According to Mark Heywood from social justice organisation Section27, “we have heard several rumours that the Free State DoH has ran out of money, but we are in the process of confirming it.”
Another unnamed activist, who heads a non-governmental health organisation in the province, said a DoH official addressed an internal meeting in early June and said that the department might be placed under national administration.
However, such allegations have been refuted by the NDoH. “There’s no problem in the Free State at all – why would we do that?” said NDoH spokesperson, Joe Maila.
According to the Democratic Alliance (DA), medical waste removal services were suspended in a number of Free State health facilities that were more than two months late with payment. Free State DA member of provincial legislature, Mariette Pittaway, said the department was millions of Rands in debt to medical waste removal company Solid Waste Technologies South Africa, and that suspension of these services “poses a risk to both patients and medical personnel.”
Solid Waste Technologies South Africa confirmed that some services had been suspended and that it provided the DA with this information, but refused to comment further.
However, Free State DoH spokesperson, Mondli Mvambi, denied that any services had been suspended. “We were lagging behind with payment on our contract with Solid Waste but we have recovered. Medical waste is being collected and dumped appropriately,” he said.
According to one health activist, “a message was delivered from health MEC, Benny Malakoane, by another health official that service providers who speak to the media won’t get contracts.”
There are also numerous corruption allegations arising, most recently about the health MEC ordering a hospital to prepare an ICU bed for his favoured patient, and upgrades worth R1 million being made to his office.
Mvambi admitted that upgrades had been done, but said the cost was “well under R1 million”. He did not know the exact amount. “This was money budgeted for maintenance and cannot be transferred to goods and services,” Mvambi said. He added that the office of the MEC has not been upgraded since 2002 and was looking “shabby”.
In 2013, the activist group Stop Stock-Outs Project, which monitors drug stock-outs around the country, found that over half of Free State facilities surveyed ran out of antiretroviral medication for HIV patients in September and October last year. About a quarter of people between 15 and 49 are HIV positive in the province.
Last month, the Treatment Action Campaign (TAC) released a statement about the frustration of healthcare workers in response to the on-going crisis in the provincial health system. There are major concerns over the non-payment and uncertain employment status of community healthcare workers in the province.
According to TAC, the provincial department is currently allowing NGOs to manage the payment of the community healthcare workers. Meanwhile, the healthcare workers do not wish to be paid via an NGO and are demanding to be absorbed back into the health system.