Further – key governance matters must be addressed by the 6th administration in relation to local government, education, health and environmental governance.
In the days preceding the SOPA – the Auditor-General (AG) announced a net regression in Eastern Cape municipal audit outcomes along with irregular expenditure of R 7.3 billion. Irregular expenditure is a clearly defined in public finance management legislation and fundamentally denotes wasted public funds. This is R 7.3 billion that would otherwise provide toilets, tarred roads and clean water to under-served municipalities.
Alarmingly – out of 31 local municipalities – only two achieved clean audits. This has a direct impact on the delivery of municipal basic services and does not bode well for residents of the Eastern Cape.
PSAM welcomes the inclusion of education as one of the priorities for the 6th provincial administration. However, the Premier did not explain how the Early Grade Reading Programme mentioned by President Cyri Ramaphosa, in the State of the Nation Address (SONA), will be implemented in the province.
While the Premier mentioned that the 6th administration will “re-introduce a culture of performance and consequence management to improve service delivery,” the history of underperformance by the 5th administration indicates that such a culture never existed. So, it is not a re-introduction as such. Also, the Premier did not explain how this culture will be implemented in the departments. For example, how will the 6th provincial administration ensure that the history of poor performance by the Eastern Cape Department of Education (ECDoE) is addressed?
We note that the Premier did not explain how the poor spending and underperformance of the Early Childhood Development (ECD) grant will be improved. Reporting on poor spending by the Eastern Cape Department of Social Development (ECDoSD), the PSAM – in its 2018 Expenditure Tracking Report (ETR)– explained that out of R56.4 million allocated to the Eastern Cape Province for the ECD grant in the 2017/18 financial year, only R27.2 million (48.6%) was spent. The department also failed to spend its budget allocation of R10.2 million in the 2017/18 financial year, for the maintenance of ECD centres. Therefore, while the Eastern Cape Department of Social Development (ECDoSD) allocated R10.2 million for the maintenance of targeted 96 ECD centres, it failed to spend this money. This underspending and underperformance context affects the access of children to quality ECD.
The ECDoSD reported that 63% of its provincial allocation was spent by the end of December 2018. This pattern of poor spending must be addressed through stronger fiscal management by the MEC for Social Development, Ms Siphokazi Iris Mani-Lusithi, team and more rigorous scrutiny by portfolio committees..
Decisive steps must be taken to address the problems resulting in underspending and underperformance. When the MEC for Social Development tables budget and policy speech, she should report on the progress of ECD maintenance component. In our pre-SOPA statement, it was noted that only 35% of all the targeted 26 ECD centres were reported as completed under the maintenance component. The 26 ECD centres were planned in the first quarter and it was estimated that they were going to be completed by 22 March 2019.
We urge Premier Mabuyane to engage key stakeholders on his plans to fast-track delivery and ensure a responsive, accountable provincial administration. Additionally, there needs to be introduction of oversight for expenditure of the ECD grant.
The Eastern Cape Department of Health (ECDoH) has been contending with medico-legal claims for years. These claims seem to be frequent, on the rise and exert pressure on the current healthcare system. To address the issue of medico-legal claims, an integrated approach is required as mentioned by the premier during the SOPA however, included in the stakeholders should be the treasury and the private sector.. All resources in the health sector need to be utilised if we are to find a solution to this problem.
To date – medico-legal claims in the Eastern Cape amount to a staggering R 630.1 million paid in settlement and an additional R 37.9 million paid to the office of the state attorney This is simply unacceptable.
In February – Minister Tito Mboweni tabled a Budget Review in which he outlined plans to curb this drain on health budgets. Two stand out; referring cases directly to the Special Investigations Unit (SIU) and introducing legislative reform to allow periodic settlement of such payments. It is not clear what progress has been made in the former in relation to the Eastern Cape. Have any cases been referred and/or resolved by the SIU? What provincial reforms are planned that would be preventative – in contrast to the current reactive proposals?
We welcome the employment of 500 unemployed nurses to support healthcare centres and 300 additional support staff to ensure that clinics and hospitals maintain health standards as mentioned by the premier during the SOPA. However, there was no mention on community health workers as a budgetary consideration. This is especially concerning considering the continued contribution of community health workers to primary healthcare services. Furthermore, in employing the 500 unemployed nurses, the ECDoH must ensure that there is extensive training of the incoming nurses on how to deal with various vulnerable groups in our society with patience and professionalism.
During March 2017/18, the ECDoH employed 334 nurses and only managed to retain 158. The ECDoH needs to determine new and innovative ways to retain its nursing staff going forward.
Since May 2019 – seven initiates have died in the Eastern Cape. While the Premier rightly outlined the current state of male circumcision as a health matter, the premier failed to outline mechanisms the department intends to take to address the issue of illegal initiation schools, which are contributing to the death of initiates during the sacred initiation custom. The National Department of Health must consider norms and standards to regulate initiation schools to ensure these schools are licensed and those tasked with the responsibility of circumcising young men have the required skills to prevent further deaths of initiates. While having a provincial coordinator is important, there needs to be mechanisms in place to hold the owners of illegal initiation schools accountable for the negligent deaths of initiates.
In South Africa, all new HIV/Aids infections are estimated to occur among the youth aged 15-25 years. While we support the investment of resources for effective education and advocacy on HIV/AIDS, TB and Cancer as outlined by the Premier during his SOPA, an integrated approach to the education and advocacy is required with different stakeholders including the department of health, education, civil society organisations and community health workers.
The National Health Insurance (NHI) Bill is a contentious piece of legislation. During the 2019 SOPA, the Premier outlined that the 6th administration would move to advance the roll out of the NHI in the province. It is imperative that before this is done, the ECDoH share lessons learnt from previous pilot programmes to uphold governance, accountability, transparency and responsiveness to the people of the province whom the NHI seeks to benefit.
In relation to environmental management, it is noted that the Constitution provides for the right to an environment, which is not harmful to human health and well-being, together with the complementary right to have the environment protected by way of legislative measures. Correspondingly, South Africa has an impressive basket of environmental protection statutes, for which the Provincial Government has numerous implementation responsibilities. Despite this, however, the Address was very silent in relation to the Province’s environmental governance mandate, which is synonymous with the paltry budget consistently allocated to it.
For further information on these opinion pieces, please contact:
The following PSAM staff wrote this joint commentary:
Siyabulela Fobosi: Education Researcher
Tlamelo M Mothudi: Health Researcher
Nicholas Scarr: Environmental Governance Researcher
Public Service Accountability Monitor (PSAM)
School of Journalism & Media Studies