Eastern Cape Health MEC breaks promise to appoint CEOs for all major state hospitals

6 Feb 2025

Eastern Cape MEC for Health Ntandokazi Capa has failed to appoint CEOs for major state hospitals within the first six months of her term, as she had promised. Only one appointment was made, for Dora Nginza Hospital in Nelson Mandela Bay.

Six months ago, Eastern Cape MEC for Health Ntandokazi Capa, promised that she would have permanent CEOs in place for the province’s major state hospitals at the end of her first six months.

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 that the MEC would “provide an update” when the six months were over.

With Ndamase having left the beleaguered department, no answers were forthcoming.

But department communications director Siyanda Manana, who said he was temporarily filling in for Ndamase until Capa had appointed a new spokesperson, said this week that the appointments had not been made, except for a CEO for Dora Nginza Hospital in Nelson Mandela Bay.

He blamed prospective CEOs for turning down the posts and the department’s financial burden from medico-legal claims.

“Some prospective CEOs declined last minute, meaning we then had to restart the head-hunting process,” he said.

One of the major tertiary hospitals in the province, Livingstone Tertiary Hospital, has been without a permanent CEO since 2018. Three years ago, the department announced that an appointment was “imminent”. But nothing has been forthcoming.

“The CEO post at Livingstone is still vacant. There is still an acting CEO. The department is going to headhunt in order to fill it,” Manana confirmed.

The department announced the appointment of Professor Akhter Goolam Mahomed as the head of internal medicine and clinical domain medicine at Livingstone Hospital. This position 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 hospitals in the province, 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.

Read more: Eastern Cape’s new health MEC promises improvement, but critics are doubtful

During her policy speech delivered in August 2024, Capa said: “We have an obligation that the Department of Health has a stable leadership and administration during the seventh term. With the executive council intervention in the Department of Health, we commit to stabilise critical leadership positions like the chief financial officer, chief executive officers for all identified hospitals within six months.”

She has kept her commitment that the department must conclude all matters related to commuted overtime and institutionalise coordination and the management of overtime in all areas. Manana has confirmed that the department is busy with a wide audit to identify and stop all overtime payments to non-qualifying personnel.

The department, however, cannot make further overtime payments this financial year and has indicated that it will continue doing so, with catch-up payments, in April.

Financial strain

In an alarming letter sent to employees, head of the provincial health department Dr Rolene Wagner set out the department’s financial woes. She said an intervention was being implemented because they were even finding it difficult to pay for life-saving needs such as the blood bank, laboratory services, medical gas and medicine.

“There is an intervention with the Office of the Premier, Provincial Treasury and the National Department of Health that includes means to begin addressing the historic debt; however, in the meantime, the department is finding it increasingly difficult to pay all of its core business suppliers for non-negotiables such as the National Health Laboratory Services, Afrox (supplier of medical gas), the South African National Blood Services and medicines and medical supplies.

“Payment arrangements have had to be made with most of these suppliers. There are other creditors, such as municipal services, security services, facilities maintenance services and telecommunications services, for which payment arrangements have also had to be made. These efforts aim to promote continuity of health services to our communities,” Wagner said.

The department has faced the same problem for several years and in 2024 an unpaid Telkom bill of R36.5-million shut down emergency medical services. Contingency plans had to be made to switch the ambulances to a cellphone system over the Easter weekend.

Read more: EC Health Department scrambles to set up new emergency numbers after not paying the phone bill

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 medical negligence claims decreased by R2.59-billion from last year, their impact remains significant as the health department cannot fully budget for them. In 2023-24, claims of R339.93-million were paid from funds budgeted for service delivery, contributing to the department overspending its budget by R294.90-million.

“These claims, with increasing employee costs and poor financial management, threaten the department’s financial sustainability and hinder its ability to fill critical vacancies and procure essential medical equipment, thereby 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 backpay to medical officers who did not qualify for such,” the Auditor-General stated in her report. DM

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Financial strain