Gauteng patients’ woes intensify as care is delayed and suppliers go unpaid

Photo: Jack Bloom,  DA Shadow MEC for Health in Gauteng

According to the DA’s shadow Health MEC in Gauteng, Jack Bloom, many suppliers have now been forced to stop delivering lifesaving equipment and services to the provincial health department, exacerbating the ongoing provincial health crisis that is putting patients’ lives and the delivery of healthcare services at risk.

Responding to a written question by Bloom in the Gauteng Legislature, Health MEC Nomantu Nkomo-Ralehoko said 940 suppliers were owed R1.855 billion at the end of last month. This means that only 40% of suppliers have received payment.

Bloom asked the question following an earlier interview with AxessHealth on the current state of healthcare in the province. Despite giving the GDoH almost three weeks to respond to questions on issues raised by Bloom during the interview and several assurances by the department’s spokesperson, Motalatale Modiba, that people were working to gather the information requested, not a single question has been answered to date.

But pushed by Bloom to answer questions about supplier payments, Nkomo-Ralehoko conceded that 223 of the 940 suppliers are owed R983 million for more than three months and 176 are owed R35.5 million for longer than six months. In March last year, the department owed suppliers about R4.7 billion with some of the outstanding payments then dating back to 2017.

“The situation is so bad that some unpaid companies are refusing to supply essential equipment to hospitals, with the MEC blaming the late payments on the settlement of accruals from previous years, and court/ordered medico-legal payments that are not planned and budgeted for,” Bloom said.

Earlier this year, delays in the procurement of specialised machinery and renovations of operating theatres were given as some of the reasons for the growing backlog of surgeries in Gauteng’s public health sector. However, nothing was said about unpaid bills to suppliers and the possible impact it could have in delaying the procurement of medical equipment and other supplies. Other factors the MEC then blamed for what she said, was a backlog of 32 000 surgeries, the Covid-19 epidemic, load shedding, delays in filling critical posts and a mass exodus of healthcare professionals to the private sector and other countries. The solutions proposed to fast-track critical and advanced medical procedures that had waiting lists of up to five years included regular theatre marathons, utilisation of cluster hospital theatres and collaborations, the filling of critical vacant posts and minimising disruptions at facilities through contingency plans.  

Promises to divert attention from real issues

Bloom says these promises are nothing but a whitewash of the realities currently experienced in the public health sector.

“The remedies proposed are tepid measures to address an ever-worsening situation that is being exacerbated by poor management, load- and water-shedding, a dire shortage of specialist posts, corruption and a crumbling and overwhelmed infrastructure that can’t cater for the province’s fast-growing population,” Bloom told MedBrief Africa.

“The reality is that the problems are getting worse and are underestimated. What the MEC failed to say is that the backlog waiting list is actually a waiting list of a waiting list. People only get on the surgery waiting list after they have seen a specialist who has diagnosed and referred them for surgery.”

However, with the shortage of specialists at public hospitals, people can wait months to get a specialist appointment and when they finally manage to reach the top of the waiting list, they’re often told that they will have to wait some more because there is a power failure or a lack of water or the equipment needed for the operation is broken or the hospital doesn’t have clean linen.

“There is a large number of cancelled operations for totally preventative reasons such as no clean linen. The MEC blames renovations, a lack of beds and critical posts not being filled. These problems have been there for years but there is no urgency to solve them,” Bloom noted.

“I’m afraid a surgery marathon here and there is not going to cut it. It is not going to bring this backlog down. These surgery marathons and other plans are just chipping away at the backlog, but it will never get rid of it because every day more names are added to the waiting list.

Referring to the health department’s reluctance to take up offers from the private sector to assist and its failure to implement recommendations from the Western Cape Department of Health, Bloom says it all boils down to a lack of political will and endemic corruption and mismanagement that are stealing and wasting money meant to help desperate patients.

“They are not geared for private public partnerships because there is no motivation and there is no way you can cut a backlog of this magnitude unless you have a private public partnership. They are not friendly to the private sector and their excuse is they don’t have the budget, but they don’t because they spend it so badly.

“If you just look at the millions that were stolen or wasted that were earmarked for the Covid-19 pandemic, and the refurbishment of the Tembisa and Anglo Gold Ashanti hospitals – what that money could have done to ensure that patients get much-needed surgeries and care,” says Bloom.

“We are in an absolute crisis and government is punting National Health Insurance as the ultimate remedy. They are using it as a diversion to cover up their failures. NHI is pie in the sky. What they really need to do is to fix up the public sector. It is possible and there are solutions – just look at the Western Cape.

However, it is not going to happen under the current government. Without radical intervention that will bring stability the promised light at the tunnel remains very dim. The crisis in the Gauteng health system should be looked at in the same way as the Eskom catastrophe. With an ANC government in charge, there’s not much hope of ever fixing public health. At the end of the day, it boils down to the fact that a lot of people have died and are going to die while waiting for surgery or other live-saving healthcare,” Bloom concluded.