Dr Mark van der Velde and his team operate on Angelique at the Red Cross Childrens Hospital in Cape Town. Picture: WESTERN CAPE HEALTH DEPARTMENT
Dr Mark van der Velde and his team operate on Angelique at the Red Cross Childrens Hospital in Cape Town. Picture: WESTERN CAPE HEALTH DEPARTMENT

The Western Cape health department is lobbying the provincial treasury to spare it from budget cuts, as officials around the country grapple with the looming reductions signalled in the medium-term budget policy statement.

In October, finance minister Tito Mboweni announced that transfers to provinces and municipalities would be cut by a combined R40.8bn over the three-year medium-term expenditure framework. With a little over a month to go until the minister tables his budget in parliament on February 26, provincial departments are now putting their business cases to their respective treasuries in the hope of minimising the pain.

“The provincial treasury is in a very difficult situation,” said the Western Cape’s incoming head of health, Keith Cloete, who is due to take over from Beth Engelbrecht on April 1. Deep budget cuts have the potential to destabilise the health system and quickly cause damage that would take years to repair, he warned.

Western Cape health officials met their treasury counterparts on Thursday morning and made the case for the health budget to be protected.

Cloete described it as a “very difficult session”, given the bleak economic environment, but said he is hopeful the health budget would be spared deep cuts. “We are confident that we will get a positive response to the case we’ve made,” he said.

The department has been under sustained financial pressure as its budget has failed to keep pace with inflation for the past five years despite soaring demand for services. The province’s population has grown 10% over the period, and the complexity of the conditions affecting patients is on the rise. The growing gap between resources and need has been worsened by the surge in violence, with the homicide rate doubling in the past three years, said Cloete.

The department currently faces a R500m shortfall on its R24bn budget for 2020/2021, said Cloete. “If we can be freed up from any reductions, we can manage,” he said.

The Western Cape health department is the only health department in the country to have received a clean audit, which it achieved in 2018/2019. Prior to that, it had 14 unqualified audits.

Engelbrecht, the Western Cape’s head of health, said the provincial treasury is expected to get clarity on its budget allocation from the national Treasury on February 6 and the departmental allocations would be finalised after that.

Cloete said the Western Cape is well prepared in the event that the potentially deadly coronavirus, which emerged in China in December, is imported into SA.  By Thursday afternoon a total of 555 cases had been confirmed, and the disease had spread to Thailand, Japan, South Korea and the US, sparking fears of a global outbreak.


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