Reports on the public health sector in Limpopo have been depressing over the years. It seems that the people of this most rural of provinces are so often left out in the cold when it comes to service delivery, and this Cinderella status is particularly evident in the health sector.I certainly hope that the new MEC for Health, Phophi Ramathuba, starts to make the kind of changes this province so desperately needs. He has been in his new role for just over a month now, and I am sure he would have familiarised himself with the Public Services Commission briefing to the Portfolio Committee on Health earlier this year.
The report which looked closely at District hospitals and clinics in Limpopo the availability of medicines and equipment and the role of health district officers was based on inspections into eight hospitals in six districts.
Both announced and unannounced visits were held to determine availability and adequacy of medicines and equipment and whether the district health offices were ensuring availability. The PSC also wanted to follow up on recommendations made in 2009 and establish whether provincial departments had developed guidelines and procedures to manage selection, procurement, distribution and use of medicines and maintenance of medical equipment in line with National Drug Policy of South Africa. It was also looking into whether service sites were compliant with the Batho Pele framework.
There was some good news. Therapeutic committees had been established at all hospitals at district and provincial levels, for identification of new drugs. The product selection was well institutionalised and made effective contributions. Supplies were done through a medical depot for provincial hospitals, and procedures were available for urgent cases.
There was bad news too. The Limpopo medical supply depot was operating without a pharmaceutical license as its building was not compliant. When this Province was placed under a section 100 order, the health department was not able to take decisions in relation to procurement, and it had approached Gauteng to form partnerships to enable it to buy in bulk. There were problems in that storerooms and pharmacies were located next to the outpatient dispensary, which impacted on confidentiality and security.
Members were appreciative of the report, which would help the Portfolio Committee in doing oversight. They asked if the PSC followed up on personnel who had been found to be stealing medicines, and if it looked at the state of water supply and sanitation in hospitals especially Limpopo which was a rural province. They also commented that the PSC did not appear to have considered the perspective of patients. Members commented in particular on problems in Musina, which was accessed by many foreigners, which, although a pilot site for the National Health Insurance, had spent only 38.3% of the NHI grant, and only 19.8% of the regular budget, despite having desperate needs to upgrade its infrastructure. Members asked how the invoking of section 100 had affected the Province. There were further questions addressed to certain staff categories and shortages of clinicians and administrators, and Members also asked if PSC was intending to make further follow-ups, if it had reported the findings to the National Department of Health and what the responses had been. Members wondered if PSC proactively followed up on cases reported in the media, and whether it dealt with all levels of staff.
The PSC, in its answers, identified some further problems, such as lack of transport that led to patients being transferred in nurses’ private cars, and noted that it had received numerous grievances and could present another report on these, dealing with health-workers, cleaners, nurses and doctors, and commented that it seemed illogical that although PSC covered all sectors of the public service, it was only reporting to the Portfolio Committee on Public Services on a regular basis. It asked the Committee to ensure that general cleanliness of hospitals was raised as a serious issue and to ensure that repairs and maintenance were performed.