On a mission: Limpopo health MEC Phophi Ramathuba is driving a turnaround strategy to overhaul the Limpopo health department, which she says went on a hiring spree, appointing 5,000 ‘noncore’ staff. Picture: SOWETAN
On a mission: Limpopo health MEC Phophi Ramathuba is driving a turnaround strategy to overhaul the Limpopo health department, which she says went on a hiring spree, appointing 5,000 ‘noncore’ staff. Picture: SOWETAN

The Limpopo health department is poised to radically restructure its staff complement to try to free up more money for frontline workers and goods and services, according to health MEC Phophi Ramathuba.

The department’s compensation bill has ballooned in the past decade, rising from 58.9% of its healthcare budget in 2008-09 to 71% in 2016-17, according to an analysis published by the Treasury as part of the medium-term budget policy statement last week.

The department had gone on a hiring spree and appointed more than 5,000 "noncore" staff before it was placed under section 100 administration in 2011, said Ramathuba.

As a result, it employed far too many clerks and administrators and did not have enough doctors, nurses, cooks and cleaners in its health facilities, she said.

The MEC said she had submitted a turnaround strategy to the Limpopo executive council, which if approved, would enable her to overhaul the Limpopo health department’s staffing, review its budget allocation and prioritise infrastructure spending on maintenance instead of constructing new facilities.

She made her remarks after receiving a report from the Treatment Action Campaign (TAC) cataloguing shortcomings at hospitals and clinics in the Vhembe and Mopani districts.

The lobby group collected patient testimonies in October, highlighting long waiting times, staff shortages, medicine stock-outs and equipment failures.

There was insufficient accountability in the public health sector and the government needed to reprioritise its spending, said TAC general secretary Anele Yawa.

There were similarities across all the provinces, Yawa said. "We have a health minister who has a lot of responsibility but no legal authority in the provinces. MECs are political appointments. The government can’t say it doesn’t have money to fix the healthcare system but spend R246m on Nklandla and millions more on jets and blue-light convoys," he said.

South African Medical Association vice-chairman Mark Sonderup said patient experiences were useful, but health outcomes — such as tuberculosis cure rates or HIV/AIDS-testing coverage — offered a better gauge of how hospitals and clinics were performing.

The poor quality of Limpopo’s public healthcare system is reflected in its maternal mortality rate, which was the fourth-worst in the country in 2014, at 153.3 per 100,000 live births in 2014, almost three times higher than the 66.5 per 100,000 live births in the Western Cape.

It can also be seen in the number of medical negligence cases it was forced to confront over the past few years: the number of cases rose from 93 in 2014-15 to 218 in 2016-17, according to a parliamentary reply from Health Minister Aaron Motsoaledi earlier this week.

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