Eastern Cape hospital boards are missing in action

Inept hospital boards have been blamed for the Eastern Cape’s poor response to the Covid-19 pandemic, with some “existing on paper only”  and others hijacked by people lacking the necessary expertise to manage operations.

Health unions have labelled boards “dysfunctional” at best, and have also charged that processes to appoint boards are deeply flawed.

One source has alleged that up to 50% of state hospitals in the province do not have boards.

Department superintendent-general Thobile Mbengashe scoffed at this claim, saying all 85 health facilities in the Eastern Cape  had boards. But he conceded that while some were “active and functional”  some were “not so functional”.

DispatchLIVE spoke to a former board member of a hospital, a nurse and representatives from the Democratic Nursing Organisation of SA (Denosa) and National Education, Health and Allied Workers’ Union (Nehawu).

All said  hospitals either did not have functional boards or that these boards did not meet at all.

Denosa provincial secretary Khaya Sodidi said as far as Denosa knew, the boards existed on paper only.

“As stakeholders we’re supposed to be a part of that,” Sodidi said.

He said he had never seen notices or advertisements calling for applications for board membership.

In his 15 years in office with Denosa, he had “never seen” a process to recruit a hospital board.

“It makes sense to link the fight against Covid-19 and hospital boards. It would have been easier for hospitals to deal with the issue because the hospital board would be coming from the community,” he said.

Nehawu secretary Mickey Jaceni said: “It’s true that they (the boards) are dysfunctional. I’ve served on the Frere Hospital board. There are very limited powers, making the boards dysfunctional. We had thought that by this time the MEC would have given them powers, but for now they don’t have that. We are still pursuing that.”

He said the situation meant that hospital CEOs were accountable only to themselves.

Jaceni called on the MEC to fast-track a process that would make hospital boards functional.

“Almost all of them are dysfunctional. [While serving at Frere] I did not get a sense that Cecilia Makiwane or Komani hospital boards were functional. Hospital boards must be constituted by different people with diverse skills.”

Mbengashe said there were “variations of functionalities of boards”.

“Some are very active and functional. Some are not so functional. What the MEC has actually done is give stipends of about R500  based on their (board members) attendance and registry of them being there.”

Mbengashe said each board member was supposed to attend “about four meetings a year, making their stipend about R2,000 each”.

The stipend was meant to cover transportation costs.

DispatchLIVE understands that in rural settings, traditional leaders nominate community members with technical expertise to hospital boards. They are then appointed by the MEC.

Queried about the state of boards and the alleged jobs-for-pals scandal at Cofimvaba Hospital, Mbengashe said: “There are rules. The boards are an oversight body, which forms part of the voice of the community. They’re working under the auspices of the MEC and the MEC appoints them and they function for a period.

“It’s important I tell you this because you’ve heard the other side [from the unions and nurses]. If there is an issue of corruption or nepotism and the board picks it up, their responsibility is to inform the MEC. There are people who are going to break the rules — you can’t stop them — but you need to put in place the control systems and make sure you deal with that.”

Hospital boards are meant to represent patients, staff and the community. Members are required to have expertise in health, law, finance, accounting or any technical expertise relevant to the management of hospitals.

The former board member said: “Technically, [in terms of requirements] it’s supposed to be that way. But community leaders, political veterans and NGOs can be represented.”

The source said the lack of hospital boards had also led to the escalating medico-legal claims, which are believed total more than R29bn in the province.

“More than 50% of Eastern Cape hospitals don’t have hospital boards. At those where they do exist, they’re dysfunctional,” he said.

DispatchLIVE contacted Nonqaba Mzana, who is responsible for hospital boards at the department. Mzana referred queries to provincial spokesperson Siyanda Manana.

Gomba’s spokesperson, Judy Gombayi, said the MEC had written a memorandum to the superintendent-general and all CEOs indicating that the current boards — interim or endorsed but about to expire — should continue until December 31.

“The reason for that is because of the new guidelines that will have to be adopted and the boards trained.”

Manana did not respond to queries. 

Speaking on condition of anonymity, the former board member said the matter had been raised with health MEC Sindiswa Gomba.

He said  Gomba had launched a new constitution for hospital boards in 2019 but this had largely been ignored.

The source said there had been a jobs-for-pals crisis at the Cofimvaba Hospital when the health department recently advertised low-skill posts as part of the department’s Covid-19 programme.

“People at the hospital would just call others from their communities for those jobs. They would shout that so-and-so should get this job or that one.”

Speaking on condition that their name and hospital details be withheld, a nurse said: “Only one woman used to come here. There are no other (board) members. I attend leadership meetings, but I don’t see board members. I can’t even tell you the name of the woman and we don’t know who the other board members are.” - DispatchLIVE

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