'We are attending to Gauteng's health leadership problems to bring stability' — Phaahla

Health minister Joe Phaahla has promised to tackle the issues of poor leadership and governance that have dogged some of the major hospitals in Gauteng, saying several key appointments will be made soon to bring stability to the health department of the country's’ economic hub. 

“We totally agree with him in terms of his (former health ombud Prof Malegapuru Makgoba's) diagnosis of the issues here, and we are dealing with them together with the health MEC (Nomantu Nkomo-Ralehoko) and premier (Panyaza Lesufi) in terms of making sure that we move from an acting HOD, which is the situation currently.” 

Speaking to the media during his introduction of the new health ombudsman, emeritus professor Taole Resetselemang Mokoena, Phaahla said his office would also provide support to the provincial department's  head office, which does not have permanent staff in key positions. One such position is that of a CEO.

Acting CFO Masibolekwe Ndima replaced Lerato Madyo in September. Madyo was suspended after being implicated in the Tembisa Hospital's R850m tender scandal. The department also does not have a permanent head since the resignation of Dr Nomonde Nolutshungu, who resigned in March for “health reasons”, after hardly a year at the helm of the department. 

Mokoena succeeds Makgoba, who this week was scathing about the failures of the Gauteng health department. 

Reflecting on the end of his seven-year tenure on Wednesday as the country’s first health ombudsman, Makgoba said the Gauteng and Eastern Cape health departments were the country's most dysfunctional and lacked progress, leadership, capacity or vision,

He said the Eastern Cape health department was an “embarrassment”, and Gauteng’s health department was “problematic” and “changed its CEOs [like] panties”. 

The Free State health department, added Makgoba, was characterised by “disorder and no harmony”. Makgoba, who described his office as independent and not beholden to any political party, said the only province that “seems to have got its act together is the Western Cape”.   

Of just more than 10,000 complaints his office had received, half were from Gauteng, which he said was run like Eskom and lacked stability due to frequent changes of top leadership, resulting in poor service delivery. Makgoba said an investigation into Rahima Moosa Mother and Child Hospital in Gauteng found “the criteria for appointing the leadership of hospitals is the weakest”. His office also found the hospital to be unsafe, filthy, neglected with crumbling infrastructure and disrespectful to patients. 

On Friday Phaahla described the issues that faced Gauteng’s health department as much deeper, saying Gauteng is the only province that has had several health MECs in a single term. 

“It’s much deeper because as you would know, even the current MEC I think is hardly a year in office. It's the only province in the country where you've had four or five MECs within one term of government from 2019. Their term of government is not yet over.” 

Phaahla said these multiple changes brought about instability at an institutional level, “the coalface of delivery, the hospitals, especially clinics”, and the leadership vacuum must be filled.

The department was in the process of filling key positions, mostly CEOs, at various hospitals, including Steve Biko Academic Hospital, Chris Hani Baragwanath Hospital and Dr George Mukhari Academic Hospital. 

Phaahla said it was normal for people in key positions to seek greener pastures, “but when that happens in the institution which is already weak and has various weaknesses, that does create more difficulties”. The turnaround “is not going to be very short, but we are working together to address these challenges”.

Phaahla said Makgoba’s departure was a loss to the system that still required a huge overhaul and deep reform. “We are glad that he managed to set up systems which we believe his successor will be able to continue with good work he left behind.” 

He described the incoming health ombudsman as “one of the most outstanding South African medical scholars who has transcended the globe to show the quality of South Africans' academic prowess”.

Having attained his medical degree from University of Natal, he graduated with a DPhil from Oxford University and was a fellow of the Royal College of Physicians and Surgeons of Glasgow. He recently retired as a professor and academic head of department of surgery and chief surgeon of department of general surgery at the University of Pretoria and Steve Biko Academic Hospital.

His clinical and research interests encompass immunology, oncology and endocrinology. Mokoena has previously been part of the renal transplant units in at the Natal and Wits universities.

“He is active in academic and professional leadership, having served at different times on a number of national and professional bodies like the South African Medical Association, Health Professions Council of South Africa, Colleges of Medicine of South Africa, College of Surgeons of South Africa. This track record gives credence to his appointment as the new health ombud, armed with experience in investigations and inquiries in wrongdoing and injustices in the healthcare sector,” said Phaahla.

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