Former head of the Eastern Cape Department of Health Dr Rolene Wagner returned to the position this week after intervention from the Office of the Premier in efforts to keep the ailing department’s head above water.
Her return as HoD came on the heels of a meeting between high-ranking officials from the National Department of Health (NDoH), National Treasury, Office of the Eastern Cape Premier and Eastern Cape Department of Health, and clinical staff and hospital managers to discuss how to save the collapsing dfepartment.
In the previous financial year, the department had declared R6bn in unpaid bills, almost wiping out its operational budget (excluding the cost of employment), reports Daily Maverick.
Premier Oscar Mabuyane removed Wagner from her job last year, despite protests, and to the dismay of provincial health professionals, claiming he was setting up a “special projects” team to deal with problems in the department. Two senior officials were appointed to act in her position, but the upshot was more dysfunction.
The Office of the Premier has ignored all requests to detail any achievements by the special projects team.
At the time of her sidelining, more than 100 CEOs, doctors, scientists, medical specialists and professors had written to Mabuyane, pleading with him to reverse his decision, reports News24.
In their letter dated 28 September, they described her as “known and respected … for her leadership of strengthening and turnaround strategies in the health sector, particularly in the Eastern Cape, which have earned her and her team numerous accolades and awards”.
Beleaguered department
By July this year, supplies of medical basics like syringe needles were out of stock in provincial health facilities, and just before the Easter weekend, the department had to set up alternative lines for emergency services after landlines to health facilities and EMS services were cut off when the phone bill wasn’t paid.
In November, the Auditor-General again flagged the department for “material mis-statements” in its financial statements due to “significant internal control deficiencies”.
The department’s chief financial officer, Msulwa Daca, resigned in May.
In this past week, and before the announcement of Wagner’s return, the province had been visited by high-ranking officials from the NDoH, the national and provincial Treasuries and Mabuyane’s office.
Eastern Cape Health communications director Siyanda Manana had denied the department was being placed under administration.
Stable
In announcing the return of Wagner as HoD, the department said this would “go a long way in stabilising leadership”.
Welcoming Wagner back, Eastern Cape Health MEC Ntandokazi Capa thanked the Premier, and also thanked Sindiswa Gede and Miyakazi Nokwe for holding the fort during Wagner’s secondment.
The Rural Health Alliance also welcomed her back.
“Her work before her removal from the position stands testament to what can be achieved under her leadership – to name a few, the strategy to reduce medico-legal expenditure saved the department around R1.5bn; the roll-out of the digital health record system to more than 20 hospitals; the roll-out of three EMS (emergency medical services) units; and the strategies to address funding limitations to allow vacant posts to be filled.
"While the task ahead is still daunting, it is reassuring to know she is back at the helm … we would like to support her by providing insights on key issues pertaining to rural areas,” the alliance’s Samantha Maughan told News24.
The Rural Health Advocacy Project, a division of Wits Health Consortium that promotes fair and equal access to quality healthcare in rural communities, said Wagner and her leadership team would require increased managerial autonomy.
“Many of the province’s challenges related to cash flow and the department’s request to have the medico-legal claim expenditure condoned will help free up cash.
“We need to unite behind a common plan to improve service delivery,” the organisation said.
Sivuyile Mange, Eastern Cape chairperson of the Democratic Nursing Organisation of South Africa (Denosa), said the reassignment of Wagner had not been a good move.
“We have since been faced with instability in that (HOD) office – which we believe is key implementing the department’s strategic plan.”
Wagner said she was happy to be back, and “conscious of the huge responsibility that goes with my release back to Health”. She added that she was overwhelmed and humbled by the messages and calls for her return.
Premier promises
The road ahead for this able HoD will not be an easy one, in a department and system riddled with flaws, and despite numerous commitments from the Premier in his State of the Province speech, the reality is that these still need to be fulfilled.
In his speech, Mabuyane had said: “We are enhancing our electronic health records and data management systems to prevent incidents leading to medico-legal claims, investing in the leadership of our healthcare facilities so they can manage efficiently and effectively. In the past five years, we completed major health infrastructure projects…
“We continue to capacitate facilities with personnel and EMS vehicles …In the past four months, we delivered more than 100 emergency vehicles and mobile clinics … to ensure timely medical intervention to save the lives of our people.”
However, he failed to point out that these were replacement vehicles and that the province still fell short of basic minimum standards relating to the provision of ambulances.
See more from MedicalBrief archives:
Corruption-busting Eastern Cape Health HoD sidelined by premier
Top health experts rally behind ousted Eastern Cape Health boss
Eastern Cape hospital crisis worsens as supplies of needles, oxygen, dry up
Eastern Cape hospitals flounder under surgical backlogs and massive debts