MTN last month joined the list of service providers to temporarily withdraw services because the Eastern Cape Department of Health failed to pay its bills, hard on the hells of oxygen/gas provider Afrox threatening to suspend supply of its lifesaving products unless its account was settled.
Chief sustainability and corporate affairs officer at MTN SA Jacqui O’Sullivan declined to comment and referred Spotlight to the Health Department, writes Luvuyo Mehlwana.
Provincial Health spokesperson Yonela Dekeda said MTN has been contracted to provide telecoms services to the department since December 2021: she admitted money was owed but declined to reveal how much was due.
Spotlight understands that a payment agreement has since been reached and services have been restored.
The non-payment of suppliers is ongoing. These include contractors who provide critical services like oxygen provision, surgical consumables such as orthopaedic implants, and theatre equipment.
Spotlight also previously reported on a strike of security companies after non-payment.
‘For the sake of patients’ lives’
In June, Eastern Cape Health MEC Nomakhosazana Meth said the department owed R4bn to suppliers of medicines, as well as implants, equipment, oxygen, and anaesthetic gases.
Her department would not be able to pay all of its debts due to limited funds meant for goods and services, she said at the time.
“The department will keep negotiating with sister departments and defer payments that are likely to arise as a result of equitable share depletion. An unaudited payment of R3bn was paid in April and will be audited by 31 July 2023. The department will pay major suppliers from the conditional grant and equitable share portion of the budget who render services within its ambit,” she had said.
“Where the equitable share portion gets depleted, the department will negotiate with suppliers to continue supplying the service, for the sake of the patients’ lives. Where the suppliers only fall under the equitable share portion, it will pay the minimum from the available portion and continue to negotiate for the uninterrupted supply of services.”
At the same time, during her budget speech, Meth said that of the R28bn budget, just more than R7bn is allocated to goods and services, and 68% – about R19bn – for employment costs. All in all, 82% of the total budget is for “direct patient and health services”.
Owing billions
But DA MPL and spokesperson for health in the Eastern Cape Jane Cowley slammed the poor financial management. “How can it be that a department must beg for extended credit to ensure patients don’t die?” she asked.
“About R28bn has been allocated to the department this financial year and only 9% (about R2.53bn) will be set aside for goods and services like telecoms services, surgical consumables, and more importantly, life-saving medicines and equipment.”
She said the already limited budget is not efficiently spent. “Of the R23.38bn left after accruals are deducted, salaries take up 81% of the remaining budget.” This adds up to R19bn, yet, she said, “critical medical posts remain vacant”.
As in other provinces, the Eastern Cape is dealing with the fact that salary increases in the sector in recent years have not been matched by equivalent increases in health budgets.
Cowley said almost 17% of this year’s R28bn health budget allocation should pay off debt from previous years.
“This comprised only a small percentage of their accruals, which amounted to R4.7bn. Several small and medium suppliers have cut their losses. Some have had to close their doors. Bigger companies have adopted a zero-tolerance approach to carrying this outstanding debt, in some cases for years, and are now taking action,” she told Spotlight.
She had written to Health Minister Dr Joe Phaahla “to highlight the catastrophic impact of this poor fiscal management and maladministration on the most vulnerable in society, the patients who depend on this department for their health and well-being”.
‘No health facilities affected’
Dekeda said the impact of MTN temporarily pulling the plug on telecoms was limited to officials and “no health facilities were affected”. She said only officials’ mobile telephones were suspended by MTN on 11 August.
“But when this suspension was escalated to the Accounting Officer (Superintendent-General of the Health Department), there was an engagement with the CEO of MTN to ensure the restoration of the service. No health facilities were adversely affected by this, only official cellphone users,” she said.
“There were contingencies … the department has Telkom for landlines, a push-to-talk system, and Telullars (a wireless terminal) for officials who must work over the weekends. This is part of our system to promote business continuity in the event of a breakdown of the official cellular system.”
She said the suspension of the accounts over that weekend affected all employees in the department in possession of official cellphones. “There were no adverse events reported, as this happened over the weekend. The department diligently worked around the clock with MTN to resolve the issue… telephone lines are confirmed to have been restored.”
However, that same week Spotlight called several health facilities, including Madzikane ka Zulu Memorial Hospital in Alfred Nzo District, Aberdeen Hospital in Sarah Baartman, Madwaleni Hospital in Amathole, and Frere Hospital in Buffalo City to check if calls went through. This was after some healthcare workers and residents alerted Spotlight to difficulties with some phone lines.
Several calls to landline phones did not go through or were directed to reception before being dropped, while at some hospitals, there were recorded automated messages on switchboards that said, “Phones were not serviced”.
Spotlight has not been able to establish whether or not these issues (and those described below) were caused by the MTN situation or something else.
Dekeda insists no facility was affected by the MTN suspension.
On 16 August, a reliable source at a referring hospital told Spotlight Cecilia Makiwane Hospital and Frere Hospital lines were down. The source confirmed that cellphones had also previously been affected but were working again on 15 August.
“We were working at Frere with no landlines. There are two cellphones at the switchboard and that is how we reach Frere,” the source said.
“Other than that, the various departments at Frere have shared the doctors’ numbers on call so doctors are talking directly to them. It very frustrating when making a non-urgent appointment for a patient as we usually phone the landline and speak to a nurse in the department who has an appointment book.”
See more from MedicalBrief archives:
Eastern Cape Health: R3.8bn in unpaid bills and R37bn in legal claims
Hospital staff who refused to be reallocated get R67m for doing nothing
Eastern Cape hospitals flounder under surgical backlogs and massive debts
EC Health Department ordered to pay overdue bills for orthopaedic implants