Eastern Cape announces R236m injection for mental health
By Kathryn Cleary
The Eastern Cape Department of Health has announced that over R236 million has been allocated towards improving mental health facilities across the province for the next 3 years. The funds have been distributed across 15 infrastructure projects; 13 for psychiatric facilities, and 2 inclusive of district hospitals and psychiatric facilities.
The new money is however only about half of what is needed. The department estimates that in total the 15 projects will cost R475 million. This leaves a deficit of R239 million.
This information comes as the National Department of Health responded to a question in parliament on Wednesday, 16 October, concerning the state of the country’s mental health services. The Department told parliament that infrastructure additions, upgrades and renovations to mental health facilities are funded through the Health Infrastructure Revitalization Grant, part of the NHI Indirect Conditional Grant. They said that in the 2019/20 financial year 21 mental health infrastructure projects were currently funded and at different stages of implementation.
In August, Spotlight investigated one of the Eastern Cape’s psychiatric facilities; the Cecilia Makiwane (CMH) Mental Health Unit). Spotlight found the unit to be in a shocking condition; leaving both patients and staff in an unacceptable situation. 10 days later, the Public Service Commission conducted an unannounced visit to the unit. Following this visit, Commissioner Lulu Sizani said the unit was “a disaster” and called for immediate intervention.
The PSC stated at the time that a report on the CMH Mental Health Unit would be submitted to the Premier and the MEC for Health, Sindiswa Gomba, by 5 September. Despite numerous attempts for comment, Spotlight cannot confirm if this report has been submitted. An article in the Daily Dispatch from 20 September stated that Sizani was planning to table “a number of reports” (pertaining to health and transport) in upcoming portfolio committee meetings.
Following the PSC’s visit, provincial spokesperson Sizwe Kupelo, told Spotlight that there were plans in place for a new 600-bed facility at Cecilia Makiwane, but he did not provide a timeline.
Calls for a new facility have been ongoing since 2012, but new information suggests that it won’t be finished for at least another 5 years.
Of the R236m, only R2.6m is allocated towards refurbishing the current facility, as well as Frere Hospital in East London. Earlier this year media reports alleged that Frere’s orthopedic ward was dysfunctional; leaving patients with broken bones and severe injuries waiting on the floor, and benches for several days. Frere’s orthopedic ward is one of the listed projects falling within the R2.6m allocation for the 2020/21 financial year. No information was given for the current year.
“The Department plans to improve the infrastructure at the [CMH mental health unit] in a two-phase approach by improving the current conditions, by way of [moving] the Unit [to] a more suitable existing area, which will be renovated, whilst the longer-term plan is to construct a new building.”, said Kupelo.
These long-term plans start in 2021/22 with a R30m allocation for the financial year as well as for 2022/23. The estimated total cost of the project is R100m, but so far the Department has only allocated R60m. Should the budgeting trend continue with further allocations of R30m per year, the new facility would likely only be completed in 2025.
Kupelo added that CMH management was currently working to improve conditions at the unit by bolstering security personnel, lighting and fencing.
As well as the refurbishment and construction of a new CMH mental health unit, 8 out of the 15 projects are for reconfiguring space in district hospitals to accommodate 72 hour observation wards. The estimated cost of each project is R25m.
“The 26 priority District Hospitals and Regional Hospitals in the Province have been earmarked for this programme.”, said Kupelo.
Each of these 8 projects has the same allocation of funds; R2m for 2020/21, R5m for 2021/22 and R5,24m for 2022/23 (approx a 5%increase). Should the Department continue to allocate funds in future years at a rate of 5%, the projects could be completed by the 2025/26 year.
Projects without further allocations beyond 2020/21 include upgrades to Tower Psychiatric Hospital’s fire and water infrastructure, maintenance work at Komani Hospital as well as repairs to the 72 hour observation ward at Port Elizabeth Provincial Hospital.
In 2020/21 a further R7,5m is allocated towards new high security fencing at Komani, said Kupelo.
“At Tower Hospital the Department has allocated an amount of R8m in the 2020/21 and a further R46m over the following two years for upgrading the facility and building certain new buildings and supporting infrastructure.”
However, this R46m is not only for Tower, but also for 8 other hospitals in the Amathole District.
Thus, though the R236m injection will be welcomed in Eastern Cape mental healthcare facilities, on closer inspection it is not certain whether the province will see any significant changes for the next 3 to 5 years.
Read Alicestine October’s recent article about the current state of mental healthcare in South Africa here and Yogan Pillay of the National Department of Health’s response to October here.