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Sunday, 16 February, 2025
HomeA FocusUnspent R250m cancer treatment funds returned to Treasury

Unspent R250m cancer treatment funds returned to Treasury

Gauteng Health has attempted to justify its failure to spend R250m that was allocated for cancer treatment saying the situation is “not as urgent” as it is being made out to be. But in a blow to patients, the department has to hand back the money it was given by the provincial Treasury – because it did not spend a cent of it.

The revelation from the department’s latest court documents filed in the Gauteng High Court (Johannesburg) has dashed the hopes of thousands of desperate people who have been awaiting treatment, reports the Sunday Times.

The R250m was the first tranche of a special R784m commitment from the Treasury to help clear the backlog by outsourcing treatment to the private sector. It was paid out in March 2023 and forfeited at the end of the financial year on 31 March 2024.

The Treasury has subsequently paid the second tranche, R261m, which the department must use or lose by 31 March 2025.

The Cancer Alliance and SECTION27 had asked the court to compel the department to spend the money and clear the backlog of patients awaiting treatment, specifically, cancer sufferers who have been waiting for treatment for between 18 months and three years.

About 3 000 state patients are waiting for treatment at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital in Pretoria.

A frustrated oncologist at Charlotte Maxeke told the Sunday Times there was some hesitation among state doctors regarding outsourcing cancer treatment.

“I am not a fan of government and its bureaucratic processes and bungling, but there are huge complications in this situation. I had misgivings about outsourcing services because of the danger that private service providers could see us as this massive cash cow.

“The cost of an average patient’s treatment at Charlotte Maxeke would be around R15 000 to R20 000. Then you get these guys in private healthcare telling us they can provide that treatment, but for a cost of around R150 000,” he said.

“Charlotte treats about 4 000 cancer patients a year, so if you want to do that privately you’re looking at about half a billion,” he said.

“That’s something we could do ourselves if there were budget. For two linac accelerator machines (for radiation) with 10-year maintenance contracts, you’re looking at R200m.

“The biggest frustration is that if you gave me about R100m I could fix the problem fast, the backlog would be gone and we could get down to our real work and start focusing on research and driving cancer treatment forward,” he said.

Other challenges included the fact that radiographers at public hospitals in Gauteng were paid less than those in every other province, and far less than radiographers at private hospitals.

“We have 20 radiographers at the moment, and we need 40. If someone could just approve pay increases, we could resolve that situation quickly.”

He said other problems included equipment breaking down and the bureaucratic process necessary to get it repaired, and non-functioning air conditioning resulting in the need to shut down linac accelerator radiation machines as they had to be kept cool.

In the legal battle, Cancer Alliance also wants the court to declare that Gauteng Health acted unlawfully and unconstitutionally by failing to devise and implement a plan to provide radiation and oncology services to patients on the backlog list.

It has asked the court to order the department to outsource radiation and oncology services, interdictory relief aimed at preserving the forfeited R250m, and supervisory relief requiring the department to deliver updated progress reports and its long-term plan regarding the allocation of treatment to patients at Maxeke and Biko hospitals.

The admission by the department about the forfeiture appears to contradict its early claims in court papers filed in July and again in October, in which it said the process of outsourcing treatment to private healthcare providers was “under way”.

The Cancer Alliance questioned why the department did not mention the forfeiture in its earlier papers. “The department chose not to disclose this, even four months after the money was forfeited. It told the court the money was to be used to provide services, knowing that it had already been forfeited.

But the department claims the situation is “not as urgent” as the Cancer Alliance makes it out to be. It says it has a solution that is being implemented and that the organisation’s legal action is an attempt to “run the department from the outside”.

“It is not up to (Cancer Alliance) to determine how such treatment is to be administered, when and by who,” said head of department Lesiba Malotana in court papers, admitting, however, that “the entire R250m was unspent and returned to the provincial Treasury”.

“There is no R250m that is in the possession of the department at this stage.”

He said the money was unspent because they were still busy with tender processes relating to the outsourcing of services – and that during this time, patients would continue to be treated internally “as determined by the clinicians on site every day”.

The second tranche of money would therefore be spent “as long as the department is able to have commitments in the form of purchasing orders before the end of the 2024/25 financial year”.

He said appointments had already been made and “details will be thrashed out in the service level agreements being negotiated and concluded as we speak”.

In July, Malotana told the High Court the department had advertised tenders for three categories of cancer treatment, that two had been withdrawn, and the third – for “planning services” worth R17.48m – had been awarded to Siemens for 2 000 plans at R8 740 per plan to be carried out from May 2025 to next April.

He said Siemens was to invoice the department for planning in batches of 100, but because 100 patients had not yet been treated, no invoice had been received.

Judgment in the matter has been reserved.

Health Department spokesperson Motalatale Modiba called the legal challenge a “deliberate and desperate attempt to conduct a trial in the court of public opinion on a matter that is under consideration by the court”.

The DA, however, is calling for Nkomo-Ralehoko to be fired over the non-spending.

"The urgency is that there are about 3 000 cancer patients waiting for radiation treatment, which should be done within 60 days of surgery or chemotherapy, and no later than 90 days, to destroy remaining malignant cancer cells," DA health spokesman in Gauteng Jack Bloom said in a statement on the party's site.

"I estimate that hundreds of cancer patients have needlessly suffered and died because of the outrageous delay in spending the available budget. This is as big a scandal as the Life Esidimeni disaster in which 144 mental patients died after they were sent to unsuitable NGOs.

"This is why the ANC stalled my motion of censure in the Gauteng legislature against the Health MEC for her failure to work with cancer interest groups to ensure speedy treatment to save the lives of cancer patients."

Premier Panyaza Lesufi should fire Nkomo-Ralehoko and appoint a competent Health MEC to save the lives of hundreds of cancer patients and fix the endemic problems in our public hospitals, Bloom said.

 

Sunday Times PressReader article – Cancer patients lose R250m (Open access)

DA statement

See more from MedicalBrief archives:

 

Gauteng Health accuses Cancer Alliance of interference as case postponed

 

Cancer Alliance research: Gauteng state hospitals’ failures hamper treatment

 

Gauteng Health sued over unspent cancer millions

 

Activists march for unused R784m to be spent on cancer patients

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