The Gauteng department of health provides a stark warning against the implementation of National Health Insurance (NHI) in the way envisioned by the NHI Act.
The provincial department oversees 37 public hospitals. Gauteng has the largest population in the country, but citizens from across the country and even the continent visit these institutions. Four new hospitals would be added to those already functioning in the province in Daveyton, Soshanguve, Diepsloot and Orange Farm. It is the heartbeat of the country’s health sector. But this department has for decades been plagued by allegations of mismanagement, ailing finances and corruption. It was at the centre of the almost R50m personal protective equipment procurement corruption scandal during the height of the pandemic. Those implicated have yet to be held to account.
Officials at the Gauteng health department were charged over irregularities in a R588m contract to refurbish the AngloGold Ashanti Hospital, leading to dismissals and disciplinary action.
The latest auditor-general report indicates a lack of internal controls in the department and noncompliance with supply chain management rules, leading to medication shortages and a R1.7bn deficit. It has not received a clean audit in decades.
The latest finding is not new for the Gauteng health department. It has long been at the centre of controversies, from the Life Esidimeni saga to a Special Investigating Unit (SIU) report dating all the way back to between 2006 and 2010, which detailed allegations of corruption against its former MEC Brian Hlongwa. By far the most insidious revelations around the department emerged this month, with revelations that nine syndicates operating at Tembisa Hospital looted more than R2bn from the facility through a “complex web of fraud and corruption”, representing an “egregious betrayal of the nation’s trust”, the SIU said when it released a report on what has been happening at the health facility.
It showed that payments of more than R122m were linked to corrupt officials of the hospital and employees of the Gauteng department of health. Low-level officials in the department teamed up with a number of service providers to pilfer billions for goods and services. The corruption at Tembisa Hospital included the assassination of whistleblower Babita Deokaran after she raised the alarm to her superiors, who turned a blind eye.
Payments of more than R122m were linked to corrupt officials of the hospital and employees of the Gauteng department of health
The SIU report illustrates in vivid and horrific detail the extent of collusion between officials of Tembisa Hospital and the Gauteng department of health, who rigged tenders to benefit certain service providers. The SIU report also points to the level of sophistication of the extraction network at play, indicating that the investigation was “extraordinarily complex” involving syndicates, fraud, corruption, money laundering, bid-rigging and racketeering.
What the NHI essentially boils down to is that the state will be a central buyer of health services for the entire population, with the noble goal of providing universal health care. But can a system which Gauteng proves can be so brazenly manipulated to loot be entrusted with the provision of this crucial public good?
Imagine procuring health services for the entire nation, with a budget running into hundreds of billions of rand, at the disposal of officials akin to those looting Tembisa Hospital.
The answer can be found in the SIU’s 40-page report on Tembisa Hospital — and it is an unequivocal “no”.
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