Whistleblowers claim Northern Cape Health is in financial trouble, on the brink of more lawsuits and its service providers have downed tools in key projects because of non-payment, but the department said it was merely “re-prioritising projects to manage cash flow”.
A City Press report says insiders accused the acting chief director in the department, Dr Lesetja Mabona, of allegedly prioritising the funds for the conditions-based maintenance programmes, which insiders called his “pet projects”.
Dmitri Klaassen of contractor GVK-Siya Zama said in the report that the Port Nolloth Community Health Centre project had been halted “due to non-payment”. The work included construction of student accommodation in a nursing college in Kimberley, two other new clinics in Boegoeberg and Bankhara Bodulong, as well as a pharmacy and a new mortuary in Springbok Hospital. The combined value of these projects exceeded R232m, according to the appointment letters.
Klaassen’s company, which signed the contract with the department in 2016 through the Independent Development Trust (IDT), sent a letter of demand through its lawyers earlier in August, seeking a payment of up to R20m. The report says in a reply to the IDT, the head of the health department, Steven Jonkers, said it was experiencing delays in processing payments. “The department acknowledges the delays in paying service providers affect performance on active projects,” Jonkers said, adding that efforts were being made to remedy the situation.
However, the report says, by mid-September, the issue was still not resolved. GVK-Siya Zama sent another letter demanding more outstanding money. The company reserved its rights to “claim and institute legal proceedings” against the department.
Mabona implemented the conditions-based maintenance projects in June last year, stating in an internal memo that the public works department’s assessment of several clinics in the province revealed the need for “immediate attention”. He said the cost of repairs and refurbishment of these clinics would amount to R113m. His plan was to take unused funds in other budgeted projects to fund the maintenance projects.
The report says a month later public works, as the implementing agent, appointed at least two companies to work on the projects Mabona had highlighted. Sources said the contracts were not put out for tender. By July this year one of the appointed companies, an engineering consulting firm, had been paid R48m, R10m more than the overall project budget plan of R38m for work on facilities in Kimberley’s Frances Baard region and Kuruman’s John Taolo Gaetsewe region.
The report says another document showed multiple variation orders in at least 28 sites. Whistle-blowers said the work done on these projects did not match the amount of money the department had spent. And documents show the department repeatedly spent more than it budgeted.
In another project to refurbish a portion of the nursing college in Gordonia into a lecture room, the architects were appointed with a contract of R3.3m in March 2015 but by July 2016 the department had already spent more than double the amount, paying a total of R6.7m. The report says the consulting engineers in the same project had an appointment budget of R1.2m but in May 2015 R8.5m had already been paid. Quantity surveyors received a R1.5m contract but in September 2016 more than R2.8m had been spent on their work.
A whistle-blower’s report blamed “deviations and manipulation of scope to inflate claims”. The report says departmental spokesperson Lulu Mxekezo said “anybody who has knowledge of any illegal activities should provide that info to the department so the allegations can be investigated”.
In a separate issue Mabona threatened to sue a colleague, Mawabo Ntolosi, also director of infrastructure planning, for naming him as the person involved in another set of mysterious payment requests from service providers totalling R3.8m. The project manager had refused to approve the payments because the work claimed could not be verified. The matter was of concern for those in the provincial health department’s James Exum building in Kimberley because the allegations had not been tested internally but lawyers were already involved.
The report says Mabona served a lawyer’s letter on Ntolosi in April this year demanding evidence of wrongdoing against him as contained in an internal memo, written by Ntolosi in August last year and discussing the unexplained payments. In the memo Ntolosi wanted project managers to provide reasons for their refusal to sign off payments. The response he received was that they knew nothing about the contracts and therefore would not get involved.
One of the two project managers, Sithembile Mankahla, told Ntolosi that his life had been “endangered” since the affected service providers had acquired his cellphone numbers and called him every day demanding that he process their payments. “I feel that giving out my cellphone numbers to service providers and misinforming them about my role in their payments has endangered my life,” he said. “I am concerned about where they got my cellphone numbers and wondering who informed them that I was the one not signing their payments.”
The report says in his version Ntolosi fingered Mabona as the official responsible for the mess. “Even with these payment certificates of the consultants in question, it is (Mabona) who knows about them. I find it strange that (Mabona) is involved in the planning stage and so on but (he) is not involved in approving payments.
“When the payments need to (be) authorised it is the responsibility of the planning unit that I head to approve the payments initiated by (Mabona) with these consultants,” said Ntolosi. He said he was unable to act against the project managers “for the work … they were never involved in” and that Mabona “should handle the situation as he knows about it from the start”.
The report says despite repeated requests, Mabona did not comment on the allegations against him.
The majority of the Northern Cape’s hospitals and clinics are unable to cope with multitudes of patients at overcrowded facilities, while the shortage of ambulances has exacerbated the situation at all hospitals. The Citizen reports that the vacancy rate for professionals – which includes doctors, nurses, pharmacists and physiotherapists – is estimated at between 70% and 75% in the province, with even the new, state-of-the-art hospitals in Upington and De Aar running on what some called “skeleton” staff.
Northern Cape Health is said to have no money to pay higher salaries to attract doctors and nurses from other parts of the country.
Due to the shortage, Mangaliso Robert Sobukwe Hospital (formerly Kimberley Hospital), a referral facility, is unable to cope with the demand for specialist services and has to make transfers for operations and chronic cases to Bloemfontein.
A lack of ambulances at the Dr Harry Surtie Hospital in Upington has caused delays in the transfer of patients requiring emergency medical care to Kimberley. One of the ambulances was standing in the parking bay because its licence disk expired and drivers were refusing to drive it. The report says the problem was reported to authorities a long time ago but nothing was done. An official, who asked to remain anonymous due to fear of reprisal, described the shortage of medical staff as “historical” due to the fact that vacancies remained unfilled for a number of years.
He said many posts had acting staff for between three and four years without permanent appointments, mainly due to lack of funds and unavailability of professionals to come and work in the Northern Cape. “Some of those acting had refused to carry on in those posts, because the (provincial health) department was not paying them the acting allowances. They are also overworked because of the shortage of staff,” the official said.
The report says Democratic Alliance (DA) provincial leader Andrew Louw visited the health centres as part of the DA’s Listening Tour last month. “During my tour, which is currently taking me through Namaqua and the area around Upington, I saw first-hand how our people are being denied access to medical care,” said Louw. He and his delegation experienced a similar lack of ambulances in the rural Namakwaland’s Sanddrift and Alexandra Bay.
According to Louw, Dr Harry Surtie Hospital’s serious lack of staff, ranging from clinical to surgical staff, had resulted in only 228 of 327 hospitals beds being used. Besides low-level staff shortages, critical posts such as the CEO and other senior management positions had acting personnel.
“Communities are tired of empty promises, tired of poverty and desperate for a change which can ensure access to basic services. By refusing to appoint staff at hospitals, the ANC is undermining the delivery of quality health services to our people,” Louw is quoted in the report as saying.
DA MPL and spokesperson for health Isak Fritz said the De Aar Hospital was facing a similar crisis. This facility, which recently opened its doors, had only four doctors and ran the risk of becoming another failed project.
The report says the lack of professional health workers and funds has even delayed the plan to open a psychiatric hospital in Kimberley. Fears are that, should it open, a situation similar to Life Esidimeni in Gauteng could easily happen in the Northern Cape. This facility took more than a decade to complete, and overran its budget by more than R1bn. Last year it was reported that the funding shortfall for the daily operation of the facility could amount to at least R240m.