Sacks of medical waste are lying outside at Livingstone Hospital in Gqeberha. (Photo: Shiraaz Mohamed)
With R 3.4 billion left for the remainder of the fiscal year to run the Eastern Cape Health Ministry (excluding payroll), an order from attorneys to freeze millions of Rands in the ministry’s bank accounts poses another threat Survival of the fragile health system. This is because the provider of life-saving Covid-19 drugs threatens to stop supply due to non-payment. This is the fourth report in a row to describe the collapse of the provincial health system.
Late last week, the provincial health department struggled to transfer R 113 million from his bank account. This was originally a compensation payment of R 44 million, which was granted after botched litigation plus 13 years of judicial interest.
Ikamva Architects sued the Ministry of Health in August 2008 After winning a contract to renovate Frere Hospital in East London, the contract was subsequently awarded to someone else.
The department initially failed to discover the correct documents for five months and then failed to review certain documents for 15 months between July 2009 and October 2010. Therefore, lawyers from Ikamva Architects requested a default judgment and asked the department for defense to be struck out. This was granted.
In court papers, health ministry officials said many of the infrastructure unit’s staff had been fired and “no longer accessible.”
Therefore, one of the many affidavits the department submitted states that it did not know who appointed Ikamva Architects or why.
The department appealed to no avail. It then applied for its defense to be reinstated, but it still failed to comply with the discovery order. It then gave up his request for restitution. A default judgment of R 41 million was issued against the department, but this had risen to R 113 million by 2021 with court-ordered interest.
The department then applied for permission to appeal the order and filed a motion to have the order lifted. The appeal was denied. The request to resign was also denied.
“The matter has a long and torturous history,” wrote Judge Glenn Goosen in one of the many rulings on the matter in which several senior judges described the Department of Health’s conduct as “shocking” and “egregious”.
An analysis presented to the Health Committee of the Eastern Cape Legislature in 2020 found that in 2020 funds totaling R 80.7 million were transferred from the Ministry of Health’s bank account.
In her budgetary policy speech last week, MEC for Health Nomakhosazana Meth said medico-legal claims against the Ministry of Health are “the greatest threat to the sustainability of the Ministry of Health”.
In response to a question, she said the department had several conversations with her bank and arrangements had been made to respond to orders that had money attached from her bank account. She said the province is now moving to a different bank, but will continue with these commitments “as long as we continue to face medical and legal claims.”
Last month, the collection of hazardous medical waste at some facilities was delayed after an order was given to freeze funds in the department’s bank account. The blood gas analysis, which is important for intensive care patients, has been stopped. and now the supply of certain drugs necessary for Covid-19 patients is threatened as the department has not paid accounts which are now millions. In some cases, payments were made after the services ceased.
In previous cases, attorneys also attempted to attach buildings, ambulances, vehicles, and other department property.
Meth said the department’s medical record management system had been identified as one of the biggest risk factors, adding that it was their priority to move this to an electronic system.
She said the department had paid R 3.4 billion in damages from fiscal 2014/2015 through February 2021.
The Special Investigating Unit, which investigates fraudulent claims against the Ministry of Health, classified eight cases worth R 96 million as fraudulent in the past year.
Meth said the department’s unpaid bills, which are expected to be around R 4.4 billion by the end of the year, will be paid first from the R 26.4 billion annual budget and then another R 17.9 billion Due to the cost of spending and the projected overspending of R 689 million for staff, the department would only have R 3.4 billion left for managing the department and providing health services to the public.
“The Eastern Cape Ministry of Health has been targeted by attorneys working with some health workers on dubious medical-legal claims. As a result, billions of rand have been paid in medico-legal claims, which seriously hinders service delivery, “she said.
“Because the department uses a manual filing system, some health care workers have been accused of stealing patient records, making it difficult for the department to defend itself against false claims in court.
“These days are numbered as we are pushing the migration to an e-health filing system.
“I have already met with the Minister of Communications, Telecommunications and Postal Services, Stella Ndabeni-Abrahams, and the chief caretaker of the State Agency for Information Technology, where it has been agreed to speed up the broadband connection. At that meeting it was also agreed that qualified resources would be dedicated to the implementation of e-services to improve patient care, ”she said.
Meth added that a team will be sent to the province by this week to provide assistance on ICT issues.
“I also plan to work with the Minister for Higher Education, Science and Technology to use the services of the Scientific and Industrial Research Council. I am convinced that discarding the manual filing system will reduce medical and legal claims.
“I’m not saying it will be eradicated overnight, but a strategy needs to be developed on how to deal with this challenge.
“This is a systematic swamp that will soon collapse the department, and with it the provincial government, if it is not addressed urgently.
“I believe that the filing system is one of the main culprits in increasing the number of people affected [medico-legal] Invoice. This is an obstacle to health care for the people of the Eastern Cape. The immediate task is to review our ICT strategy with my management team, ”she said.
She added that consequence management “is undoubtedly of vital importance to ensure efficient and effective delivery of services to our employees”.
She said migrating from manual recording, critically addressing issues leading to medico-legal claims, and human resource management are her three top priorities.
In her keynote address, Meth warned that given the financial constraints, the department had to “do more with less”. DM / MC
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