), due to medical negligence claims, and overspent its R16.8bn central hospital budget by R389.2m (2.3%) thanks to unpaid bills from the previous year and performance bonuses.
It under-spent its R15.36bn district health service budget by R823m (5.4%), and failed to spend R504m (37.5%) of the R1.34bn set aside for machinery and equipment.
Emergency services failed to spend R153m (10.3%) of its R1.48bn allocation due to delays in filling vacant posts and the release of payments to fleet services, the documents show.
Gauteng Health spokesperson Philani Mhlungu said in the report that the department faced mounting pressure on its budget from medico-legal claim pay-outs, increased inflation on medical supplies and its salary bill. The overspending on the provincial and central hospital budgets was due to higher than anticipated salaries and the acquisition of goods and services. It had under-spent its budget allocation for medical equipment, due to delays in acquiring products from overseas.
“The department has applied for a rollover of these funds,” Mhlungu is quoted in the report as saying.
Bloom has complained that Premier David Makhura has failed to clarify which were the five worst hospitals in Gauteng that would receive special intervention over the next 12 months, reports The Citizen. “In the printed version of his state of the province speech (Sopa) there are only four hospitals listed – Mamelodi, Sebokeng, Bheki Mlangeni and Jubilee – but he also mentioned the Tambo Memorial and Tembisa hospitals.
“I asked the Premier in the debate on his Sopa speech last week on Thursday to clarify the five hospitals and why other extremely bad hospitals are left off the list.”
Bloom said that he considered the Thelle Mogoerane Hospital, where six babies died last year from klebsiella, a “crime scene”. “This hospital was assessed at only 70% for the National Core Standards, below the target of 75% and less than Tambo Hospital which got 86%.
“Another terrible hospital is George Mukhari in Ga-Rankuwa, which treats the poorest of the rural poor but is dreadfully neglected.”
The report says he shared an emailed message from one Lisa Tolkin, “who visited her beloved old former helper at this hospital”.
Tolkin had written: “I thought that a hospital was a place for the sick … All I saw were cages of neglect, cruelty, fear and hopelessness … The wards were separated by dirty fabric screens like shower curtains … I found Phina, her eyes were tortured and she was struggling to breathe … There was no oxygen, or a drip … I took Phina’s emaciated hand, I put her shaking head under my chin and asked her to breathe with me. I told her that she was going to a peaceful quiet place, where there was no suffering … I continued to talk to her gently and lovingly until she stopped struggling and went quiet … I ran around looking for a nurse or doctor to confirm that she was dead … All the patients watched Phina’s undignified death … (and there were) flies on her body.”
Bloom said in the report that the premier had ignored his plea in the debate to clarify the worst hospitals and why Thelle Mogoerane and George Mukhari had been left out. “The truth is that all Gauteng’s public hospitals need hefty improvements, but I agree that special attention be paid to the worst ones.”