Spotlight on health MECs: Gwen Ramokgopa

Dr Gwen Malegwale Ramokgopa is the Member of the Executive Council of Health for the Gauteng Provincial Government since 06 February 2017 Credit: gcis.gov.za

By Ufrieda Ho

Government’s merry-go-round of political appointments saw Gwen Ramokgopa return to the position of MEC for Health in Gauteng in February – a post she first held in 1999.

It couldn’t have been worse timing for Ramokgopa. She inherited the post

vacated by Qedani Mahlangu in the aftermath of the shameful tragedy of the deaths of at least 94 mental health patients released from private mental healthcare facility Life Esidimeni. They were among the approximately 1398 mentally disabled patients released to 27 non-governmental organisations (NGOs).

Her first days in office would reveal that the number of deaths was in fact over 100. As of the beginning of March, 789 of the original 1398 patients discharged from Life Esidimeni were known to be at 22 NGOs, according to health department records. The whereabouts and details of those still unaccounted for remain a glaring concern, and the focus of investigations.

Ramokgopa’s public pledge at the time of taking office was to “protect the most vulnerable among us”; also, to “reflect on this experience‚ as difficult as it is, and find ways to restore the confidence of our people in our health system”. She spoke of transparency as being important as she tackled the fallout of the crisis.

However, weeks after Spotlight went through several official channels, Ramokgopa remained unavailable for interview – her communications team didn’t bother to go beyond acknowledging our several and repeated requests for an interview.*

It’s not an ideal start. Not because media should be her priority; but open communication should be right up there, and so should answering questions fully, rather than through the filter of official statements and generic email responses. This speaks to a pig-headedness in her leadership that seems to have crept into how Ramokgopa has conducted herself in recent public-office positions.

While she was mayor of Tshwane, between 2006 and 2010, she was slammed as the ‘worst mayor in the country’ – a label she received because her city was failing to deliver services such as housing, electricity, tap water, sanitation, security and refuse removal to about a quarter of the capital city’s people, according to the Empowdex Service Delivery Index. In 2009, the city’s debt stood at R3.7 billion. She had to reshuffle her leadership, and admitted publicly to cash-flow problems and low revenue collection for the city coffers. At its nadir, Pretoria teetered at the point of being placed under financial administration; but Ramokgopa continued to pooh-pooh allegations of financial maladministration.

This was a dangerous failure, because of the chilling consequences. As the Tshwane report in 2009 pointed out: “Basic services are the fundamental building blocks to economic empowerment in South Africa.” It remains a truism today.

But it was her controversial decision to ram through two key name-changes in the capital that heaped criticism at her door, and even led to her brief ‘kidnapping’. She failed to follow due process in pushing for Pretoria to be renamed Tshwane. She also pushed through with renaming Ga-Rankuwa Hospital, to Dr George Mukhari Hospital.

According to the Daily Maverick, the name change arose from a promise Ramokgopa had made to the Mukhari family, when she spoke at George Mukhari’s funeral. So unpopular was her unilateral decision and favouritism, the Daily Maverick reported, that at one point during the fiasco angry protesters bundled her into a taxi without her bodyguards and entourage, intent on spelling out their contempt to her face. She was released unharmed.

When Ramokgopa vacated the mayoral post, in 2010, the ANC filled the position by appointing her nephew, Kgosientsho Ramokgopa. It was an appointment credited to party-political loyalties, as the family were allegedly faithful backers of Paul Mashatile, outgoing Gauteng Premier at the time.

Gwen Ramokgopa is a dyed-in-the-wool ANC activist, and over the years has worked her way up from student activism to becoming a top-ranking member of the Gauteng ANC. She grew up in Atteridgeville, a township west of Pretoria. She is married to Allen Lephoko, and they have three children and a grandchild. Her publicly available personal information extends to her being a Christian who enjoys reading.

Her husband made news in 2009 when Ramokgopa and Lephoko arrived at the Hatfield Community Court, where their then-18-year-old daughter Lerato was appearing on allegations of drug possession. Allen Lephoko’s scuffle with photographers outside the court led to an assault charge being laid against him.

Ramokgopa’s official government bio says she qualified from Medunsa as a medical doctor in 1989. She worked at Ga-Rankuwa Hospital as a medical officer until 1992, before joining the Independent Development Trust (IDT) as National Health Programme Manager.

Her medical career as a practising doctor ended and her political career took off instead, though it was always linked to healthcare-related portfolios. Before returning to the role of Gauteng MEC, she was deputy health minister between 2010 and 2014.

In 2015 the Tshwane University of Technology (TUT) appointed her its chancellor. They lauded her as “a woman of stature, a visionary who is passionate about success and excellence in every cause she commits to”.

The institution also outlined some of her achievements; she is no stranger to firsts, having been the inaugural CEO of the South African Medical and Dental Practitioners Association, and the first woman MEC for Health in Gauteng Province.

Her return to the role of Health MEC will not be about firsts; most immediately, it will be about putting out the raging fires linked to the Life Esidimeni tragedy, and carrying out the recommendations from the Health Ombud’s findings into the death and suffering that occurred.

Ramokgopa was quick to outline her plan of action – including her Rapid Intervention and Response Team, which has a dedicated reporting and assistance hotline (where someone does answer the phone, Spotlight can confirm) that is expected to give weekly report-backs. She also announced an immediate halt to the deinstitutionalising of mental health patients – a decision her predecessor, Mahlangu, had taken because, she said, the private-sector provider was costing too much.

Ramokgopa also outlined plans to gather better data and information from patients and the families of the patients; vowed better consultation with families, and urgent assessment of the province’s mental health patients, so that if necessary they can be transferred from the NGOs to better care facilities.

At the time, she said: “I bemoan the fact that as a medical professional and an activist for a just society‚ together with millions of other South Africans, I could not foresee and thus intervene to prevent this tragedy as it unfolded.”

Ramokgopa stopped short of criticising Mahlangu. Closing ranks, she called Mahlangu “hard-working”, and commended her for her “integrity” in the financial management of the provincial department, which finally achieved an unqualified audit only in 2016.

In the meantime, the Economic Freedom Fighters, the Democratic Alliance and even the ANC Youth League had laid criminal charges against Mahlangu. Premier David Makhura had also suspended head of department Dr Barney Selebano.

This was the raging furore into which Ramokgopa stepped. And her own appointment was met with immediate sniping from opposition parties. The DA’s Gauteng Health spokesman Jack Bloom called her “mediocre”, judging from her first go at the portfolio in 1999, and said: “She does not have the drive to fix this deeply dysfunctional department.”

Previously, Gauteng Premier David Makhura had mapped out the enormous challenges faced by the department. In his report on the financial health of the province in August last year, he spoke of needing to lift the financial “cloud hanging over Gauteng” for over 10 years that had gathered over poor financial audits for the Department of Health (till the unqualified 2015/2016 report). He also pointed out the challenge of meeting the needs of “large volumes of people who come from other provinces to seek medical help in Gauteng”.

It is up to Ramokgopa to restore everyone’s massively damaged confidence in the Gauteng Department of Health, and to take forward the turnaround strategy the department outlined in 2014. It features eight core focus areas: financial management; human resource management and development; district health services for primary health care; hospital management; medico-legal services and litigation; health information management and systems; communication and social mobilisation; and health infrastructure management and development.

These are broad categories, with vast, complex needs. Ramokgopa, returning to her MEC role 18 years later, will need to show that this time round she has the mettle, vision and mature leadership to get the job done. It will be about inclusivity, transparency and action to radically transform the health department – not just about a high-profile cadre sent in to do a public-relations mop-up job for the political leadership.

We watch with keen interest to see what Ramokgopa’s legacy will be on the Life Esidimeni tragedy. Will she be the MEC who held the perpetrators accountable or will her legacy be the MEC who failed to act.

*A request for face-to-face interaction with MEC Gwen Ramokgopa was first made on 21 February 2017. Khanyisa Nkuna from the Department of Health took the call, and forwarded a follow-up email request to department spokesperson Prince Hamca. Hamca was also sent further emails and SMS messages, and was called numerous times. The editor of Spotlight also contacted Hamca separately to request interview time with Ramokgopa. Hamca did not respond or make any effort to suggest alternative ways to communicate with the MEC for the writing of this profile.