Posted on

The DA to seek legal advice on the NHI rush job which seeks to nationalise healthcare

If the ANC government continues to push through the National Health Insurance (NHI) Bill, without proper public participation and consultation – the Democratic Alliance (DA) will seek legal advice regarding the highly irregular process followed in revising the NHI Bill. This follows an announcement by presidential spokesperson Khusela Diko that the NHI Bill will be tabled before cabinet next week.

Minister of Health, Aaron Motsoaledi is more determined than ever to push through the National Health Insurance scam, by side-stepping public participation processes and consultation with Treasury and Health Department officials. The Minister’s backdoor dealings subsequent to the closure of public comment period, effectively mutes any input from the public, as the proposed changes are substantive, and the public and other stakeholders have not had an opportunity to raise their concerns.

The NHI Bill in its original form and even more so in this revised form will do nothing to address the collapsing healthcare system. It is a blatant attempt to nationalise the private healthcare system and to remove funding and functions from provincial departments.

The wave of electioneering has clearly reached the policy development realm in the ANC, casting aside the long-term sustainable solutions for quick political wins, no matter the cost.

The DA has launched a plan for universal healthcare in South Africa, which we have titled Our Health Plan (OHP). We believe our offer is the most credible and workable option that seeks to ensure that no person is denied quality healthcare because they are poor.

The revised National Health Insurance Draft Bill should be made public and the public participation process should be immediately reopened. The dodgy revised Bill would put the needs of South Africans on the backburner yet again, the DA will not allow this to happen.

Only the DA has a workable healthcare plan that will speed up the provision of quality healthcare to all South Africans. Now is the time for change that builds One South Africa for All.

Posted on

Minister of Health confirms Western Cape has best doctor-per-person ratio

In a reply to a DA parliamentary question, the Minister of Health, Aaron Motsoaledi, has revealed that the DA-run Western Cape has the highest doctor-per-resident ratio in the country. At one doctor for every 553 people in the province, it is more than five times the ratio in Limpopo.

Meanwhile, Minister Motsoaledi is on his healthcare crisis denial tour, promoting the National Health Insurance (NHI) as the solution to health issues in the country, blithely ignoring the self-evident fact that NHI is completely silent on how the government plans to fix the current broken and collapsing health care system.

The World Health Organisation (WHO) advocates for a ratio of 1 doctor to every 1000 people. Currently, only the Western Cape and Gauteng (791) have ratios that meet this criteria with a current national average of 1,118.

The worst performing provinces are Limpopo (2,924), North West (2,389), Mpumalanga (2,221) and Eastern Cape (1,860).

Whilst the Department of Health’s figures include both public and private sector doctors, it is important to note the recently gazetted National Health Insurance and the Medical Schemes Amendment bills will impact both the private and public sector through price controls, and thus risk prompting an exodus of medical professionals. This will only exacerbate the current problem.

In another Parliamentary reply, Minister Motsoaledi revealed that 110 healthcare facilities in the Eastern Cape do not have access to electricity. The lack of electricity at these facilities is not only a safety concern for patients but also demonstrates the breakdown in service delivery more generally in the ANC-run province.

The DA has proven that we can run a healthcare system within the current budget that performs better and attracts healthcare professionals. While the NHI fails to address the current crisis, the DA’s Our Health Plan works in practice in the Western Cape, whereas the NHI pilot projects have failed dismally.

 

 

Posted on

#HealthcareCollapse: Public Hospitals have become a death-trap for the poor. Time for drastic action

Over the past month, the DA embarked on a countrywide oversight inspection of Public Hospitals and Clinics as part of our #HospitalHealthCheck campaign. Our aim was to assess the real conditions and quality of care at public health facilities.

This campaign highlighted a sobering reality that the counrty’s health system is teetering on the brink of total collapse. Public health facilities are no longer places of healing, they have become death-traps for the poor, who have no other options available to them.

The Minister of Health, Dr Aaron Motsoaledi, continues to downplay the severity of the countless crises in our public health sector. This is the worst form of denialism, as countless South Africans have lost their lives due to the poor health conditions available to them.

The ANC government has failed the poor and vulnerable by subjecting our people to inhumane and degrading healthcare services. It is now clear that neither the Minister nor the ANC government, have the apatite to turn things around.

It is for this reason the DA embarked on the #HospitalHealthCheck oversight campaign – to bring to light the suffering of the sick at the hands of the ANC. Among the myriad of issues we identified throughout the provinces, there were 8 areas that were particularly alarming to the DA:

  • Chronic Staff Shortages and Long Waiting times

Hospitals and clinics are plagued by long waiting times for patients, this can be directly linked to the chronic staff shortages which have also led to the neglect and even deaths of many patients. All the facilities we visited lacked staff in critical positions.

During our inspection of the Bongani Hospital in the Free State, we found that the facility only had one nephrology Sister to attend to patients suffering from kidney diseases. This, despite health Norms and Standards indicating that hospitals should have 9. We also found that there are only 4 porters available to service the whole hospital.

While inspecting the Pediatric Ward in Taung District Hospital in North West, the DA found that there was no qualified resident paediatrician to treat children and that the ward is severely understaffed, from nurses, cleaning staff and cooks.

Tembisa Hospital in Gauteng only has 40% of the nurses that are required. According to international Norms and Standards, the hospital should have at least 628 more nurses to provide proper health services to patients.

The Soweto-on-Sea Clinic in Port Elizabeth is only visited once a week for four hours by a doctor while the clinic services 3 000 patients per month. This was also mirrored in our visit to KwaZulu-Natal’s (KZN) St Mary’s and RK Khan Hospitals, where KZN’s Health Department has vacancies of 5 926 critical staff.

At the South Rand Hospital in Gauteng, the benchmark waiting time for medicines is supposed to be 40 minutes, but most patients said they wait two hours and sometimes much longer.

  • Equipment shortages

One of the key system failures that have been identified by the DA is the purchasing and maintenance of medical equipment. Medical devices and equipment are essential for the diagnosis and treatment of a wide range of medical conditions.

During our inspection of RK Khan Hospital in KZN, the DA found that the X-ray department still has no defibrillator despite us having alerted MEC Sibongiseni Dhlomo in 2014 that it was broken. This is a busy hospital where the need for what is a potentially life-saving piece of equipment is critical.

Children at the Pediatric Ward in Taung District Hospital in North West are also at risk of continual infection, as there is currently no isolated ward and basic equipment to control infections.

At Bongani Hospital in the Free State, the hospital has 9 theatres but only 3 are operational due to ineffective equipment. The renal plant has not been operational since its inception. The hospital relies on mobile Reverse Osmosis machines, which means they can only assist 8 patients a day. Had they focused on operationalising the renal plant they would have been able to assist 28 patients a day.

  • Oncology Crisis

President Cyril Ramaphosa has promised action with regards to cancer treatment. This promise was not realized as there is not a single radiation oncologist in Limpopo or Mpumalanga. In fact, half the country’s provinces may be relying on just nine radiation oncologists in Gauteng as cancer services in five provinces buckle. In contrast, the Western Cape has 16 cancer specialists in the Public Sector.

While inspecting the RK Khan Hospital in KZN, we learned that waiting times for CT scans are as long as three months while the next available mammogram appointment is in 2019. This waiting period has had a huge impact on patient care as only “possible cancers”, those that can be surgically treated or are in early stages given priority.

  • Shortages of consumables and medicine

At both hospital and clinic level, there are serious concerns over the lack of availability of medicines, vaccines and consumables. This hampers the efficient functioning of facilities and the safe treatment of patients.

While inspecting various Hospitals in Nelspruit and Barberton in Mpumalanga, Emergency Medical Care personnel told the DA that they have resorted to buying vital medical equipment such as high blood pressure machines out of their own pockets due to the department failing to provide such equipment.

In the Northern Cape at the Kimberly Hospital, procurement is done at the provincial office, which is out of touch with the actual needs of the hospital. This results in a shortage of basic supplies such as toilet paper and often results in the purchase of inferior supplies, such as surgical gloves.

For the past two months at Maphutha Malatji Hospital in Limpopo, the pharmacy has not had an Iron supplement drug, a vital medicine for pregnant women and HIV patients as well as Panado Syrup – a pain-killer for children.

While at St Mary’s Hospital in KZN, doctors and nurses complained of shortages of simple and everyday disposables such as syringes, needles and “jelcos” which are used for intravenous access to set up drips.

  • Negligence and claims

Furthermore, medical negligence claims have led to large payouts which have put a strain on the health budget.

Currently, medico-legal claims run in the billions. Last year, the Gauteng Health Department had R18.6 billion in negligence claims, Eastern Cape had R16.7 billion and KZN had over R9.2 billion. In comparison, the Western Cape Department of Health has R135 million in claims lodged against it.

The DA’s oversight inspection to Maphutha Malatji hospital in Limpopo shockingly revealed that of the approximately 230 babies born at this facility every month, an average of 28% (about 64) die.

  • Transport and Ambulance related issues

Access to health care is a particular concern given the centrality of poor access in perpetuating poverty and inequality.

In one of the hospitals that we inspected in Mpumalanga, we found that the area was allocated 4 ambulances but only 2 are operational. The other two weren’t operational due to mechanical problems. Many of the ambulances had travelled more than four hundred thousand kilometres and posed a risk to patients and medical personnel.

The inspection of St Mary’s Hospital revealed that the hospital does not have an onsite laboratory. The result is that patients are often taken into theatre without the necessary blood tests. According to staff, routine blood samples are taken to RK Khan Hospital, some 20 kilometres away, which has its own problems in terms of transport and delays in ensuring that tests are returned on time.

  • Infrastructure/Lack of Maintenance

Infrastructure is a major concern in the Health sector. The Department’s Annual Report shows that out of the 44 Community Health Centres which were to be constructed and revitalised, only 22 were completed. Out of the 8 hospitals that were supposed to be constructed or revitalised, only 3 were completed. The Department is not reaching more than half of its goals when it comes to infrastructure and this is very worrying, as the vast majority of South Africans have to suffer in inadequate health facilities.

No maintenance has taken place at the Bongani Hospital since it was built 20 years ago. Shockingly at our visit to the Schoemansdal Clinic in Mpumalanga, the toilets haven’t been working for a very long time causing embarrassment to both patients and staff. The pit toilet which is currently being used leaves an unbearable stench which is aggravated by rain.

  • Mental Health Crisis

Following the Life Esidemieni tragedy in Gauteng, government is yet again failing to stop future mental health tragedies in South Africa.

At Tembisa Hospital, psychiatric patients are kept for long periods of time as there are not enough beds for them at Weskoppies Mental Hospital – they should only be at Tembisa Hospital for 72-hour observation before they are discharged or sent to a longer-term facility.

While at Life Esidimeni in Limpopo; rather than increasing their budget to assist with the maintenance of the facility, a decision has been made to halt the funding of the non-profit and for the Limpopo Department of Social Development (DSD) to take over the management and functions of the centre.

Given the bad track record of the DSD in Limpopo, its financial constraints and record of mismanagement, every effort must be made to ensure that the mental health centre in Shiluvana remains in the hands of the of Life Esidimeni.

  • The DA’s Offer

The findings from our #HospitalHealthCheck oversight inspection campaign makes it clear that all is not well in our public health sector. Although there are financial constraints facing the Department, it is evident that at the heart of our failing health system is maladministration, poor oversight and the ANC’s disconnect with the vulnerable and sick South Africans.

Minister Motsoaledi’s National Health Insurance will not solve the mess that is the public health system. The NHI is not feasible, as seen with the disastrous pilot projects across the country.

The DA has launched our plan for universal healthcare in South Africa, which we have titled Our Health Plan (OHP). We believe our offer is the most credible and workable option that seeks to ensure that no person is denied quality healthcare because they are poor.

The DA’s mission as a national government-in-waiting is to guarantee universal health care for all South Africans.

Our Health Plan includes:

  • Faster delivery – Our Health Plan will provide quality healthcare to all within 5-8 years, whereas NHI will take 10-15 years to implement;
  • More affordable – Our Health Plan will provide quality healthcare which is affordable. It can be implemented using our current health budget. This would mean that medical aid contributions would no longer be tax deductible. The additional revenue would go to reducing the costs of medical aid. The NHI, on the other hand, is budgeted to cost up to an additionalR182 billion per year, which we simply cannot afford;
  • Fairer – By bringing the medical aid tax credit on budget, and allocating some of it to build better services in the public health sector, those with medical aid are cross-subsidising those without, an act of health justice; and
  • Works in practice – Many of the aspects of Our Health Plan have successfully been implemented in the Western Cape, and the results speak for themselves. The DA-run Western Cape Province has a track record of delivering better health care than any other province. For example, the maternal mortality rate in South Africa is 153 deaths per 100 000 live births, while the rate for the Western Cape is almost half that, at 84.

Our Health Plan is the most practical approach to universal healthcare, as it aims to keep what should be kept, fix what should be fixed, and smartly extend services that should be extended within the limits of the national purse.

Hospitals under DA governance will be places where people are cared for and lives saved; not places where people are abused and die.

There is a need for a more immediate solution to the health system which will save lives and provide decent services to people of South Africa. The #HospitalHealthCheck oversights have clearly showcased that the National Department of Health and Provincial Departments of Health have failed in their mandate to act and intervention is needed.

  • Strengthening Health oversight bodies to save lives

The Office of Health Standards Compliance (OHSC) is an independent body established in terms of the National Health Amendment Act of 2013 to ensure that both public and private health establishments in South Africa comply with the required health standards. While the OHSC monitors and evaluates health services in the health sector, it lacks the necessary statutory power to act against transgressors.

The current Health Ombudsman under the OHSC, can investigate and make recommendations to the CEO of OHSC. If the CEO does not pursue the case the Ombud can elevate the case to the Minister of Health. But as evidenced by the lack of action by the current Minister of Health, the DA proposes that the Health Ombudsman and the Public Protector coordinates to enact recommendations that are truly enforceable and independent.

  • Conclusion

The #HospitalHealthCheck has exposed both the current state of public healthcare in South Africa, as well the ANC’s failure to intervene and perform oversight in the collapsing health care system. Poor, sick South Africans do not have dignified access to healthcare because their government chooses to ignore their plights.

We are of the strong belief that the ANC government has not fulfilled its obligations in terms of Section 27 of the Constitution. Section 27(1)(a) states that “Everyone has the right to have access to healthcare services, including reproductive health care”.Subsections (2) and (3) go on furhter to say that “The state must take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of each of these rights; and No one may be refused emergency medical treatment.”

We have reported many of these cases to the Health Ombudsman Prof Malegapuru Makgoba, but we believe that the collapse of the health system requires wider and more direct intervention so the full scale of the problem can be uncovered with the mission of finding a lasting an workable solution.

We have therefore written to President Cyril Ramaphosa to estbalish a Judicial Commission of Inquiry into the Collapse of South Africa’s Healthcare System. See the letter here. The President is empowered to do so in terms of Section 84(f) of the Constituion. We also wrote to the South African Human Rights Commission (letter here), which oversaw hearings into the KZN Oncology Crisis, the Public Protector (letter here) and the Health Ombudsman (letter here) to throw their weight behind the establishment of a Judicial Commission. 

The DA has shown through our management of the Western Cape Health Department, our Health Plan and the strengthening of health oversight that better services are possible is in South Africa.

A change in government is ultimately the most direct way the people of South Africa can effect change in the heatlhcare system.

The DA will continue to expose negligence, inhumane treatment of patients and poor health services in our public healthcare facilities because of our people deserve access to quality health services irrespective of the socio-economic backgrounds.

Posted on

Gauteng provincial government should have prepared for Joburg hospital violence

Gauteng Health MEC Gwen Ramokgopa should have anticipated yesterday’s violence at the Charlotte Maxeke Johannesburg Hospital and put in extra security to prevent it happening.

There were signs earlier in the week that violence by disgruntled workers was brewing, which included tyre burning and blocked entrances on Wednesday.

Police should surely have been on standby at the hospital on Thursday as it was likely the violence would intensify.

And once again, Premier David Makhura’s much-vaunted war room failed to pick up clear warning signs and intervene early both to address the worker grievances and to prevent further vandalism at the hospital.

Following the trashing of the hospital at the end of April, Makhura made promises that workers would receive their bonus pay, but the delay in doing this led to the deplorable disruption this week.

Health Minister Aaron Motsoaledi now calls for the hooligans to be arrested, but why did this not happen after the previous vandalization?

The Gauteng Health Department has handled this whole matter poorly – they need to settle worker grievances speedily and fairly, and also ensure that hospitals are able to provide their essential service at all times.

Posted on

100 Days in and the cracks in “Ramaphoria” are beginning to widen

The following statement was delivered today by Democratic Alliance (DA) Leader, Mmusi Maimane MP, at a press briefing at Nkululeko House, the Party’s Headquarters in Gauteng. Maimane was joined by DA Chief Whip in Parliament, John Steenhuisen MP, and DA Shadow Minister in the Presidency, Sejamothopo Motau MP. Please find the press briefing document attached here.

The election of Cyril Ramaphosa as President of the Republic of South African on 15 February 2018 was predictably met by a wave of optimism and anticipation not witnessed in our nation for the better part of a decade. Many believed – and still do believe – that the election of Ramaphosa as President was the seminal moment in turning around the fortunes of our country and putting us back on track to becoming a leading light in the region, on the continent, and in the developing world.

At the time of his election, South Africa was in a state of political and institutional turmoil. State capture, pervasive and unyielding corruption, nepotism and patronage, an economy on life support and in “junk status”, record high levels of unemployment, increasing poverty reaching unsustainable levels, a basic education system failing our youth, and several broken institutions of state and State-Owned Entities (SOEs) was the status quo. It is these fundamental issues which President Ramaphosa is expected to address and do so thoroughly and timeously.

Indeed, the bar was set pitifully low by former President Jacob Zuma. However, we must not forget that President Ramaphosa also had a role to play in the turmoil he eventually inherited. Ramaphosa faithfully served as Jacob Zuma’s Deputy President for the previous four years and at every juncture displayed solidarity with, and support for, the former President. He protected and endorsed Jacob Zuma and was a crucial member of the senior leadership of the ANC and the government during these tumultuous years.

Before Cyril Ramaphosa could be elected President of the Republic of South Africa, he needed to be elected President of his own political Party – the African National Congress. This is relevant because the outcome of this conference – and the Presidential election race – shapes the scope, extent of authority, and direction a Ramaphosa Presidency would encompass.

Despite his narrow victory at the ANC’s 54th National Conference, the road to his election and the resolutions adopted at that conference will be a relentless constraint on his ability to govern. President Ramaphosa inherited a deeply divided and factionalised ANC. Internally, the ANC cannot see eye to eye on a litany of issues and therefore whichever faction won this leadership race would be forced to compromise their views to a common middle ground. The ruling party’s “top six” is split down the middle, factionally, and therefore many of the political decisions that influence government are reduced to a tussle between two factions within the ruling party.

This is witnessed in what is unfolding in the North West Province. Looting, violence and destruction of property has plagued the streets of the North West – particularly the city of Mahikeng – as different factions of the ANC fight each other for power in the party and in government. This has seen Ramaphosa use his executive power, through Section 100 of the Constitution, to try and resolve internal political strife within the ANC by placing the province under administration. We must condemn this move and call it out for what it is. Ramaphosa cannot use the state for internal political ends – we saw this under Jacob Zuma and will oppose it at every juncture.

In addition to the North West, at least three other provinces are falling apart – namely the Free State, KwaZulu-Natal and the Eastern Cape. Different factions within these provinces are taking each to court to challenge the validity of Provincial Executive Committees (PECs), and decisions taken by the ANC provincially. This has hamstrung these provincial governments. In KwaZulu-Natal, political killings are on the rise as ANC factions fight each other for control of resources and access to patronage networks. This has a direct effect on governance in those provinces and because of ANC infighting, the people suffer. President Ramaphosa is presiding over a disintegrating ANC, and our governments are feeling its negative effects.

Indeed, his first 100 days have been underwhelming, as South Africans have rightfully expected much for from the President. We remain stuck in a jobs crisis, while our country is not safe from crime, and our politicians continue to commit acts of corruption and nepotism. All while living conditions of South Africans have not changed. Tax is up, jobs are dying, petrol is increasing, and food is becoming unaffordable.

President Ramaphosa is governing on a fragile, compromised mandate, and therefore will never be able to effect total change that will turn our nation around, eradicate corruption, create millions of jobs, make our country safe, and fix our broken education system.

The National Executive

President Ramaphosa inherited one of the biggest Cabinets in the world – bloated and comprising of many compromised and incompetent individuals. The 35 Ministers and 37 Deputy Ministers will – in salary earnings alone – cost our country R163.5 million this year, and R510.5 million over the medium-term. This excludes Ministerial houses and vehicles, VIP protection, travel allowances, and private offices and their staff contingents.

While committing to reducing the size and cost of Cabinet – and ridding it of those who are underperforming and are linked to corruption – the President has failed on both accounts.

To this day he retains Jacob Zuma’s Cabinet in form, changing only a few personnel along the way. While he removed the likes of Mosebenzi Zwane, Des Van Rooyen, Lynne Brown, David Mahlobo, Faith Muthambi, Bongani Bongo and Fikile Mbalula – his new broom failed to perform a clean sweep of all compromised and incompetent ministers. Malusi Gigaba, Nomvula Mokonyane, Bathabile Dlamini, Aaron Motsoaledi and Angie Motshekga all remain in Cabinet, despite their dubious track records.

To create a capable, streamlined state, President Ramaphosa must cut the size of the National Executive, and remove all those compromised, underperforming, and non-performing Ministers. In this first 100 days, he has failed to do such.

The Economy

Due to a combination of the ANC’s uncertain economic policies, and Jacob Zuma’s personal mishandling of the economy, Ramaphosa inherited a struggling and stagnant economy. Once again, as the former Deputy President and second in charge, he cannot absolve himself from the mess he inherited. The expanded unemployment rate was 36.3% by the end of 2017, and with a staggering 9.2 million unemployed South Africans. The SA economy grew by a paltry 1.3% in 2017, coupled with a decrease in net Foreign Direct Investment (FDI).

Within the first 100 days, the President has signalled an intent to move us in the right direction. Small, cosmetic changes such as the appointment of four investment envoys to attract foreign investors to South Africa; signing long-delayed renewable energy contracts worth $4.7 billion with Independent Power Producers (IPPs); a proposed Youth Employment Service (YES); and the appointment of Nhlanhla Nene as Minister of Finance are all examples of such.

However, there are still policies within his government and the ruling party that will always act as a barrier to growth and job creation. Until he deals with such policies, we will continue our low growth high unemployment trajectory for the foreseeable future. This has seen the number of unemployed South Africans increase during the first months of his Presidency, from 9,216 million in the previous quarter to 9,481 million.

If Ramaphosa is serious about revitalising our economy and ensuring jobs are created, he should at once:

  • Reverse the 1 percentage point VAT hike;
  • Upgrade the current Employment Tax Incentive (ETI) to a full Youth Wage Subsidy;
  • Introducing a National Civilian Service year to provide work experience for the approximately 78 443 unemployed matriculants (from the class of 2016 alone) to enter into work-based training in the community healthcare, basic education or SAPS fields;
  • Reverse the decision to cut the Competition Commissions budget, as the Commission is crucial to reducing the concentration of the economy and allowing small businesses to flourish;
  • Institute a review of all labour legislation, with a view to liberalise the labour market making it easier to employ people;
  • Amend B-BBEE legislation to include internships, bursaries, and funding of schools as legitimate empowerment;
  • Reject the proposed amendment of section 25 of the Constitution to expropriate all land without compensation, which creates uncertainty and volatility in the economy;
  • Ensure that the 100 000 unpaid invoices, worth over R7.7 billion, between government departments and small businesses are paid;
  • Adopt a City-led economic growth agenda, focusing on cities as the drivers of growth and job creation; and
  • Reconsider a blanket National Minimum Wage, which favour the employed at the expense of the unemployed and will cost at least 700 000 jobs, killing many small businesses.

Countries rise and fall on the strength of their economies, and this holds especially true for the developing world. Just tinkering at the edges, with a talk shop here and a summit there, will not fundamentally restructure the economy to creates jobs. The President still has a long way to go when it comes to the economy.

Corruption

Corruption has long been the hallmark of the ANC-led national government. Since the first allegations relating to the now infamous “Arms Deal”, corruption has been rampant across government – fed by the patronage politics of the ruling party.

President Ramaphosa has had a seat at the table throughout the majority of the Zuma years, witnessing and turning a blind eye to the corruption within government. Therefore, it remains difficult to know where Ramaphosa stands when it comes to corruption.

During his State of the Nation Address he said the word “corruption” six times, four of which related to public sector corruption, and the other two touching on private sector corruption.

Most notably, he stated that “this is the year in which we will turn the tide of corruption in our public institutions” – signalling an intention to tackle corruption head on during his first year as President. He also said he would “urgently” deal with the National Prosecuting Authority “to ensure that this critical institution is stabilised and able to perform its mandate unhindered.”

Over the past 100 days, the evidence of Ramaphosa tackling corruption head on has been scant, and he has left much to be wanting. His appointment of Arthur Fraser as National Commissioner of Correctional Services is a move from the Jacob Zuma playbook, where questionable and compromised individuals are reshuffled and rehired, instead of fired. We have approached the courts to have this decision reviewed and set aside, and we urge the President to not waste time and to reverse his decision to rehire Fraser following the allegations against him during his time employed at the State Security Agency (SSA).

For the President to stamp his mark and be taken seriously when it comes to corruption, he needs to take the following decisions:

  • Ensure the independence of the NPA by immediately appointing a National Director of Public Prosecutions (NDPP) with the ability to restore the integrity of the NPA;
  • Support the DA’s move to remove the current Public Protector, Busisiwe Mkhwebane from office;
  • Ensure justice is served in the ongoing trial of Jacob Zuma by cancelling the agreement for the state to continue to pay Zuma’s legal bills;
  • To not oppose the DA’s legal action in this regard; and
  • To take firm again against those accused of corruption within the ANC, including Secretary-General, Ace Magashule, and National Spokesperson, Pule Mabe.

Basic Education

Basic Education in South Africa is in an appalling state, and with each passing day it jeopardizes the futures of our young people. Currently, we have one of the worst literacy rates in the world, and 3 of every 4 children cannot read with meaning. We essentially have two education systems in South Africa – one for the rich, and one for the rest. Those who cannot afford private schooling are sent to schools that are run by SADTU appointees, where teachers cannot pass the subjects they teach, and where infrastructure is almost non-existent.

While there are many excellent and dedicated teachers in South Africa, there are currently over 8 million children attending dysfunctional schools where the quality of teaching, in general, is not up to standard.

In order to save our crumbling education system, the President must ensure the following:

  • SADTU’s stranglehold on education is broken;
  • Reestablishment of teacher training colleges;
  • An independent inspectorate is established, mandated and empowered to inspect schools and evaluate the quality of teaching, leadership, management and governance; and
  • Charter schools are established, allowing a private-public sector partnership which will increase standards of education and accountability.

Health

President Ramaphosa inherited a health system that is in disarray within various provinces – Gauteng and KwaZulu-Natal to name just two. Despite Health Minister, Aaron Motsoaledi, overseeing both the Life Esidimeni tragedy and the KZN oncology crisis – claiming 144 and over 500 lives respectively – he remains in his job. Motsoaledi is also responsible for the medical student placement crisis, whereby due to administrative failures by government, hundreds of qualified doctors were not placed for their community service for 2018 – many of which are still unemployed.

At a national level, there are too few clinics with 3 182 clinics in South Africa, each serving 16 971 people on average, whilst the WHO suggests a clinic to population ratio of no less than 1:10 000. South Africa has insufficient medical practitioners with less than one (only 0.7) physicians per 100 000 population, and 2.2 nurses per 100 000 population, leaving us well behind peer and OECD nations. Over 2.5 million South Africans live further than 5km from their nearest primary healthcare facility. This is the state of healthcare in South Africa.

As of now, the oncology crisis in KwaZulu-Natal is still not solved. There was and still is a major shortage of doctors, nurses and medical personnel.  Various hospitals and clinics are and were in a dilapidated state and have a major shortage of working medical machinery, essential medicines and other medical equipment. Ramaphosa has taken little action in relation to the healthcare system.

President Ramaphosa’s first move should have been to announce the scrapping of the NHI in favour of a more sustainable and affordable hybrid system, which will still ensure all South Africans receive healthcare cover.

He should have placed the KwaZulu-Natal and Gauteng Health Department’s under administration, and assessed other provincial health departments for staff shortages, ongoing strikes by nurses and health workers, and equipment and medicine shortages.

Ramaphosa should immediately introduce an Expanded Clinic Building Programme in under-served areas nationwide, conduct feasibility studies for under-served areas in order to assess the impact of extended clinic operating hours, and ensure mobile clinics are provided for existing settlements which are not yet formalised and exist beyond a 5km radius from existing public health facilities.

The announcement of a few roadshows and the implementation of the unworkable NHI – as witnessed in his State of The Nation Address – will not solve our country’s healthcare shortfalls.

Public Enterprises

Over the past decade, State Owned Enterprises (SOEs) have been a constant strain on our economy and the national fiscus. Not only were SOEs the playgrounds whereby billions were stolen from our country via State Capture, but the overwhelming majority of SOEs are inefficient, loss making entities which need largescale reform.

Despite chairing the Inter-Ministerial Committee for State Owned Entities (SOEs) while Deputy President, Cyril Ramaphosa failed to ensure the Committee carried out is mandate of “overseeing the stabilisation and reform of state-owned entities”.

For the 2017/18 financial year, SOEs hold R466 billion in government guarantees. These SOEs continue to make massive losses. Overall, public entities lost R53.7 billion in the 2016/17 financial year. Each and every year, these entities lose more money, ask government for further guarantees, and provide a platform for corruption and nepotism.

In his State of the Nation Address, Ramaphosa undertook to change the fortunes of SOEs, including the manner in which their Boards are elected and removed, and the extent of private sector strategic involvement – all the while coordinated by Ramaphosa himself.

The President has made some positive decisions – including replacing the boards at Eskom and Denel, as well as ensuring SOE boards reviews bonus payments and conduct lifestyle audits.

While these appear to be positive steps in the right direction, much more is required to address the real menace here. The President should have already:

  • Identified SOEs that are to be part-privatised;
  • Begun the process of splitting Eskom into a generation entity and transmission entity, with the generation entity privatised, and the transmission entity state owned;
  • Ensured stability at PRASA, and investigated tender irregularities and the R50 billion locomotive deal;
  • Made sure all those who are found of wrongdoing be held criminally and civilly accountable;
  • Finalised new shareholder compacts which highlight the targets and specific objectives for the SOEs – to which they will be held to account;
  • Merged SAA, SA Express and Mango, with a view to sell off the ailing airline; and
  • He should have changed the board of both Alexkor and Safcol.

Police

President Ramaphosa inherited a police service that is chronically under-resourced, under-staffed, under-equipped and under-trained. Crime is rampant in South Africa, and the police are simply unable to reduce crime and ensure our country is safe. This would require an entire overhaul of the SAPS, in order to professionalise and equip police men and women, and to depoliticise the appointment of those at the very top.

In his State of the Nation Address, Ramaphosa committed to a range of new programmes that will tackle crime and build safer communities – including the “Community Policing Strategy” and the “Youth Crime Prevention Strategy.”

Since then, it appears not much has materialised. The President did replace Police Minister Fikile Mbalula with former Police Commissioner, Bheki Cele, which received mixed feelings due to Cele’s recent past.

The President should have immediately moved to professionalise and equip the police service by:

  • Conducting a thorough lifestyle audit of all senior police members to stem corruption;
  • Beef up the independence of IPID and see to it that they are properly resourced;
  • Conduct an audit of all station-level resourcing issues and determine where the gap; and
  • Commission an independent evaluation of all current policing strategies and their effectiveness.

It would appear that tackling the scourge of crime in South Africa does not appear high on the President’s list of priorities.

Land Reform

President Ramaphosa inherited two problems. Firstly, a skewed pattern of land ownership to the exclusion of the majority of black South Africans. And secondly, a Department of Rural Development and Land Reform that has failed to address this skewed pattern for more than two decades.

The story of land reform in this country is one of utter failure of the ANC government. While land reform is often part of campaign rhetoric, results over the 24 years paint a dire picture. The recent EWOC campaign yet again just a campaign slogan that offers no real solution to the current crisis. The core argument is that compensation has not been the major stumbling block. The ANC must address the systemic issues from lack of political will, corruption and elite capture to lack of capacity, budgeting and post settlement support.

Unfortunately, the President has failed to carve his own view on land and has resorted to the divisive rhetoric of the ANC. In doing so, he has failed to protect property rights, ensure justice, and attract investment that will lead to job creation.

In his State of the Nation Address, Ramaphosa reaffirmed his commitment to expropriation of land without compensation, which should be implemented in a way that increases agricultural production, improves food security and ensures that the land is returned to those from whom it was taken under colonialism and apartheid.

Expropriation without compensation has provided uncertainty to investors and land owners in general, and people with informal tenure such as people living on communal land and farms are still not fully protected. ANC land reform programmes have continued to champion state custodianship which doesn’t expand black ownership of land and is an injustice to people deserving of the land they have been deprived of.

In his first 100 days, the President has erred in his approach to land reform. Instead of using the Constitution as a scapegoat, he should have done the following:

  • Directed more funds to land reform. Currently, the government spends more on VIPs for politicians and Ministers – R2.8 billion – than it does on land reform – R2.7 billion. Less than 1% of government’s total budget spending is on land reform;
  • Put in concrete steps for the speedy resolution of land claims and disputed land claims;
  • Inclusion of urban land reform to facilitate economic opportunities for people in urban areas;
  • Ensuring the protection of people’s land especially those with insecure land rights;
  • Assess all government owned land with a view to transferring to individuals; and
  • Ensure that 4 300 state-owned farms which forms part of the 17 million hectares of state-owned land must be assessed for distribution to black land beneficiaries.

In his first 100 days, the President has missed an opportunity to affect real change and unity in our nation regarding the land question. Instead, he’s reverted to the ANC’s rhetoric on blaming the Constitution – while many black South Africans remain without land and without dignity. We urge the President to make a necessary about-turn on this matter, in order to protect property rights, ensure justice, and attract investment that will lead to job creation.

Conclusion

Since this election as President, Cyril Ramaphosa has worked overtime in trying to distinguish himself from Jacob Zuma and the ANC – as a savior of the nation and the man who has the will, the grit, and the integrity to turn our country’s fortunes around and see it prosper.

Over the past 100 days, it has become clear that regardless of Ramaphosa’s intentions, he is a comprised President whose powers are greatly restrained by his political party, and by the individual and interest groups that got him elected. The cracks in “Ramaphoria” are beginning to widen.

Our country needs a fresh start and total change, that which President Cyril Ramaphosa cannot bring about. South Africa deserves better. Our vision is to see our nation become the united, prosperous and non-racial country we all desire. Where we champion a vibrant and growing economy that creates jobs, where those left behind are given opportunity, where our streets are safe and crime free, where our education system serves students and not SADTU, where the government serves the people and not politicians, and where corruption, nepotism and patronage are relegated to the pages of history.

Only the DA can bring about that future. We will work tirelessly to inspire hope in our nation and continue our mission of building One South Africa For All, based on the values of Freedom, Fairness, Opportunity and Diversity.

We have begun our election preparation ahead of the National Elections next year. Yesterday I met and briefed all our public representatives and staff in the North West, and this morning I did the same here in Gauteng. Our structures are ready and fired up, and we believe South Africans will be given a real alternative to the ANC come election day in 2019. Total change is possible, and it starts with the DA.

Posted on

Shutdown of Tsepong Hospital endangers the lives of the sick and vulnerable

The DA notes reports that NEHAWU protesters have shut down Tshepong Hospital in Klerksdorp, North West.

While the DA supports workers’ right to down tools and protest for better working conditions, they cannot do so at the expense of patients’ lives.

Yesterday, the DA conducted an oversight inspection at the Tshepong Hospital and the hospital management confirmed that it does not have adequate security to maintain order and that freelance nurses would have to be employed once the strike commences.

Protestors have reportedly been burning tyres, refused to allow ambulances access and refused anyone from entering or leaving the hospital.

Staff at the hospital yesterday have warned the crisis in the North West health sector could possibly escalate into “a tragedy that will have a bigger aftermath than the deaths at the Esidimeni Health Care Centre”.

Such statements cannot be ignored as they give us an account of the dire situation on the ground.

The DA urges protesters at the hospital to adhere to the prescripts of the law and to respect patients’ right to access health care services.

Health Minister, Aaron Motsoaledi’s visit to the North West yesterday yielded no results and was clearly nothing more than a PR stunt.

The collapse of health services in the North West falls squarely at the feet of North West Premier, Supra Mahumapelo, and North West Health MEC, Dr Magome Masike. The ANC continues to protect ineffective leaders at the expense of the lives of the sick and vulnerable.

Posted on

Minister must prevent a repeat of the Esidimeni tragedy in North West

The DA will write to the Minister of Health, Dr Aaron Motsoaledi, to urgently request that he ensure proper staffing and resources at the Klerksdorp/Tshepong Hospital Complex in Klerksdorp.

During our oversight inspection, we were shocked when doctors asked us for urgent help on the eve of a planned strike by NEHAWU which would see nurses down their tools. The strike in Klerksdorp is scheduled to begin tomorrow.

The doctors indicated that they are extremely concerned for the lives of patients who are currently receiving critical care. The complex (which includes Klerksdorp Hospital) has more than 1 000 beds.

Without professional nursing staff and proper care, these patients’ lives are at risk. Professional medical staff said this can escalate into “a tragedy that will have a bigger aftermath than the deaths at the Esidimeni Health Care Centre”.

NEHAWU is demanding that North West Premier, Supra Mahumapelo, steps down. During our visit, a group of members barged into the hospital complex singing and dancing amongst the waiting patients. See video here.

The hospital management confirmed they do not have enough security staff to keep order and that they will have to make use of freelance nurses once the strikes begin.

At the Khuma Clinic, in Stilfontein, there is a lack of chronic medications and some patients have been sent home without medication.

Medical staff in North West shared an open letter that was signed by 73 medical doctors. This was published in the Mail and Guardian today.

Herein they state who the biggest losers during the strikes are:

  1. Poor/ homeless;
  2. Disadvantaged;
  3. Disabled/vulnerable;
  4. Those with lack of access to private care; and
  5. Those with chronic illnesses that include HIV, TB, Hypertension, diabetes, psychiatric disorders, etc.

An extract of the letter reads: “As caregivers, we have been silent for too long. We have taken an oath to “do no harm” and in our silence, we have contributed to harm. This cannot go on as we are concerned about methods used which include closure of health care facilities that affect the health of our society. Of note provision of health care is an entrenched Constitutional right in South Africa”.

It is time for Total Change. A DA-led government will always support the Constitutional Rights of patients to receive health care and will ensure that proper resources are available to support our healthcare workers in their important quest to save lives.

Posted on

Health Minister’s delayed intervention in NW Health Department causes patients to lose their lives

The Democratic Alliance welcomes the announcement made by the Health Minister, Dr. Aaron Motsoaledi, to call on the South African National Defence Force (SANDF) to assist with the distribution of medicines in the collapsed North West Health Department.

However, the Minister’s announcement comes a little too late. In March, nearly a month ago, the DA wrote to the Minister asking him to intervene in resolving the complete collapse of the NW health Department but he failed to do so.

Since yesterday, residents in Mahikeng have barricaded the streets, burning busses, trucks, looting local shops and businesses and protesting.

This was triggered by among other things, the death of two patients who could allegedly not get medical help due to an ongoing strike by health workers.

Public departments, institutions, and businesses in Mahikeng are currently are closed, the DA has also learned that there are plans to spread the protests to Rustenburg.

The DA is convinced that had the Minister intervened timeously the unnecessary loss of lives at clinics and hospitals could have been avoided. The DA maintains that there might be more lives lost and not reported as a result of the collapse of the health services in the province.

The DA will in the upcoming days collect information on all people who have been negatively impacted and lost their lives due to the protracted strike in the public health facilities of the North West.

The DA will write to the Health Ombudsman, Professor Malegapuru Makgoba, requesting him to investigate the loss of lives due to the collapse of health service in the province.

The people of North West need a better government that will bring Total Change by prioritizing the delivery of quality health services.

Posted on

Health Department instructs all ports to stop testing imported goods

The DA has in its possession a letter from the Chief Environmental Health and Port Health Services instructing Port Health Officials to stop testing imported chicken products for Listeria.

According to the letter, Minister of Health, Dr Aaron Motsoaledi, announced that the source of the current Listeria outbreak has been identified at cold meats “processing plants located in the country” in reference to the Rainbow Chicken and Enterprises facilities. The Minister therefore thinks there is no need to do any further testing.

Although these two facilities have been identified as sources of the current outbreak of Listeriosis, it still remains unclear how these factories were contaminated in the first place.

It is outrageous that the Health Department would stop the testing of imported meats, considering that just recently it was revealed that Australia has been exporting Listeria contaminated products. In Brazil, Listeria is not recognised as a notifiable disease and is a major distributor of meat products which South Africa imports.

It is, therefore, vital that South Africa tests imported goods on an ongoing basis to ensure that our people are protected against any possible contamination.

To date, more than a thousand people have been affected by this outbreak and almost 200 people have died. To prevent even further loss of life the government must ensure that the following steps are taken:

  • An over-arching independent body must be instituted to regulate and monitor food safety and security in the country, as there are currently too many bodies with no specific mandate;
  • Interim norms and standards have to be adopted to ensure that the outbreak is contained and this will get the ball rolling on permanent regulations for all animal products and the processed food industry; and
  • Permanent standards, regulations and mechanisms for testing must be instituted for Trade and Agriculture and other food industries.

The government must put the health and safety of its citizens first, considering that there is still uncertainty of where the listeria outbreak originated from.

The DA will continue to closely monitor this Listeriosis outbreak and hold Minister Motsoaledi accountable, as it is clear that there is no political will to get to the root of the problem.

Posted on

Basic Health Care denied to residents in Ga Pila, Mogalakwena

Not one analgesic, which assists with pain, fever or inflammation was available at the Sterkwater Clinic in Ga-Pila Village, Mogalakwena.

On an oversight visit to the clinic, the DA has established that the clinic cannot provide the most basic medicinal care to residents in the area.

Apart from being unable to assist with pain medications, the clinic was also desperately short of antibiotics and had no cough mixture available, at a time when a change of season and winter colds and flu become prevalent. Despite constantly ordering the basic supplies, the clinic does not get supplies ordered or are short delivered.

Seriously understaffed, the clinic is under pressure from the surrounding farming communities who often come to the clinic because the mobile clinics servicing the farms do not arrive or when they are due. Most of the patients from the farms require regular medication for HIV/Aids and TB, which is available at the clinic, but the farm workers are frustrated by the costs of travel and time lost from work.

Any ill or injured patient at the clinic requiring emergency relocation to a hospital, is likely to have to wait between 6 and 8 hours for an ambulance to arrive. The shortage of ambulances in the area has resulted in emergency services being logged according to time of call. Well equipped with emergency supplies and resuscitation equipment, the nursing staff cannot assist with medication for pain or fever in the interim.

The staff kitchen at the facility is in a serious state of disrepair and the grounds are overgrown. The washing machine which is used to sterilize and clean dirty and contaminated linen does not work most of the time, so linen is washed by hand.

The DA has written to both the MEC of Health, Phophi Ramathuba, and asked formal questions to the health Minister, Aaron Motsoaledi, to assist and assess the neglect of primary health care in the area.

All South Africans are constitutionally entitled to proper primary health care.

The DA Health policy puts primary health care and properly equipped emergency services at the fore and is designed to ensure that every citizen regardless of their situation is protected and assisted.

We will not sit back while the poor and vulnerable suffer without the most basic health care.