NHI Lawmakers: Face to face with DA MP Siviwe Gwarube

On May 22, while taking the oath as a new Member of Parliament, Siviwe Gwarube’s eyes swept the packed gallery. There were mothers, fathers, grannies, sons and daughters. But her mind was on her own uncle – Mkhanyisi –who was not there.

Mkhanyisi had passed away just two weeks earlier, in the village of KwaMdingi near King Williams Town, where Gwarube is from. A father figure to her, he was supposed to be her guest on the big day. But he had contracted bronchitis, then fatal pneumonia.

“So that day at Parliament, obviously it was deeply emotional for me,”says Gwarube. “Standing there I said to myself: ‘I’m going to do this for you, Mkhanyisi, my man! I am going to do my absolute best.’Because you know, he was such a courageous man. He was an amputee, and he had such a big personality. So when I stood there to take the oath, I decided I am going to give everything I have and more to this job for the next five years, fully in his memory.”

Behind a large desk, Gwarube’s voice carries in her soft-carpeted office. She is barefoot, her black high heels waiting by the door. She radiates energy, a smile never far from her lips.

Women in leadership

Before our meeting, Gwarube visited Siphamandla Secondary School in Khayelitsha Site C, to drop off sanitary towels to 200 grade eight girls due to write exams. This she paid for from her own pocket with the help of a few friends and colleagues. On the subject of subsidised sanitary products for women in South Africa, Gwarube’s eyes glow: “How can poor female pupils concentrate on their education, when they cannot afford to look after their bodies?”She throws up her hands. “And you know what it is? We’re not making headway with things like this, because we don’t have women in leadership. Women are not making the decisions.”

Outside Gwarube’s office, the Parliamentary precinct is bustling. Finance minister Tito Mboweni is delivering his medium-term budget speech. Gwarube continues: “I’m going to challenge you to look at the picture of the people who emerge from this medium-term budget. So the finance minister is usually accompanied by a cohort of people –and they’re men. Women are not in decision-making positions. And I’m not saying women should be pushed into decision-making positions. I’m saying women should demand to be there.”

Aged 30, Gwarube cut her political teeth at 22, when she was appointed spokesperson to then Democratic Alliance (DA) Parliamentary Leader, Lindiwe Mazibuko. Since then, she served as Head of Ministry at the Western Cape Department of Health under MEC Nomafrench Mbombo, and in the lead up to the 2019 elections, she helmed DA communications before being elected to public office.

“After my uncle’s death, when I returned from KwaMdingi to Cape Town for the swearing in week,”says Gwarube, “I had to choose what portfolio I was going to ask to be placed in. I mean, I thought about land. And I was like, ‘Oh, that’s going to be interesting.’I thought about water and sanitation, because obviously having been the head of communications for the DA during the drought and Day Zero, I had learned a tremendous amount about that. But then I also worked as chief of staff for Dr Nomafrench Mbombo for two years. So I was like: ‘Look, you can do a lot of things. You are a very capable person –but what is it that you really want to do, where can you make a difference?’

“And so I settled on health, because you know, one of the things I truly believe is that healthcare in this country is deeply expensive. My uncle wasn’t on medical aid when he died. And I don’t know, maybe if he had received private medical care he would have lived? And 85% of the people in this country don’t have that option.”

 

Deliberating over the NHI Bill

In June, the DA announced Gwarube as their Shadow Minister of Health. As a member of Parliament’s health portfolio committee, one of her key tasks is deliberating over the controversial National Health Insurance (NHI) Bill, which was introduced to Parliament on August 8.

“So Parliament has its process,” she says. “Within thirty days of tabling the legislation, they are meant to advertise and get people to participate.”So far, the health portfolio committee has received over 100 000 submissions. A special portal set up by the DA has received an additional 70 000 –although there might be overlap.

Gwarube has been spending her weekends attending NHI public hearings around the country. Preceding the interview, they toured Mpumalanga: visiting Nkomazi, Bushbuckridge, Thembisile and Ermelo.

“Parliament sends out notices to villages and townships and say: come to this hall on this date, and come air your views,” she says. Then she shrugs, shaking her head. “But the problem is that political parties simply bus in supporters. Then they pack these halls to the rafters, and people get rowdy. So is that really a gauge of what public sentiment is? It becomes a political boxing match –the clash of the buses.”

These challenges aside, when the health portfolio committee has finished receiving and collecting public submissions –what then? “So my next big fight will be that every single one of those submissions are read by the committee,” says Gwarube.

“If it means we have to sit here day and night going through the submissions, then that’s what we have to do. We don’t have the luxury of overlooking what people feel about this legislation. I mean it’s literally going to affect 56 million people.

“After that, we’re going to analyse the bill clause by clause. Obviously there are many issues that we have identified and that’s where we should –theoretically–be able to amend certain things.”

As it stands, Gwarube has issues with the bill. She insists she will not rubber stamp legislation which she believes is fundamentally flawed.

“So the official DA stance is this: we support universal health coverage, right?,” she says. “What the ANC often do is to paint us as being anti-poor, anti-black, and all of these insults. Like whatever, it’s Parliament and people jostle and they grand-stand. But it’s important when it comes to law-making, that we separate the politics from it all.

“We don’t think that the NHI legislation –as it stands –will achieve universal health coverage. In fact, we think it will completely destroy the system, which will certainly not improve the lives of people.

“Our concern is that the bill proposes a centralised fund. And you speak of centralisation in any context in this country, well you are bound to fail. It will be open to corruption in a massive way.”

‘Healthcare is not like the SABC’

“But healthcare is not like the SABC,” Gwarube says. “When the SABC fails, somehow we are still fine. If this entity fails and is open to corruption, we’re in deep trouble. I mean, it’s literally a situation of life and death. And so, you know, we’re not playing games here. And I’ve said to the minister [Zweli Mkhize] personally, and he can attest to this, I’m prepared to work with him to make sure that whatever comes out –the final bill that comes out –is something that will improve the lives of South Africans.”

Gwarube points out that presently South Africa spends 8.7% of its GDP on healthcare – one of the highest such allocations in the world. She says the problem with South African healthcare is not funding –there are plenty of funds –it is corruption and inefficiency that leads to the squandering of these funds. Plus, systems that allow this to happen.

“We need a massive systemic health overhaul,”says Gwarube. “We don’t just need a simple funding model. And this is where the government of the day doesn’t understand the problem. We need to improve the health system in general, in its entirety. As it stands, the NHI simply speaks about funding. It doesn’t speak about accountability mechanisms. It doesn’t speak to how provinces are spending their allocated budgets. It doesn’t speak to how provinces have become almost chronically dependent on conditional grants. We sit here every year and we go through annual reports of departments and we see this on paper –not even through the lived experiences of people – how departments, provincial departments, are corrupt and failing people.

“What we’re trying to convey is that we’re not just being oppositional here. We’ve done the work to put together a framework of what universal health coverage under the DA would look like. For starters, medical legal claims would go down, meaning this money would go back into the pots.”

Gwarube adds that Parliament has become divorced from the reality of most South Africans:“I mean, the people I grew up with –they are the people I want to work for. And so, in retrospect I’m grateful. I’m grateful for how I grew up. I’m grateful for the obstacles and I pray that I never lose that connection to the reason why I’m here.”

Growing up in a halfway house

Gwarube was raised by her grandmother, Veliswa, whom she refers to as her mum. Veliswa was an atypical woman at the time. A teacher, she did not feel compelled to get married after falling pregnant. “She wanted to self-actualise and have a life of her own,”says Gwarube. “She did not feel as though she needed a husband to get the most out of life. Her son, my uncle, was always in the house; plus lots of people who were not related to us. You know, there were always other young girls who would come live with us. My mum would try and help them get some kind of post-school qualifications. So that was my family set-up, we were kind of a halfway house.”

Gwarube attended the prestigious Kingsridge High School for Girls in King William’s Town, commuting to class every day. This taught her about the duality of life in South Africa.

“My mum is passionate about education and that’s why I got the education I got,”she says. “And not because she had the money, because she literally sacrificed everything. This taught me empathy for kids who go to places where financially they don’t belong. The kind of thing a lot of South Africans don’t understand.”

After school, she completed a BA in Law, Politics and Philosophy at Rhodes University in Grahamstown. This was funded through Veliswa’s pension, a bank loan, and a National Student Financial Aid Scheme (NSFAS) loan. The latter, she is still paying off.

“If it wasn’t for the NSFAS loan, I would not have a higher education,”says Gwarube. “So I’ve chosen the DA, because it’s the political party most aligned to my own ideology. But at the same time, I’ve also lived in an ANC-governed country for 25 years. And despite their trajectory, which has been detrimental in many ways, there are instances where the ANC Government has done well. And the NSFAS is an example.”

It was a dark moment when she could not continue her studies. There simply was no money, and the NSFAS did not cover postgraduate degrees. But during her final year at Rhodes, Gwarube had joined the DA Young Leaders Program. Through the program she had met her mentor: Lindiwe Mazibuko.

“And Lindiwe was like, you should definitely apply for DA jobs when you see them advertised,”recalls Gwarube. “And so an advert came out while I was writing my exams in 2011, for a spokesperson role. And I applied and I was shortlisted. And they said, look, we would love to meet with you. We’d love for you to come to Cape Town. And I was like, ‘Oh, I can’t afford to travel to Cape Town!’I remember crying at home. I was like, ‘Oh my God, I’m not going to get this job and I’m going to be unemployed’.

“So Lindiwe was like, just be honest with them. So I was. And they said, that’s fine, we will interview you over the phone. Then I was like, ‘Well, I’m not going to get this job because, you know, I’m obviously not going to be as impressive as anyone else they see in person’. Well, I got the job. I started working for Lindiwe on the 9th of January, 2012.”

In the big city

It was an early summer morning when Gwarube first arrived in Cape Town, stepping off the long-haul Intercape bus. She shakes with laughter at the memory: “Me and my suitcases, and the Intercape bus. I was like, ‘Oh my God! I’m in the big city!’ Friends in the program helped her find a flat in Gardens. “And that’s how it started,”she says.

On a shelf behind Gwarube sits a box of lemon and ginger root tea. “I love tea, I’m such an old woman!”She laughs deeply again, then reaches for a photograph, tilting the frame. “Hey, look, and these are my friends!”

On the topic of the Rugby World Cup, she enthuses:“I am religiously following the rugby. You know, I was sitting in a public meeting on Saturday, and we were playing Wales. Obviously I was very committed to being in that public meeting, but I had to check the score.

“Siya Kolisi, he’s got such an interesting story –again, a typically South African story. And I mean, he’s a young man and he’s leading. There’s a misconception in South Africa; leadership is not just confined to political leadership or Government. Young people are doing amazing things in different spheres. I mean, he’s one person doing an amazing job on the world stage –leading a team with all its complexities.”

Gwarube’s enthusiasm is far-reaching. Like that of her late uncle Mkhanyisi, hers is a big personality. One certainly felt inside the high-ceilinged corridors of Parliament.

*Spotlight on NHI: This is the first in a series on the faces behind the NHI Bill in Parliament.