Health shambles in KZN ‘the norm’
Jonathan Erasmus, The Witness
Pietermaritzburg - The KZN Health Department is in a shambolic state and needs to take decisive action against incompetent and corrupt officials.
This was according to members of the Standing Committee on Public Accounts (Scopa) on learning that the department had posted a massive R679 million in irregular expenditure.
MPLs across the political spectrum called for “accountability” and said the department’s unit heads “weren’t doing their jobs” while maintaining there seemed to be little consequence for under-performing employees.
The department admitted to not having an asset register and needing to account for 450 000 assets existing on a manual document management system.
It was slated for lacking key skills and being slow in handling litigation. The department said it was re-training staff in basic administrative functions and said that the mortuary service was under severe pressure.
The irregular expenditure, combined with amounts still unaccounted for from previous years, now stands at a massive R2.7 billion.
Scopa was scrutinising the department on the basis that the KwaZulu-Natal Auditor-General gave it a qualified audit, a negative finding, for its 2014/15 financial statements.
And despite apologies from both MEC Sibongiseni Dhlomo and new HoD Sifiso Mtshali, MPLs asked for greater “consequence management” and “solutions” rather than “excuses”.
They said the problems facing the department had appeared to “become the norm”.
The department blamed the Public Works Department and the Independent Development Trust for failing to complete key projects timeously.
Dhlomo also lashed out at the “paper pushers” in the department, alluding to middle management.
“There is a particular layer; the people who are pushing papers, the foot soldiers of government departments — it is [in that] layer [where the corruption takes place],” he said.
Dhlomo said this group of officials was “well crafted” in disguising corruption, which was often only picked up years later.
Committee chairperson Maggie Govender said they were “concerned” that the auditor-general’s findings were “the same as the last three years”.
“Members are asking for consequences, about procedures and systems. The [lack of] report keeping is a major concern and the [lack of] availability of information,” she said.
Govender said they were also concerned that officials were not asking for three quotations before procuring services, and that there were no functional Bid Evaluation Committees — a key oversight in the tender process.
Dhlomo admitted that their “situation has not changed since last year”.
“We are a work in progress, hoping next year we will have a different situation,” he said.
Mtshali said the department was working with the auditor-general.
“I can assure you we are not going to regress further than this. I think this is our bottom line. There is only one way and that is up.”
The auditor-general, in making its qualified audit, found “with concern” 16 weaknesses in controls, including the “appropriateness of medical waste storage facilities” and the “collection, safeguarding banking and recording of revenue”.
Meanwhile, litigation claims against the department increased by more than R2 billion to R6.7 billion, with nearly half being medical-related and the remainder split between civil, labour and accidents.
The department’s acting CFO, Sihle Mkhize, told the committee that while the claim amount reflected as a “huge contingent liability”, the “actual amounts emanating from the settlements of claims do usually differ”.
Recently Weekend Witness revealed that the highest number of medical malpractice litigation claims came from obstetrics and gynaecology, with the second highest coming from paediatrics.
“We are coming up with a strategy to work on medical claims.
“The problem is that some of these cases were not well defended,” said the department’s HoD Dr Sifiso Mtshali.
During the financial year under review, R9.3 million was paid to the state attorney for medical litigation costs and other services.
The department has admitted that its mortuary services faced critical challenges, including inadequately qualified staff, a lack of equipment and the excessively long storage time of unclaimed bodies.
Health MEC Sibongiseni Dhlomo suspended the manager of Durban’s Gale Street Medico-Legal Mortuary on Tuesday, on the allegation that she failed to give “leadership on numerous occasions”.
Dhlomo’s action is connected to a manager’s alleged failure to act and deal with a grieving family who had taken the incorrect corpse for burial and wanted to return it to the mortuary.
According to a statement released by the department, this was just one of a string of incidents to have occurred at the mortuary, including a rat infestation that damaged several bodies.
“We really cannot keep a person without empathy in such a sensitive environment. Here we need people who will appreciate that even the departed have a right to dignity,” said Dhlomo.
According to the 2015/16 annual report, the 39 mortuaries in the province performed 12 583 post mortem examinations during 2014/15. The department said it intended reducing the number of mortuaries to 22 to try and streamline its services.
Other challenges faced by the mortuary department include aged infrastructure, bodies not being claimed due to delays by police in authorising burials, a lack of X-ray machines, inadequate skills and demotivated staff.