Trauma trolleys outside Livingstone Hospital's busy emergency unit. (Photo: Shiraaz Mohamed) 
The respected administrator Dr Rolene Wagner will return as the superintendent-general of the Eastern Cape Department of Health on Tuesday. This comes after high-ranking officials from the National Department of Health, National Treasury, Office of the Eastern Cape Premier and Eastern Cape Department of Health met with clinical staff and hospital managers to discuss how to save the beleaguered department.
The Eastern Cape Department of Health declared R6-billion in accruals (unpaid bills) in the previous financial year, almost wiping out its operational budget (excluding the cost of employment).
While the Office of the Premier ignored requests for confirmation, nine high-ranking sources in the department confirmed that Wagner would return as superintendent-general and clinical staff were also informed of this.
Premier Oscar Mabuyane removed her from her job last year and claimed he was setting up a “special projects” team to deal with problems in the department. Two senior officials were appointed to act in her position, but the upshot was more dysfunction in the department.
The Office of the Premier has ignored all requests to set out what the special projects team has done.
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Trauma trolleys outside Livingstone Hospital's busy emergency unit. (Photo: Shiraaz Mohamed)
Beleaguered department
By July, supplies of medical basics like syringe needles were out of stock in Eastern Cape public health facilities. Just before the Easter weekend, the department scrambled to set up alternative lines for the province’s emergency services after landlines to health facilities and EMS services were cut off when the department failed to pay its phone bill.
In November, the Auditor-General once again flagged the department for “material misstatements” in its financial statements due to “significant internal control deficiencies”. The department’s chief financial officer, Msulwa Daca, resigned in May.
Since last week, the province has been visited by high-ranking officials from the National Department of Health, the national and provincial treasuries and Mabuyane’s office.
National Department of Health spokesperson Foster Mohale said, “The team from the National Department of Health is there as an intervention by the Premier’s Office to strengthen the Eastern Cape Health Department. Involved are Provincial Treasury, Eastern Cape Health Department and the Office of the Premier.”
The Eastern Cape Department of Health’s communications director, Siyanda Manana, was at pains to point out that the department was not being placed under administration.
“The Office of the Premier and Provincial Treasury have interests in ensuring that these two departments [health and education] obtain unqualified audit opinions. These are the two biggest departments, that consume 76.05% of the total provincial budget of R95.4 billion,” said Manana.
“Equally, these are departments that directly and indirectly affect the welfare and lives of the Eastern Cape populace. You will note that the Eastern Cape government has invested a substantial budget of R30.106-billion, hence the EC Department of Health is being assisted and monitored.
“The accruals and payables were indeed R6.2-billion as of 31 March 2024 and these are attributable to unbudgeted medico-legal claims. It is a well-known fact that the department has been and is still a live prey of … attorneys,” he said.
Read more: Eastern Cape Health Department wins significant legal victory against medico-legal claims
However, a briefing document to the Standing Committee on Public Accounts, compiled by the Auditor-General and presented to Parliament in November 2023, had a considerably lower figure.
The document reported that there were contingent liabilities of R26-billion against the department in 2023, but only R38-million was paid out.
In reply to a parliamentary question about medico-legal claims in the province, the former minister of health Joe Phaahla said the province had not provided him with numbers.
Sources in the department said there had been widespread abuse of the department’s overtime policy.
“The department is working hand in hand with the National Department of Health to deal effectively with the commuted overtime. The process has commenced at Gqeberha and will go throughout the province to deal with this,” said Manana.
“The doctors who qualify will be paid the commuted overtime and those who do not qualify will be required to repay the department.”
Premier’s commitments
In his State of the Province speech, Mabuyane said: “We are enhancing our electronic health records and data management systems to prevent incidents that lead to medico-legal claims.
“We are investing in the leadership of our healthcare facilities so they can manage efficiently and effectively. In the past five years, we completed major health infrastructure projects in our province, making them ideal for the provision of quality healthcare services to our people.
“We continue to capacitate our health facilities with personnel and EMS vehicles to deliver better services. In the past four months, we delivered over 100 emergency vehicles and mobile clinics to our healthcare facilities to ensure timely medical intervention to save the lives of our people.”
However, Mabuyane failed to point out that these were replacement vehicles and that the province still fell short of basic minimum standards relating to the provision of ambulances. DM