MEC Gwen Ramokgopa spells out problems with health system
Poor management is at the heart of the issues plaguing the Gauteng health department, according to its political head, health MEC Gwen Ramokgopa.
Ramokgopa told Business Day on Wednesday that the poor management system, coupled with inadequate control and insufficient performance management, needed to be dealt with in order to advance public health in the province.
The MEC’s view is in line with the findings and recommendations contained in a ministerial task team report presented to Parliament’s portfolio committee on health by the health minister last week.
That report found there was a tendency for management, at both local and provincial hospital level, to defer accountability for the deficiencies to others. The lack of managerial capacity affected procurement, budget expenditure and the human resources function.
The South African Health Report also identified leadership stability, a change in management strategy and strong managerial capacity as essential for achieving greater efficiency.
Dr Ramokgopa outlined the problems faced by the department including rising medico-legal costs, infrastructural problems and staffing issues but was certain that a lack of management skill and control was at the root of the problems.
She said while managers needed to be held accountable, they also needed the authority to make decisions. "We must expect more from senior management. As it stands, our management systems are not optimal," she said.
The director of the Centre for Health Policy and chairperson of the Public Health Association of SA, Prof Jane Goudge, said financial management in public health was affected by the fact that it was often unclear who was responsible for making payments in government.
A further complication was that enough money was not made available in budgets to carry out the policy mandate of the state, which was under pressure to deliver.
"The findings of the integrated support team’s report of 2009 showed that health was financially poorly managed, and much of that still remains true till this day," Goudge said.