It may be business as usual in the Northern Cape Department of Health for former acting head of health and the chief financial officer, both back at work after suspension, but concerns over the impact of leadership instability on public healthcare services remain, especially here, where there has been no permanent HoD for 30 months.
In March 2021, then-acting head of health Dr Deon Theys and CFO Dan Gaborone were suspended after being implicated in fraud and corruption relating to a R43m personal protective equipment tender, writes Refilwe Mochoari for Spotlight.
However, Theys was back on 23 January after a year-long suspension, saying there are “no hard feelings” from his side.
Cleared – for now
Kaizer Kganyago, SIU spokesperson, said “with regard to the criminal matter, the SIU referred it to the National Prosecuting Authority and it is still ongoing”.
Regarding the SIU’s disciplinary recommendation, the matter was referred to the Office of the Premier.
Spokesperson for the National Prosecuting Authority in the Northern Cape Mojalefa Senokoatsane said the PPE case against both Theys and Gaborone was provisionally withdrawn on 8 December 2022 and it would be premature for the prosecution to disclose the reasons.
“What the NPA can confirm is that the matter is still being investigated … we believe there is a case that needs to be answered. We will not be able to share any additional information.” They are trying to get more evidence and if they do, “the case can be reinstated”.
Meanwhile, spokesperson for Northern Cape Health Lulu Mxekezo also confirmed the two officials had returned to work in January.
“The internal human resources procedures have been followed,” was all she would say.
Thirty months and no permanent HoD
The Public Service Act states a vacant post must be filled within six months and someone cannot be “acting” for more than a year. However, the Northern Cape Health Department has now been without a permanent HoD for more than 30 months.
The department last had a permanent HoD in July 2020 – Dr Steven Jonkers, now working as a deputy director-general in the Office of the Premier. Jonkers is also facing corruption charges.
The Hawks had previously alleged that Jonkers fraudulently awarded a security tender for the department to Defensor Electronic Security Systems for an amount exceeding R384m between August and October 2017.
This week, Hawks spokesperson in the Northern Cape Captain Tebogo Thebe told Spotlight that Jonkers’ case would go to trial in the Northern Cape High Court (Kimberly) from 6-21 March this year.
Director-general of the Northern Cape Government Justice Bekebeke said Jonkers has not been suspended because they are awaiting the outcome of the court case.
“In the meantime, he has positively contributed (through) the execution of his duties in the Office of the Premier and the province,” she says. She added that the Premier evaluated the charges against Jonkers and didn’t deem suspension necessary.
Meanwhile, Theys did not return to the acting HOD position but is now back in his former position as provincial medical director. Gaborone took up his old CFO post.
Riaan Strydom has been acting as HoD since Theys was suspended in March 2021.
Mxekezo told Spotlight the recruitment and appointment of a HoD is the responsibility of the Premier’s Office, and would not be drawn on the progress of recruiting and appointing a permanent HOD.
In March last year, Bronwyn Thomas-Adams, NC Premier spokesperson, told Spotlight the recruitment process of a new HoD was in its “final stages”. Last week, however, she said: “The recruitment process for a HoD is under way and we expect a permanent head to be appointed in a month or two. It took so long because we had to organise the right panels and ensure everyone is available at the same time.”
Concerns mounting
Like other provinces, Northern Cape Health is beset with several serious challenges, including staff shortages, public health infrastructure issues, and problems with patient emergency transport services. Not having a permanent HoD in the most important health administration post in the province is not helping, say organised labour and opposition parties in the province.
“In the end, it will lead to the suffering of healthcare services,” says Denosa provincial secretary Andrew Vassen.
“Riaan Strydom has embarked on various service delivery improvement programmes with the MEC, but all efforts could be of no relevance should a new HoD be appointed tomorrow,” said Vassen. “Having no permanent HoD is putting a strain on healthcare services. The department is running like a headless chicken where it is uncertain whether a plan – good or bad – will be implemented if a new head is appointed.
“The inconsistency of not having permanent senior managers has a bad influence on service delivery.”
Vassen said Denosa was now working with the department on an organogram. “It is not only the HoD who is acting. So are many chief directors and senior managers. These things are delaying the process of appointing more staff and improving the infrastructure of facilities.”
As of September last year, there were 17 vacancies in key senior management positions in the provincial Health Department, according to a response to a written parliamentary question posed by DA MP Michele Clarke.
Among those were: deputy director-general; chief director, Office of the MEC; chief director Robert Mangaliso Sobukwe Hospital, chief director for priority programmes, chief director for district health services, chief director for corporate services, chief director for provincial hospital services and EMS, chief director for strategic planning and analysis, director in the office of the DDG (DDG position also vacant), director facility planning and maintenance, director quality assurance, director rehabilitation, director financial accounting, director maternal, child, youth and women’s health and nutrition, director communicable diseases, director human resources, and director legal services.
In April last year, the DA recorded the Northern Cape as having a medical specialist post vacancy rate of a staggering 46%.
Wynand Boshoff, provincial leader of the Freedom Front Plus, said it was the people depending on public health services who suffered most from inadequate top management.
“There was joy when the previous HoD and CFO were arrested for corruption for the acquisition of PPE equipment during Covid-19. Acting HoD Riaan Strydom was generally well accepted and our sources within the department praise his work ethic. However, acting in a position is always an impediment to doing great work,” Boshoff said.
The DA Northern Cape spokesperson for health Dr Isak Fritz said the department was in critical need of stability that could only come with stable management and the firm decision-making powers accompanying a fixed appointment.
“That government continues to drag its feet in this appointment is concerning. The quality of health in the Northern Cape continues to decline. Emergency medical services are hampered by a lack of operational ambulances and emergency practitioners, the province’s only tertiary facility Robert Mangaliso Sobukwe Hospital has a growing surgery and treatment backlog due to limited operational theatres because of serious nursing shortages, and the districts have severe staff shortages and shortages of life-saving equipment,” he said.
No consequences?
The opposition parties are also concerned about the return of Theys and Gaborone.
“The charges faced by these officials relate to irregularities in PPE and are serious. What is disturbing is that the department does not seem to have instituted any further internal disciplinary procedures against them, other than their suspension with full pay,” says Fritz.
“Now they welcome them without any mention of internal investigations. Given the deep-seated rot within this department, it is worrying that both Theys and Gaborone return to influential senior management positions as if nothing has happened.”
Although the department claims HR processes were followed for the return of Theys and Gaborone, Theys told Spotlight there were no internal processes against him. Mxekezo did not respond to follow-up questions to clarify this.
See more from MedicalBrief archives:
Second set of fraud charges but Northern Cape Health official still working
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DA: More than 21,000 specialist medical posts vacant, reaching 46% in Northern Cape
AG warns urgent intervention needed to prevent provincial health collapse
Northern Cape doctors protest working up to 180 hours a week