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Northern Cape Health drowning in debt, corruption, inefficiency

The Northern Cape Health Department is in a dire state – its own annual report pointing to gaps in service provision; a third of its budget being swallowed by medico-legal claims, while it continues to grapple with numerous corruption allegations.

Currently, reports BusinessLIVE, a security contract worth a whopping R380m is at the centre of a trial in the Kimberley High Court, where three men stand accused of defrauding the provincial government.

The National Prosecuting Authority (NPA) says former provincial health department head Steven Jonkers and Defensor Electronic Security Systems directors Gert van Rooyen and Claudius Peterson allegedly flouted the rules of the Public Finance Management Act in the tender process. In addition, Defensor wasn’t registered with the Private Security Industry Regulatory Authority, as required under tender regulations.

The defendants have denied the charges, but earlier this month the court quashed their request to be discharged from trial after Defensor’s bid documents were allowed into evidence.

The contract’s value is substantial, considering the department’s budget for the 2023/2024 fiscal year is R6.1bn. So R380m, which equates to 6.2% of the funds, is almost 90% of the R425m budgeted for emergency medical services in the province.

Additionally, a chunk of that budget is already swallowed by medical negligence claims.

“The medico-legal contingent liability amounts to R2.1bn comprising 93 active cases,” health MEC Maruping Lekwene told the provincial legislature during his June budget vote speech. “Most are birth injuries, resulting in cerebral palsy.”

And last month, nine top department officials were arrested and arraigned after being linked to personal protective equipment (PPE) fraud involving R16m.

In that matter the NPA’s Asset Forfeiture Unit obtained a preservation order against health department head Dion Theys, CFO Mosimanegape Gaborone, supply change management director Montgomery Faas, deputy finance director Victor Nyokong and five others.

In the case of co-accused Kenyaditswe Visser, director of MKV Investment – the company that provided the PPE – the NPA seized a R4.4m Kimberley house and a 2015 Bentley Continental.

All have denied the charges, and Visser is opposing the preservation order, says NPA regional spokesperson Mojalefa Senokoatsane.

Theys was transferred this month to the position of medical director in the health department (Alastair Kantani was appointed acting department head to replace him). And Gaborone was moved to the provincial department of transport, safety & liaison as CFO.

The MEC said the move was made “to strike a balance between the protection of the image of the department, the rights of employees accused on charges relating to fraud and corruption of PPE procurement, all competing public interest, as well as any internal investigation that must unfold”.

It doesn’t end there.

In May, former provincial public works head Patience Mokhali, Tshegolekae Motaung, owner of Babareki Consulting Engineers, and disgraced former finance MEC John Block appeared in court on charges of fraud, corruption and money-laundering related to the construction of the Kimberley psychiatric hospital, worth R51m.

The development has been mired in controversy, with local media reporting some buildings had to be demolished and rebuilt due to poor workmanship.

The 2003 contract for the hospital was granted by the department that was then headed by Block, now serving a 15-year sentence for various property-related frauds in the province a decade and more ago.

Amid all this, public health services are suffering in the province, with frequent stockouts and a lack of trained staff at clinics.

By the health department’s own admission, only 23 (14%) of clinics in the province were ready for National Health Insurance accreditation in 2021/2022 – down from 35% the previous year. That’s according to its annual report, which cites “dilapidated infrastructure” and the “non-calibration of essential equipment” as reasons.

Looking at district hospitals, the reports states that maternal deaths in these facilities jumped to 107 out of 100 000, against 74.9 the previous year. (The national average is 109, according to the national health department.)

Reasons include a “lack of basic essential equipment”, including blood pressure apparatuses and haemoglobin machines, late referral to the two regional and tertiary hospitals in Upington and Kimberley, and inadequate emergency medical services.

Even immunisation rates in the province are in decline. The percentage of children under one who were vaccinated in 2021/2022 was 72.2%, against 79.9% the previous year and a target of 88%. The WHO puts the national rate at 85%-91%.

Due to the remoteness of many rural communities, mobile clinics were, for many years, a first line of defence, immunising children and delivering chronic medicine to those in outlying areas. Now, says a retired nurse, “the mobile clinics don’t run as often as they did”.

Given what at least on the surface appears to be squandered funds, it is no wonder that the department received a qualified audit opinion – again – in 2021/2022.

For one, the auditor-general “was unable to obtain sufficient appropriate audit evidence for basic salary included under compensation of employees”. In other words, the department apparently couldn’t provide the requisite information on its own payroll.

Also, it didn’t know the precise extent of its contingent liabilities, which include medico-legal claims.

The department also did not provide proof related to the R315m it owed creditors, suggesting it could pay creditors without proof of service delivery, nor could it prove the R1.36bn in movable tangible assets, the audit report said.

2022-northern-cape-health-annual-report

BusinessLIVE article – A sick state of affairs in the Northern Cape (Restricted access)

 

See more from MedicalBrief archives:

 

Senior Northern Cape Health officials back in court over PPE tender

 

Northern Cape buckling under financial stress and no full-time HoD

 

Ex-Northern Cape Health HoD fined for irregular R13m lease deal

 

Northern Cape sitting with R2.1bn medico-legal claims

 

 

 

 

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