The Eastern Cape health department is grappling with a severe budget crisis, with only R1.8 billion of its R28 billion budget for 2023 left for service delivery after accounting for salaries, wage increases, and cost overruns from the previous year. This was revealed by former health MEC Nomakhosazana Meth to the National Council of Provinces (NCOP) appropriations committee, as reported by the Parliamentary Monitoring Group.
The province’s health department, already stretched thin, is crucial for a population where 72% live in poverty and unemployment approaches 50%. With 89% of the population dependent on government health services, the system’s functionality is paramount. However, recent reports highlight significant deficiencies in the system.
Major hospitals like Livingstone Hospital in Nelson Mandela Bay have faced critical shortages of medical supplies, including needles, nappies, oxygen masks, and gloves. Additionally, there are reports of linen, beds, and food shortages. Of the province’s 432 ambulances, 196 are in for repairs, leaving some areas severely underserved. Patients have experienced significant disruptions, such as being sent to distant facilities for essential services like oxygen and X-rays.
For example, patients at Holy Cross Hospital in Flagstaff are sent 40km away for oxygen, and patients in Stutterheim travel over 100km to Frontier Hospital for X-rays. At some hospitals, patients were even told to provide food due to shortages. The department’s administrative challenges compound these issues. The health department began the current financial year R4.8 billion short due to unpaid service provider bills from the previous year.
This resulted in suppliers halting services, leading to disruptions such as electricity outages and security withdrawal from facilities. Furthermore, the department faces astronomical medico-legal bills, having paid out R339 million in claims for 2023/2024, with a total of R3.7 billion since 2015. The auditor-general estimates the value of claims against the department to be over R30 billion.
Despite promises from former National Health Minister Joe Phaahla to assist the struggling department, little has changed, highlighting the need for more political will to address these deep-rooted issues. The situation underscores the challenges of implementing National Health Insurance (NHI) without first resolving fundamental service delivery problems.
The Eastern Cape’s health crisis exemplifies the dire consequences of mismanagement and inadequate funding in public health, as emphasised by Jane Cowley, a DA member of the provincial legislature. The ongoing issues raise significant concerns about the feasibility of NHI in its current form, given the existing systemic failures at the provincial level.