The long road to recovery

There is a stack of boxes in Macks Lesufi’s office in College Street, Polokwane.

The head of communications is proud of what’s inside: there are scales and blood pressure machines. They are donations from a private corporate donor. More than the value of the much-needed equipment, the donations signify a vote of confidence from the private sector in building relationships with a department that is in desperate need of resurrection.

Alongside relationship-building, Lesufi highlights a few other key strategies as the department emerges from three years of being under national administration.

Administration through National Treasury is a dramatic invention. It is meant to arrest the disease, stop the bleed and stabilise the department. At the same time, though, it did mean three years of no forward action. Posts were frozen and no new procurement took place. Furthermore, no maintenance took place – and there was no funding for nurses’ training or staff development.

Lesufi is trying to focus on the positives, one month after the handover back to the provincial authorities. He is fully aware of the big job of catch-up that must be done, on a slim budget that – for this financial year – stands at R14.8 billion for the department.

The big positive, he says, is that, for the first time, last year, they managed an “unqualified audit”, not one with disclaimers. He says: “It meant that we could say to the auditor general that ‘we got R20 here, and this is how we spent it’. This was the first time.”

Lesufi says: “We have to concentrate on our core services, and set aside the non-core services, and stop illegally-funded transactions.

“We have learnt our lessons from the intervention of Cabinet, and we know that things were bad. By 2009, things were in sharp decline. Even in 2013, doctors were up in arms because they couldn’t function. We also still have unpatriotic public services who don’t want to serve. Additionally, there are 24 criminal cases against corrupt staff members which are now being dealt with in the courts. But we have to stabilise now, build our revenues and communicate and bring people together to hear what their interests and concerns are in health.”

Lesufi highlights five key priority areas in moving forward. To scale up the maintenance schedule for facilities; to scale up the clinics to become 24-hour operations; to ensure that EMS is functional; to develop the capacity of the two academic hospitals in the province; and finally, to strengthen the human-resource capacity to attract more doctors and nurses to the province.

Currently Lesufi says the Department of Health (including all staff) is about 34 000 strong. There are 44 hospitals in the provinces, 438 clinics, and 65 health centres. There are five private hospitals in the province.

He says: “We have a population of five million people in the province, and about 4.5 to 4.8 million of the people rely on public health care. At the end of the day we have a duty – we have to drive the message of how human life is precious.”

The department will embark on an intensive health imbizo for the remainder of the year. MEC Ishmael Kgetjepe and the top leadership of the department will make spot visits to health centres throughout the province. A key focus will be to communicate the department’s plan for the financial year, and highlight focus areas in which communities can expect to see changes. Frequently, political changes and political appointments remain a challenge to building good working relationships; and to the continuity of established projects and programmes, and the retention and application of institutional knowledge.

“Through the imbizo we want to test that the message relating to the changes will get back to our clinics. We know that we can say to hospitals and clinics, ‘here is the ambulance we have bought’, but people will say, ‘yes, but there are problems with one, two, three…’, so we want to be able to hear about these things.”

Lesufi knows that the journey towards the recovery of the system will be long. As he puts it: “We are not at our desired destination yet; but we are excited, because we feel like we have turned a corner.”