Tackling a health service in crisis: New portfolio committee chair is a medical doctor who aims to enforce accountability

Reflecting on the mammoth issue of corruption casting a shadow over South Africa’s health sector, Dr Kenneth Jacobs stresses the importance of safety nets for whistle-blowers, and of establishing technological systems to enforce accountability.

More than most, Jacobs is in a position to do something about these issues.

Last month, Jacobs, a member of Parliament for the African National Congress (ANC), was elected chairperson of the National Assembly’s Portfolio Committee on Health.

Among other things, he will play a pivotal role in deliberations on the National Health Insurance (NHI) Bill. Public hearings have been underway in the health portfolio committee until recess on September 10. The NHI public hearings so far (they will continue later in the year) have flagged corruption as a major concern, particularly pertaining to a centralised NHI fund.

Acknowledging concerns

“From what was raised at the public hearings, people are concerned that the power would be with the minister [of health] to appoint members to the various boards,” says Jacobs. “There are concerns that those appointed in these positions be held accountable.”

He agrees that the critical question remains: How will these systems of accountability be created and enforced?

Refreshingly, he offers ideas that go beyond the usual political rhetoric. “Fortunately, we have this age of technology where it is easier to implement such decisions and processes. It starts with the political will. Then, the technical side is not my field of expertise but we have young people who are analytical specialists, software technicians, informatics specialists. These are the kind of people who would be required to assist [in developing] the necessary systems and, of course, whistle-blowers. There must be safety nets for whistle-blowers. For people, once they see something is wrong, to be able to bring it to the necessary authorities. I think that’s really important.”

Shock over Digital Vibes scandal

Opposition parties have pointed out how former health minister Dr Zweli Mkhize assured the public that the NHI will not be affected by corruption — “empty promises” they say, given that Mkhize is now facing possible criminal charges himself for involvement in the dubious R150-million Digital Vibes tender.

Speaking to Spotlight over Zoom from his home in Wellington in the Western Cape, Jacobs responds to a question about Mkhize and Digital Vibes. “One was perplexed, one was upset and shocked,” he says. “I don’t know what exactly the truth is in terms of the SIU [Special Investigating Unit] report, because I have not seen it yet. I’m waiting to study the report and of course, we’ll also want to study it as the committee.”

Jacobs’ Zoom background is a photograph of the houses of Parliament in Cape Town, with the Parliamentary crest in the left corner.

“You know, it’s so interesting to watch the Zondo commission,” he says. “Because it really does surprise one. It does make one feel that we could have done so much better as a country.”

Of course, doing better as a country depends in part on Parliament, and committees such as that chaired by Jacobs, holding the executive to account.

Will we see greater accountability?

At least some opposition party members are hopeful that Jacobs will have the backbone to hold the Department of Health to account in his new role. His predecessor, Dr Sibongiseni Dhlomo, now Deputy Minister of Health, who has a longstanding relationship with Mkhize, was thought by some to toe the party line in his duties as chairman.

Upon Jacobs’ appointment, Philip van Staden, Freedom Front Plus MP and the party’s spokesperson for health said, “Dr Jacobs is highly qualified in the medical field… He is, among other things, a scientist as well as a medical doctor. The party hopes that Dr Jacobs will consider the inputs and opinions of opposition parties and not, like previous chairpersons, focus only on furthering and executing the ANC’s policy.”

Responding to this, Jacobs agrees that his role as chairman is to be impartial.

“I think he’s correct in the sense that the chairperson should be a neutral person. You’re supposed to be fair, you’re supposed to allow different opinions to be raised.”

Political campaigning

At present, the 62-year-old politician and medical doctor is preparing for the 2021 municipal elections on 1 November. He has been knocking on doors around the Drakenstein municipal area, rallying votes for the ANC.

Jacobs traces his political awakening back to when he was five years old in Gqeberha, then known as Port Elizabeth. At the time, his family was forcibly evicted from sea-facing South End and moved to Gelvandale, in the city’s northern suburbs.

“South End was like Port Elizabeth’s District Six,” he says. “So yes, honestly, that was something that had a huge impact on me. I decided then that I would not allow somebody to suppress or oppress me and I think it is probably why I just kept on studying and improving.”

A family of doctors

There is a pause in the interview, as Jacobs speaks to his wife. He turns back to the camera. She had reminded him to add that as a child, he was put in school a year early.

“I went to school in Port Elizabeth a year early, but they said I was too small. After two weeks they sent me home, but I was crying at home. When my mother couldn’t take my crying anymore, she sent me off to Somerset East, to my grandmother. My grandmother then decided to put me back in school again, for which I’m very thankful to this day. So I matriculated a year early too.”

One of eight siblings born to his father who worked in a shoe factory and his mother, a home executive, Jacobs says today they have six — soon to be seven — medical doctors in the family.

“My father lost his employment as a shoemaker in the factory when I was in standard eight. So my father didn’t have funds for both my two elder brothers to study. The one had to work at the Ford motor company in Port Elizabeth for a while and that was the worst thing for him, for my second eldest brother. That thing changed him because he pursued education like you wouldn’t believe. He later went to university, finished a Master’s in Zoology, and then he went to study medicine, specialising in cardiothoracic surgery.”

Jacobs describes himself as a student for life.

“Mostly, we just had to find our own study funds,” he says. “And so, I was always trying to get bursaries, you know. I had to work really hard for that, otherwise, I would’ve had to go back home. That was the challenge.” 

Jacobs holds a BSc degree from the University of the Western Cape and a BSc Medical Honours from the University of Cape Town.

In 1983, at the University of Cape Town, he was working on a Master’s degree in biochemistry, which he was about to upgrade to a PhD when he says apartheid police forced him to flee to Namibia.

At the time, his research was on apple proteins and cholesterol.

“I’ve always been interested in chronic diseases and things like obesity and diabetes,” he says. “But so, I had to give up on that opportunity.”

Upon returning to South Africa, he enrolled at Stellenbosch University’s medical school, obtaining a Bachelor of Medicine and Bachelor of Surgery degree and a Master of Medicine degree in family medicine. In addition, he later completed a Master of Science degree in sports medicine at the University of Pretoria.

Jacobs practised as a doctor in Paarl, at times also serving as physician to the Stormers and Springbok rugby teams. “I worked with the emerging Springboks, with [rugby coach] Heyneke Meyer and, of course, with some of the Springboks,” he says. “I was very fortunate to be their doctor at the time.”

Jacobs played rugby himself, which he gave up when he got spectacles for his eyesight. “Ja, I played at school-level and early university days, but then I had to get spectacles. We didn’t have contact lenses back then. And these guys, they run you into the ground if you can’t see where the ball is. So unfortunately I had to stop rugby, but then I pursued athletics instead.”

He speaks of his four children with great pride. His daughter is a medical doctor in her second internship year and he has three sons who are studying electronic engineering, geoinformatics, and medicine, respectively, all at Stellenbosch University.

“What we prize in my family, there’s a word in Afrikaans, is deursettingsvermoë,” he says. “Something like perseverance, with discipline.”

Jacobs’ deursettingsvermoë has certainly taken him a long way from the five-year-old boy whose family was forcibly evicted in Gqeberha.

He entered Parliament as an ANC MP in 2019, while still occasionally teaching medical students at Stellenbosch University. “I have permission from my chief whip for that,” he adds quickly, laughing. DM/MC

*This article was produced by Spotlight – health journalism in the public interest.