Urgent life support needed for critically injured health system

The Eastern Cape health department remains in complete disarray and no one will assume any responsibility for it.

Despite its almost complete collapse under the weight of the Covid-19 pandemic, health minister Dr Zweli Mkhize has strenuously resisted placing the broke and mismanaged department under administration. His provincial counterpart, Sindiswa Gomba, has literally laughed out loud at calls for her resignation.

Mkhize insists a national takeover should only happen when there was “a whole breakdown of management, a reluctance to follow directions and instructions, and an internal inability for people to be co-operative”.  He felt that the Eastern Cape wasn’t “quite there yet”.

If that is the criteria, it is hard to imagine a riper candidate than this provincial health department, which has been in a downward spiral for years. Mismanagement and corruption has led to a dearth of money which has led to understaffing, predictable medical negligence which in turn contributes to massive, unaffordable medico-legal payouts. Rinse and repeat.

The department is currently in the red to the tune of over R3bn.  It is effectively bankrupt and faces the humiliation of having its assets sold off to meet judgment debts. Reportedly waiting in the wings is a further R29bn worth of medico-legal claims. Some may well be fraudulent, but the department's management is so weak and corruption so rife in its ranks that even the crooked claims are likely to succeed.

The pandemic has laid bare years of neglect, systemic failures and an almost unbelievable level of dysfunctionality.

It can be of no surprise to anyone that our decrepit, understaffed hospitals would never cope. But the pandemic also hit hard at our primary healthcare system, something this newspaper predicted would have a terrible long-term effect on SA's fight against HIV-Aids, TB, diabetes and other chronic conditions that desperately require careful monitoring and treatment regimes. We will pay the price for decades to come. Many will pay with their lives.

But Gomba giggles at calls for her resignation, saying no one can be held responsible for an unknown like Covid-19. Instead, she wants to be measured against what she terms the department’s “manifesto” and its “deliverables”.

Her department’s manifesto includes to "improve health status through the prevention of illnesses …  and to consistently improve the healthcare delivery system by focusing on access, equity, efficiency, quality and sustainability”.  The end result should be “a functional, quality-driven public health system”.

If these are her measurables, she has – by any standards – failed miserably.

Our health system is in need of life-support and none is forthcoming from any quarter.