The R81.5m budget allocation for the Cuba-South Africa Student Doctor Programme has come under fire in the Gauteng legislature, with Democratic Alliance (DA) health spokesperson Jack Bloom saying the money could be better spent on training doctors locally.
According to a Sunday Independent report, he was reacting to Gauteng MEC for Finance Barbara Creecy’s provincial midterm budget, in which an additional R284.3m was allocated to the ailing health department, which has become synonymous with the Life Esidimeni tragedy.
The health budget allocation, according to Creecy, included R182.2m for improvement in conditions of service, R81.5m for the Cuba-SA Student Doctor Programme, R20.6m for the payment of agencies collecting patient fee revenue from the Road Accident Fund and a further R120m for lease payments and the acquisition of machinery, furniture and equipment for the new office building where the department relocated following the fire at the Bank of Lisbon building.
The report says the official opposition was not impressed with the allocations. “The R81.5m that is allocated for the Cuban doctors’ programme would be better spent on local training of doctors, but many doctors graduate and can’t find positions in public hospitals. The department consistently under-spends on maintenance and building, although many hospitals desperately need rehabilitation. Extra money is needed, but it needs to be spent efficiently and effectively,” said Bloom.
The Cuban doctors’ programme was started in 1996 and thousands of medical students have since graduated through it. In May, Martin Veller, chair of the SA Committee of Medical Deans, said 720 students would return from the programme this year and 800-plus students next year.
The report says Creecy urged the department to develop and implement a proper human resource plan that dealt with management of the compensation budget and ensured staff were appointed to critical posts. “One of the major risks to the sustainability of the provincial health system comes from budget over-runs in the five academic hospitals. A major contributor here is the steady reduction in conditional grants to fund these hospitals from the national fiscus.”
Meanwhile, the department’s acting chief financial officer, Jonas Shai, said a strategy was in place to monitor budget use. Internal control was complemented by oversight by the provincial treasury and the health portfolio committee, among others.
The R118m in the adjustment appropriation budget set aside by Creecy for the relatives of those who suffered in the Life Esidimeni tragedy is inadequate to pay out all the claimants. The Citizen quotes Bloom as saying: “According to the premier’s office, they have received 200 new claims, most of which have been verified as being covered by the arbitration ruling made by Justice Dikgang Moseneke.”
According to the report, Moseneke ruled that R1m be paid to each claimant for constitutional damages, R180,000 for emotional trauma, and R20,000 for funeral expenses for those who died. This meant that R1.2m would be paid to relatives of those who died, and R1,180,000 to relatives of patients who survived, he said.
“Payouts to 200 claimants would cost about R236m, so the present allocation falls short by more than R100m. The premier’s office has promised that all claimants would be paid by the end of the year, but this is unlikely for nearly half the claimants because of the budget shortfall.
“Premier David Makhura’s record is badly tarnished by the deaths of 144 mental health patients and he needs to ensure that all claims are paid before his term of office ends in May next year,” Bloom said.