Western Cape Appropriation Bill: Vote 6: Health

Meeting report

Representatives from the Western Cape Health Department were present with the Western Cape MEC for Health, Dr Nomafrench Mbombo, and gave a brief overview of the Budget Estimates for the Western Cape Health Department in the current year 2020.

Minister Mbombo, alongside Dr Keith Cloete, DDG: Chief of Operations, Western Cape Department of Health, alluded that South Africa faces challenging times with the economy of the country struggling and the growing population of the Western Cape.

The struggling economy affects service delivery, and due to this, some budget programs were increased. Others were decreased and some have not been changed. The noticeable changes in some budget programs were made according to need. Dr Cloete said, as a result of the new five-year period the country entered, the new Budget is an opportunity for the Western Province’s Health Department to discover what its plan is for the next five years, and how to prepare for the next five years. The Department’s creation of this new Budget is not only focused on finances, but on testing how flexible the Department can be during testing times, and how prepared it can be to face challenges arising in the next five years.

Discussion

Mr R Mackenzie (DA) asked the Minister about the policy on integrating the filing systems in hospitals, as it is an issue that affects service delivery, an update on the Corona virus (COVID-19) - what people must do and not do, and if it is a good idea or not to spend lots of money on preventative measures instead of waiting for three to six months to see how far the virus spreads and then respond.

Mr R Allen (DA) asked the Minister about the activities cut from the Budget and what those activities are.

Ms L Botha (DA) asked the Minister how members of the community are informed about the Corona virus, specifically those who do not understand English, and how the Corona virus will be included in the Budget.

The Chairperson asked the Minister if the Corona virus will be included in the unanticipated events aids of the Budget

Minister Mbombo said about filing systems, the inconvenience is mainly caused by the fast-tracking of provincialisation of the Department and this issue is something they are working on. The major problem is actual hard copies of people’s medical files. The Premier and Mayor are discussing improvement plans for Manenberg schools and sports facilities.

On Corona virus updates, the Minister said it is an international issue, it is also a societal issue as it affects everything, including the economy. There are information pamphlets about the virus, but the Department of Health is also using other communication platforms to spread the messages. This includes government websites, churches and schools. The Department is venturing to different radio stations to spread the information about the virus in different languages, thus reaching out to more people, including those who do not understand English. It is inevitable that the Corona virus will spread in the entire country, but what is important right now is the preventative measures people need to use, and getting people to get tested, and isolation in cases where people test positive. The entire country must work together to fight the Virus. Minister Mbombo said the budget in place right now was created before the outbreak of the virus, meaning the Virus is not included in the Budget, as it is focused on the current issues facing the Western Cape Province, such as the growing population.

The Chairperson allowed for more questions from the floor on the actual budget, page by page.

Ms R Windvogel (ANC) asked the Minister about overcrowding and long queues in clinics and hospitals and how the Department aims to address this issue through the Budget, and for clarity on the budget shortfall.

Mr Mackenzie asked the Minister if there is a policy plan in place for the public to be able to trust the services it gets from hospitals and clinics when asking for help for diseases and viruses such as the Corona virus.

Ms Botha asked the Minister about money allocated to the Theatre backlog in Tygerberg Hospital and if it is going to be enough to eliminate the entire backlog, for clarity on the increase of security in hospitals and if it will be for a specific hospital or all the hospitals in the Province.

Mr Allen asked the Minister for clarity on the supply chain management and how it is supposed to work.

Minister Mbombo said the Health Department takes responsibility for social ills including those not health related, such as poverty, unemployment, and inequality. These issues affect ordinary people, and to deal with issues related to these social ills, for example crime, the Department must sometimes take funds intended for health related matters in order to fix those social ills. There is no budget for unforeseen events which could take place, such as the H1N1, Listeriosis or even the Corona virus outbreak, and also for load shedding, robberies on health facilities, arson on health facilities, drought and such. It is impossible to say through this budget everything will be fine. She anticipates there will be more challenges.

Dr Cloete with the Minister, answered questions about the budget shortfall, supply chain management and Tygerberg backlog.

The Chairperson opened up the floor for more questions on the Budget.

Mr Allen asked about inter-hospital transfers and the uncertainty it may cause amongst doctors who are employees of these specific hospitals, as well as doctor-patient relationships which may be affected.

Ms Windvogel asked about the high increases in capital expenditures.

Dr Cloete said, on the high increases in capital expenditures, the Department works hand-in-hand with the South African Police Service in death-zones in cases of emergencies. It has an immediate response line to incidents where a doctor is needed for an emergency. Increases in expenditures include for services where there must be a doctor on call even if it is after working hours, and these doctors in some cases need to travel with ambulances and medical kits.

The questions about inter-hospital transfers and capital expenditures were answered using the budget book.

Ms A Bans (ANC) asked the Minister how much of the Budget is allocated to the Cape Peninsula University of Technology (CPUT) Nursing Campus in Athlone and if all concerns leading to protests in the Campus are resolved, if there are funds for allocation to students who failed, and for clarification on budget cuts.

Minister Mbombo answered Ms Bans by saying the Department has its own nursing college, and CPUT has its own. The Department assists CPUT with bursaries for students to study. The reason behind the student protest was, students are done with their practice. The end of the protest can only happen if the students find employment opportunities. Students who fail do not get further funding from bursaries.

The Chairperson invited Members of Parliament to ask more questions of the Minister. After indicating there was nothing further, the Chairperson invited members of the public to pose questions.

Ms Damaris Kiewiets, Cape Metropolitan Health Forum, asked the Minister about the amalgamation of services in the Metro, if City Health is included in the Budget, when the public can expect amalgamation to happen, the inclusion of Health Committees in the Budget and coordination at the different levels of engagement within the Department, and who is given the role and responsibility to ensure that Health Committees are in place.

Dr Cloete said the Minister engaged the City of Cape Town about the amalgamation of services, and amalgamation can only happen if the City of Cape Town’s political sphere agrees to it. There is a certain disjointedness within the City of Cape Town’s political sphere, causing the amalgamation of services to be slow.

Ms Kiewiets asked the Minister for a clear answer about when to expect the amalgamation of services.

The Minister said, for now she cannot state the exact time-frame as to when it will begin to happen because as much as there are resources in place, some Metros do not respond in time, which leads to postponement in most cases.

The Chairperson said Ms Kiewiets input and involvement in the meeting is appreciated, and invited her to attend more of these meetings and invite more of the public.

The Standing Committee agreed to have its next engagement specific to the Corona Virus on 1 April 2020.

The Minister and the guests from the Western Cape Department of Health left and the Members of Parliament stayed behind to look at resolutions.

There was a general consensus in support for the Budget. The Chairperson thanked the Standing Committee for its engagement and attendance.

The meeting was adjourned.