Eastern Cape Health MEC Ntandokazi Capa has failed to appoint CEOs for major state hospitals within the first six months of her term, as promised. Only one appointment was made – for Dora Nginza Hospital in Nelson Mandela Bay.
Her former spokesperson MK Ndamase, who left the employ of the Eastern Cape Department of Health last Friday, had refused to comment on the issue since November 2024, saying the MEC would “provide an update” when the six months were over.
Last week, department communications director Siyanda Manana, who said he was temporarily filling in for Ndamase, confirmed no appointments had been made, except for a CEO at Dora Nginza Hospital.
He blamed prospective CEOs for turning down the posts and the department’s financial burden from medico-legal claims, reports Daily Maverick.
One of the major instituions in the province, Livingstone Tertiary Hospital, has been without a permanent CEO since 2018, although three years ago, the department announced an appointment was “imminent”.
“That post is still vacant…there is still an acting CEO. The department is going to headhunt to fill it,” Manana said.
The department has, however, announced the appointment of Professor Akhter Goolam Mahomed as the head of internal medicine and clinical domain medicine at Livingstone Hospital, a position which has been vacant for six years.
For the first time in six years, all departments at the hospital have permanent leadership. The hospital’s head of clinical governance, Dr Stacey Rossouw, resigned in November, as did several specialists.
The two other tertiary institutions, Frere Hospital in East London and Nelson Mandela Academic Hospital in Mthatha, do not have permanent CEOs. The department also has an acting chief financial officer after the resignation of Msulwa Daca last year.
During her policy speech in August 2024, Capa said: “We have an obligation that the Department of Health has a stable leadership and administration. With the executive council intervention in the Department of Health, we commit to stabilise critical leadership positions like the chief financial officer, and chief executive officers for all identified hospitals within six months.”
She has kept to her commitment that the department conclude all matters related to commuted overtime and institutionalise co-ordination and the management of overtime in all areas.
Manana confirmed the department was busy with a wide audit to identify and stop all overtime payments to non-qualifying personnel.
However, it cannot make further overtime payments this financial year and has indicated that it will continue doing so – with catch-up payments – in April, he said.
Financial strain
In a letter to employees recently, the provincial Health HoD Dr Rolene Wagner listed the department’s financial woes. She said an intervention was being implemented because it was even finding it difficult to pay for lifesaving needs like the blood bank, laboratory services, medical gas and medicine.
“The intervention with the Office of the Premier, provincial Treasury and the National Department of Health includes means to begin addressing the historic debt, however, in the meantime… it is increasingly difficult to pay for non-negotiables like National Health Laboratory Services, Afrox, the South African National Blood Services and medicines and medical supplies.
“Payment arrangements have been made with most of these suppliers, as with other creditors, like municipal and security services, facilities maintenance services and telecommunications services.”
The department has faced the same problem for several years. In 2024, an unpaid Telkom bill of R36.5m shut down emergency medical services.
Contingency plans had to be made to switch the ambulances to a cellphone system over the Easter weekend.
Wagner’s letter echoed the findings of the Auditor-General for the 2023/2024 financial year.
Capa, however, came into office only in August last year.
“Although negligence claims decreased by R2.59bn from last year, their impact remains significant as the department cannot fully budget for them,” said the AG’s report.
“In 2023-24, claims of R339.93m were paid from funds budgeted for service delivery, contributing to … overspending by R294.90m.
“These claims, with increasing employee costs and poor financial management, threaten … financial sustainability and hinder its ability to fill critical vacancies and procure essential medical equipment, delaying improvements in primary healthcare quality.
“In driving accountability, we notified the accounting officer of a material irregularity due to inadequate payment practices that resulted in salary increases and back pay to medical officers who did not qualify for such.”
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