Madam Speaker, this is the 28th Health Budget that I have spoken on.
I regret that yet again I cannot support a budget that is likely to be spent inefficiently and ineffectively, instead of providing the best health services for people in our province.
I am reminded daily by desperate people who call me because they have been failed by the public health system.
Here is one story that is truly tragic on many levels.
I received a call in the evening that an ambulance was urgently needed in a poor area of Tshwane to pick up a middle-aged woman with Covid-19 symptoms.
They had phoned the number for a provincial ambulance and were told that no ambulance was available. Then they were told that an ambulance would arrive but an hour later it still had not arrived.
At this stage I tried to get them an ambulance from the Tshwane Metro Council, which was on its way when the provincial ambulance finally came.
The sick woman was taken to Kalafong hospital and admitted at 11pm. At 4am the next morning they phoned to say she should be picked up.
A Good Samaritan neighbour used his car to pick her and he said she looked in a bad way way.
Two days later the hospital called and said they were sending an ambulance to pick her up as her Coronavirus test had come back positive.
A few days later she died in the hospital.
The failures in this tragic story include the following:
Firstly, a poor ambulance service, which has been worsened by the botched provincialisation process. Two of the three metro cities, Johannesburg and Ekurhuleni, have ambulances and staff doing nothing in the middle of the Covid-19 epidemic. Only Tshwane is trying to keep their local ambulances with an extended temporary operating licence.
Secondly, the criminal irresponsibility of sending a sick woman with Covid symptoms back to her family, putting everyone at risk, including her husband and the Good Samaritan who gave her a lift home.
Thirdly, the slow testing for Covid which should ideally be less than 24 hours.
But there is more tragedy in this story.
I helped the family to lay a complaint with the CEO of the hospital and he promised to attend to it.
The hospital did contact the family some days later, just after the funeral of the woman. They asked how she was doing. Can you believe it?
I don’t think this type of story is uncommon. I can give other stories where ordinary people are let down by the health system in this province.
The health budget this year is R55.7 billion. It’s the largest budget item, even though it is only 1.4% higher than last year’s unadjusted budget.
I remember previous Health MECs who thought that the annual budget could be adequate for a quality health service, but there is no costing tool to determine where the money should best be spent.
This is why we need an integrated health information system which every single Health MEC since 1994 has promised, but never delivered.
The biggest problem, however, is poor spending controls.
According to the Auditor-General, R12 billion was spent irregularly by the Gauteng health department in the past five years.
This is a stupendous figure, and the situation does not seem to be improving.
Last year we saw several hundred million rand lost because of the PPE corruption. The real figure of stolen money is probably more than R1 billion a year.
We also have incredibly poor spending decisions like R500 million spent on the Anglo Ashanti hospital in the far west rand which will not treat a single Covid-19 patient.
Then there is the NASREC field hospital which cost about R250 million for mostly empty beds.
We are still waiting for the 300 extra beds at the Kopanong Hospital which should have been completed last year.
Why is it that the worst contractors are chosen for building jobs who never finish on time, and often a new contractor is needed to finish the job that is way over budget.
The biggest gap in this budget is for refurbishment of hospitals to make them compliant with occupational health and safety standards.
There isn’t a single hospital that meets the required standard. This is because of years of poor maintenance.
About R8 billion is need to fix our existing hospitals, and a similar amount is needed for desperately needed new hospitals such as Kempton Park.
All we get this year is R2.276 billion which will probably be misspent with the usual failing contractors.
It has been estimated that about R400 million was needed to ensure that Charlotte Maxeke Johannesburg Hospital met safety standards, but this hospital wasn’t even on the budget priority list for this last year.
Here we are, in the middle of a severe epidemic, and this hospital is still closed two months after a fire that should have been prevented or properly contained.
It’s a disastrous failure that will cost lives and increase the suffering of hundreds of patients.
There have been four hospital fires in the last six years, which surely shows that there is negligence in this area.
I am not going to go through an exhaustive list of failures in this department.
All you have to do is to read the latest Auditor-General’s report to be thoroughly depressed about the poor management in this department.
I do wish to single out the extra R200 million on bursaries for medical training in Cuba. This is a slap in the face for our local medical schools which train better doctors at lower cost. The medical students in Cuba have to spend a year learning Spanish, and a year at our own medical schools to finish off their training. Does this make any sense at all?
The only hope is what I see in the dedication of medical staff who do their best in the circumstances, including power cuts and water shortages.
We really do have wonderful people and organisations like Gift of the Givers who have dug boreholes while the department failed to maintain the old boreholes.
We need to have more private/public partnerships such as the proposal for Netcare to treat state cancer patients.
The Honourable MEC is a dedicated and caring person. My advice to her is to weed out the non-performers in her department and put in the systems that will improve management in all critical areas.
The old saying is that Rome was not built in a day. But it is also true that every day a brick was being laid, and this is what needs to be done to ensure a decent health service for everyone in Gauteng.
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