The Portfolio Committee on Health conducted a two-day oversight visit to the Thabo Mofutsanyana District in the Free State.
The Committee visited two hospitals, the Mofumahadi Manapo Mopeli in Qwaqwa and Dihlabeng regional hospital in Bethlehem. The committee also visited the Mphathalatsane and Mahaing clinics. On the last day of the oversight, the committee had a meeting with the MEC for Health Benny Malakoane, to present challenges identified.
Briefing the Provincial Department of Health, the committee said that staff shortages, and poor infrastructure and maintenance were some of the issues identified, along with the heavy bureaucratic requirements in supply-chain management and procurement.
Reporting back on its findings at Mofumahadi Manapo Mopeli Hospital, the committee found that the hospital’s boiler had not been working for five days and there had been no response from the service provider.
The roof leaked and cleaning and catering services were outsourced. The Chief Executive Officer (CEO) for the hospital, Bongi Mthimkhulu, said the hospital’s budget is insufficient for its needs.
Furthermore, maintenance problems are exacerbated by the centralisation of services in Bloemfontein. At Manapo, the committee was also of the view that hospital management was removed from the day-to-day challenges, for example, the CEO was unaware that the hospital’s generators are broken.
When the committee arrived at the gate of Mofumahadi Manapo Mopeli hospital the Treatment Action Campaign (TAC) was outside to raise issues with the committee, on issues that the TAC has with the provincial department of health. Representatives from the TAC informed said the provincial health department does not want to meet with them and after the engagement, the committee recommended communication between the TAC and the province be improved to address areas of concern.
It was requested by the committee that the TAC should send their concerns in writing to the office of the chairperson. The committee also requested the Malakoane’s office to address matters that are in the competency of the province, in particular to address the challenges at Mofumahadi Manapo Mopeli Hospital.
The committee observed and expressed concern on the management and leadership at Mofumahadi Manapo Mopeli Hospital and members noted that management differs from one hospital to the next. They recognised that delays in staffing appointments are exacerbated by the fact that the department is under administration and the provincial Treasury must sign off on all appointments.
Concerns were raised at Manapo hospital about the outsourcing of key services (such as cleaning, catering and security), which could lead to the inflation of costs and a lack of benefits and job security for workers.
At Dihlabeng Hospital, the committee learned the hospital has its own maintenance unit and all services and staff are not outsourced. It commended the management of the hospital for its hands-on approach and willingness to serve. It was of the view that the hospital should serve as a benchmark for other health facilities in the district.
At the clinics, the committee found them to be too small (particularly Mphatlalatsane). Security and waiting times were also big problems.
It urged the district to look at the National Development Plan (NDP) to determine the requirements for the social determinants of health (such as water, nutrition). The committee also said an integrated approach with other stakeholders appeared to be lacking. Without a multidisciplinary approach, the committee was of the view the fight against malnutrition would be lost in the district.
Member of the committee observed the laxity on health workers (in all the institutions) for not wearing distinguishing devices when on duty and raised the issue with management in all the institutions that the Committee had interacted with. At the various clinics, members noted that some governance structures are functional and that there is a good relationship between the community and health workers.
“Health workers need to be commended on the work and services that they provide to people. With the challenges of staff shortages health workers are executing their duties and doing their best,” said the Chairperson of the Committee Lindelwa Dunjwa.
Dunjwa explained that they will deliberate on all issues and thereafter make recommendations on areas that need urgent attention.
Statement Issued by the Parliamentary Communication Services