MPs lament national health department's limited ability to intervene in provinces
The parliamentary select committee on social services has urged the legislative sector to review the powers of national and provincial government‚ "as this has presented challenges to the proper functioning of the health sector".
This follows a briefing on Tuesday by the Minister of Health‚ Dr Aaron Motsoaledi‚ on various issues in the department‚ including the Annual Performance Plan for the 2018/2019 financial year.
Through its many oversight visits to provinces‚ the committee said it has witnessed first-hand the challenge presented by the inability of the Minister of Health to intervene in provinces‚ due to national government’s lack of legislative authority in provinces.
"It is concerning that the Minister can only intervene at a much later stage‚ which impacts on dealing with challenges effectively."
Cathy Dlamini‚ the chairperson of the committee‚ said: “While the committee understands why the legislative prescripts governing the sector are the way they are now‚ it is of the view that amendments have to be made to ensure a system that is fit for purpose.”
The "concurrent nature" of health services also poses a challenge in the standardisation of delivery of infrastructure‚ according to the committee. "In some provinces this is affected by lack of capacity‚ which then impacts on the overall delivery of services."
The delegation of authority‚ especially in finances and the recruitment of human resources‚ in particular‚ continued to present challenges.
"The committee reiterates its position that the approval of appointments only at provincial department level is cumbersome and unsustainable. As a remedy‚ the committee has recommended that the authority to appoint‚ particularly medical personnel‚ be devolved to hospitals. Also‚ the Minister must play an advisory role in the appointment of provincial heads of health departments to ensure that people with adequate skills are employed."
The chronic skills shortage in the sector was also highlighted by the committee. It recommended: "The department must continue to engage institutions of higher learning to find solutions within a cooperative framework to solve the skills shortage."
Going forward‚ the committee resolved to invite the national department together with provincial departments and their MECs in future "to account on concurrent issues affecting the two spheres of governance. This will ensure that answers are heard from both at one time and will strengthen oversight."
It stated the lack of adequate equipment in hospitals needs attention at both national and provincial level. Similarly‚ provinces must share best practice on how some are able to maintain infrastructure while others continue to struggle.
Dlamini and fellow MPs welcomed the improvement in provincial health departments’ audit outcomes‚ despite the fact that the North West provincial health department has regressed‚ when it was one of the best performers in previous financial years. "The support given by national government in this regard is welcomed‚ as good governance represents the first pillar of quality service delivery‚" the committee stated.