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

25 Jun 2024

Spotlight speaks to Thandokazi Capa about her vision for healthcare in the province and rounded up some early responses to her appointment from healthcare unions and political parties.

Newly appointed Eastern Cape health MEC Thandokazi Capa has vowed to improve healthcare conditions in the province.

“I have the responsibility to turn things around,” she told Spotlight after being sworn in on 21 June in Bisho. “I’m ready to face the challenges of the department because I’m also from the province, so I fully understand the issues faced by the department. I will try my level best to make it a point that we turn around the situation in the department.”

Capa took over from Nomakhosazana Meth, who is now an MP in the National Assembly.

In recent years, the Eastern Cape Department of Health has often been in the headlines for the wrong reasons – ranging from a controversial scooter ambulance tender and severe difficulties during the height of the Covid-19 pandemic, to labour disputes, budget shortfalls and high levels of medico-legal claims.

Despite these challenges, Capa appeared to be brimming with confidence during a short interview with Spotlight.

“The Department of Health is a service delivery department, so it is important for our people to get healthcare service because as the department we have that responsibility,” she said. “It will not be acceptable if healthcare facilities run out of medication. Ambulances must be available, and our hospitals must be able to render good-quality service. That is my vision for the department.”

She said her priority is to understand the challenges facing the department as it is the first step towards finding the best solutions. “I will meet all the stakeholders involved in the health sector to ensure that I understand challenges facing the department, such as medico-legal claims and issues of budget constraints,” she said. “With the assistance of the Office of the Premier and Treasury, we will be able to tackle whatever challenges are facing the department as a team.”

Capa was a councillor in 2011 in Ingquza Hill Local Municipality and in 2016 was elected Speaker of the council. Towards the end of 2021 she served as mayor. After the local government elections in 2022 she was appointed OR Tambo District Municipality Speaker and is currently chairperson of the ANC Women’s League in the province.

She was born in Flagstaff in the OR Tambo District where she grew up in a family of healthcare workers. Her mother, Zoleka Capa, who served in the sixth administration as deputy minister of agriculture, land reform and rural development, is qualified as a nurse and midwife.

Backing from the premier

Oscar Mabuyane, who became the province’s premier in 2019, told Spotlight he will use this term to ensure that problems in the health department are tackled. This is one department, he said, where all of its chronic problems must be addressed.

Regarding the systemic challenge of medico-legal claims against the department, he said his office is putting every system in place from Treasury to “projectise” the department to deal with it. Our understanding is that this means, among others, that the department is responsible for clinical and administrative interventions, while the Office of the Premier is responsible for the medico-legal defence, and the provincial Treasury investigates suspected fraudulent claims and provides the funding for medico-legal settlements.

Read more in Daily Maverick: Few rays of hope as patients continue to suffer amid Eastern Cape health mismanagement misery

“We will go hand [in] glove to ensure that problems of health in this term are addressed. I know some are national, such as medico-legal claims and all that, but we have to find a solution. We are not going to sleep, we have to find a panacea to those chronic challenges in that department. She [Capa] has all our support because from the sixth administration we have already set up systems to make sure Treasury as well as the Office of the Premier are able to assist,” he said.

“I still believe in the hub and bespoke service delivery model that we introduced during Covid-19. It really simplified how we worked during Covid-19; it indicated all these bureaucratic systems that are sometimes collapsing can be put aside and we deliver,” Mabuyane added.

Capa is the Eastern Cape’s 11th health MEC in the past 30 years. Among the previous 10 only two completed their terms of five years or more: Dr Trudy Thomas from 1994 to 1999 and Dr Bevan Goqwana from 1999 to 2006. Between 2010 and 2018 both Sicelo Gqobana and his predecessor, Dr Phumza Dyantyi, served four years each. Meth had a three-year tenure as MEC after being appointed in 2021. As MEC between 2019 and 2021, Sindiswa Gomba served for a short period, as did Nomsa Jajula from 2006 to 2008. Helen Sauls-August, Pemmy Majodina and Phumulo Masualle all served only one year in the position.

Mixed responses

Sivuyile Mange, Eastern Cape chairperson of the Democratic Nursing Organisation of South Africa, welcomed Capa’s appointment.

“We believe that the experience she has in the local and district sphere of governance and her activism in women issues makes her a capable person to lead the department,” he told Spotlight. “However, she will need all the support, especially at a time when the department is faced with uncertainties because of instability in the office of the head of department.” Former head of department Rolene Wagner was controversially moved out of the position in 2023.

Vicky Knoetze, a DA member of the Eastern Cape legislature, said: “Capa will have her work cut out for her as she tackles the systemic problems in her department, and the DA will closely monitor her performance to ensure good governance and accountability.”

Read more in Daily Maverick: Prosecutions loom over failed Eastern Cape scooter ‘ambulance’ project

She stressed that managing the health department is “a huge portfolio for a new, as yet untested member of the legislature”.

This sentiment was shared by EFF Eastern Cape chairperson Zilindile Vena who said it will be difficult for someone with no background in health to transform the department.

“The appointment of the new MEC is very complex because the new MEC was a Speaker of OR Tambo District Municipality, she was not an executive, and now she is being drawn into a totally collapsed department,” he said.

“In the history of the department, we had doctors who were trying to change the situation of the department. Now, it has been proven that everyone without a medical background is easily misled by officials,” said Vena. “That is why there was a scooter ambulance controversy; politicians make decisions based on misleading information by officials because they don’t have a clue about how the department functions.” DM

This article was published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.

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South Africa

Backing from the premier

Mixed responses