Northern Cape health without permanent head for 20 months and counting

Northern Cape health without permanent head for 20 months and countingWaiting for healthcare at Augrabies Health Care Clinic outside Kakamas. PHOTO: Thom Pierce/Spotlight
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Organised labour and opposition parties in the Northern Cape are raising the alarm over the impact leadership instabilities in the provincial health department have on public healthcare services.

The Northern Cape Department of Health has been without a permanent head of department (HoD) since July 2020 and an acting HoD has been suspended following his arrest in August last year on charges of fraud and corruption. A second acting HoD is now in place.

A timeline of charges

Dr Dion Theys was the acting HoD until around August/September last year (the department did not give us an exact date for his suspension). Theys, along with the department’s chief financial officer Daniel Gaborone, appeared in the Kimberly Magistrate Court in August last year and were both released on R20 000 bail. They are facing charges relating to procurement irregularities in a personal protective equipment (PPE) tender from 2020 valued at R43 million.

Northern Cape's cuMr Maruping Lekwene, Health MEC (right) and the head of the provincial health department Dr Dion Theys. PHOTO: NC Health/Twitter
Mr Maruping Lekwene, Health MEC (right) and the acting head of the provincial health department Dr Dion Theys earlier. PHOTO: NC Health/Twitter

Spokesperson for the National Prosecuting Authority in Northern Cape Mojalefa Senokoatsane says the PPE case for both Theys and Gaborone was postponed to 13 April 2022 for a pre-trial and a suitable trial date will then be set down.

Theys is no stranger to controversy. In March last year, he appeared in the Kimberly Magistrate Court on other corruption charges and was released on R30 000 bail. Those charges relate to a 2014 lease agreement of the JP Hugo residence (nursing students accommodation) amounting to R96 million.

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The last permanent HoD of the province’s health department Dr Steven Jonkers is now the Deputy Director-General for Policy and Governance in the Office of the Premier, but he too is facing charges.

According to a media statement released by the Hawks, Jonkers appeared before the Kimberly Magistrate Court in October last year on charges of fraud and contravening the Private Security Industry Regulation Act. He was released on R50 000 bail.

“It is alleged that in 2017 between August and October, while Jonkers was the health HOD, he fraudulently awarded a security tender for the department to Defensor Electronic Security Systems for an amount exceeding R384 million. It is further alleged that the directors of the company submitted fraudulent documents in order to gain an unfair advantage over others to be awarded the tender as the highest bidder,” the statement reads.

Theys: “I’m cleared”

Responding to the corruption charges Theys says he has been cleared by the SIU. “My arrest was a waste of money and resources and I am supposed to go back to work,” he says. “The SIU report has cleared my name of all the charges of corruption, money laundering, and fraud. So now it is interesting to see what is going to happen in court when we go back on 13 April. Will the charges be thrown out? I don’t know.”

Theys says his suspension was based on the Hawks’ charges and now “the SIU has cleared him of these charges”. “So what does that say about the system? It does not make sense that I am still on suspension. It is actually very embarrassing to the system,” he says. Theys says he has not received word from the department after the SIU report. “It is unfortunate because my name has been tarnished. We saw the headlines when I appeared in court for corruption, but now there are no headlines stating that the SIU has cleared my name.”

From what Spotlight could establish from the SIU’s final consolidated report on PPE corruption released in December last year, Theys along with Gaborone is mentioned once in the SIU’s referrals to the provincial department to take disciplinary steps against the two officials.

Hawks spokesperson, Mnisi did not want to comment on Theys’ claims and referred queries to the SIU.

When asked if Theys and Gaborone have been cleared by the SIU, SIU spokesperson Kaizer Kganyago said, “Our report has not cleared any individual or entity that we are investigating. The R23 of 2020 proclamation investigation is still ongoing and our deadline is 31 May 2022 for investigations to be finalised. The criminal matter involving Dr Theys and Mr Gaborone is being dealt with by the Hawks. The disciplinary proceedings involving Theys and Gaborone are also still ongoing.”

Remain “full employees”

Provincial health department spokesperson Lebogang Majaha says the two officials, Theys and Gaborone, would remain on suspension until the court process is concluded. “We cannot comment further on this matter except for the fact that the two officials are on suspension with their full salaries and benefits.” Majaha also says the two officials remain “full employees of the department”.

In the meantime, Majaha  says that two officials within the department have been appointed to act as HOD and CFO, to enable the department “to continue to operate and provide quality service to the people of Northern Cape”.

Although Majaha declined to confirm to Spotlight who the acting CFO and HOD were, a report by Health MEC Maruping Lekwane to the provincial legislature presented in September last year stated that Riaan Strydom is the Acting HOD and one P Ngcoboti the acting CFO.

Northern Cape Health MEC Maruping Lekwene gets his jab along with NC Premier Dr Zamani Saul. PHOTO: Northern Cape Health/Facebook
Northern Cape Health MEC Maruping Lekwene gets his COVID-19 jab along with NC Premier Dr Zamani Saul. PHOTO: Northern Cape Health/Facebook

When Spotlight asked Majaha why he cannot reveal the names of the two acting officials he told Spotlight, “The reason is that it is difficult for us to reveal names of acting positions, especially HOD and CFO since the positions are not sustainable. These are month-to-month contracts, and the acting person may be removed at any time. So, until the posts are permanently filled, we cannot confirm names.”

Spotlight put the same question to the Premier’s Office and asked why the names of acting officials cannot be revealed in an open and democratic society. Bronwyn Thomas-Abrahams, spokesperson for premier Zamani Saul,  confirmed that Strydom is acting HOD but says she cannot comment further on health matters as the Premier is only responsible for the appointment of the HOD. Saul has on numerous occasions been outspoken about fighting corruption in the province.

Trade unions not happy

According to Cosatu provincial secretary Orapeleng Moraladi, the Northern Cape Department of Health is practicing double standards when it comes to disciplining employees.

“It is clear that some employees are better than others. Our view is clear, Theys and Gaborone should be held accountable. Had it been any other ordinary employee, they would have undergone the formal disciplinary process and then eventually been dismissed, but for top managers such as Dr Theys and Mr Gaborone, they are placed on suspension with their full salaries. It is worse because these two officials are facing criminal charges,” he says.

Moraladi says the union has on several occasions warned the government to stop employing “people with tainted names in the name of deployment”. “The Department of Health must institute disciplinary processes for Theys and Gaborone. It is standard procedure,” he says.

Nehawu’s provincial secretary in the Northern Cape, Moleme Moleme says, “Six months later Theys and Gaborone are still enjoying employment benefits, and that, unfortunately, amounts to fruitless expenditure for the department because these people are not working but they are receiving a full salary with all benefits. As Nehawu, we are hoping for a speedy trial and we hope that justice will take its cause.”

According to the Public Service Act, vacant posts must be filled within six months and someone cannot be acting for more than one year.

After first being advertised in August 2020, the HOD post was re-advertised with a closing date of 31 December 2021.

Thomas-Abrahams told Spotlight that the recruitment process to find a suitable candidate for the position of HOD is underway.

road sign - Brandvlei Clinic in the Northern Cape.
Brandvlei Clinic in the Northern Cape. PHOTO: Tom Pierce/Spotlight

Impact of leadership instability

According to the provincial spokesperson for the Democratic Alliance (DA) Izak Fritz, the health department is largely lacking strategic direction. “This leads to delays in decision-making and especially the finalising of submissions,” he says.

“Certain financial and human resources delegations are also largely centralised, due to a critical management vacuum at some facilities,” he says, pointing out that as a result payments are delayed. . “Ordering of medicines and supplies is affected, causing suppliers not to deliver. Payment for the repair of equipment and maintenance is delayed and service providers, in turn, withdraw certain services. Even staff appointments get delayed, despite critical shortages of nurses and emergency care practitioners.”

“Ultimately, health professionals who wanted to work for the province’s health department wait so long to get feedback on their applications that they get appointed in other provinces and the Northern Cape loses out,” he says.

Leader of the Freedom Front Plus in the Northern Cape, Wynand Boshoff says they are also concerned about the instability of top management positions in the provincial health department. “The bungling of the (Kimberley) mental hospital is only the most expensive error in a department which just seems to be unable to rid itself from corruption and mismanagement,” he says.

Boshoff says suspending the head of the department is a radical step but necessary if they want to get to the root of the problem. “Of course, it is a huge disruption for a department to function without a [permanent] head, but if the head is too corrupt or unable to manage the department correctly, it is better off without a head,” says Boshoff. He however also warns that it may be a problem if only one individual is used as a scapegoat for a systemic lack of accountability.

Patients waiting outside Alheit Primary Health Care Clinic outside Kakamas in the Northern Cape. PHOTO: Thom Pierce/Spotlight
Patients waiting outside Alheit Primary Health Care Clinic outside Kakamas in the Northern Cape. PHOTO: Thom Pierce/Spotlight

Health service delivery amid suspensions

In the strategic overview in its Quarterly Performance Report (July to August 2021) tabled in the provincial legislature, the department acknowledges that “the one thing that has been an Achilles heel of the department in the latter years, including in the financial year 2020/2021 is the continued instability and vacancies in key senior management positions”.

“There have been too many changes at this level. There was again a change in the position of Head of Department. This invariably has had negative extrapolations for the strategic direction of the department. There is increasing realisation of the need to stabilise this level of leadership in the department,” the report reads.

The report also hints at the ripple effect on health services.

For example, the quarterly performance report notes that “the non-filling of administrative and support posts still has an effect on performance” and replacement clinical posts are still done at a slow pace. The report also notes various challenges with the availability of medicines. “On district-level access to medicine was negatively affected by the closing of facilities due to the COVID-19, local municipal strikes in the sub-districts, local floods in some districts; as well as challenges with the delivery and distribution of stocks by the depot to and within the districts,” the report reads. It also noted that due to a limited cash flow, the depot and districts suffered certain stockouts at the depot and in the districts. Listed among the measures to address this, was to ensure continuous cash flow to pay suppliers within 30 days and to redistribute medicine stocks in the districts.

The central chronic medicines dispensing and distribution programme (CCMDDD) is an important lever to get medicines to people, but all the districts performed poorly on this. The report notes the need for an “urgent resuscitation of this programme”.

Health infrastructure is another area where the department is found lacking since many projects are years behind schedule, often due to delayed payments by the health department. For example, the Bankhara Bodulong Clinic project reportedly started in September 2017 and was due to be completed in 12 months. The report notes it “is currently 32 months behind schedule”. “The contractor did not return to the site in January 2020 until May 2021, citing perpetual delays in the processing of payments. The contractor is back on site to complete the outstanding works,” the report notes.

The Boegoberg Clinic project, among others, faced similar challenges and is 24 months behind schedule.

Spotlight could not reach Jonkers for comment. An attempt to reach him via Thomas-Abrahams had not succeeded by time of publication. Spotlight also contacted Gaborone but he did not respond to messages.