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By Kwazi Dlamini

Years of misconduct, negligence and corruption are putting a heavy strain on the health department as it continues to battle the Covid-19 pandemic. Provincial health departments are a particular cause of concern, especially for oversight bodies such as the Auditor-General.

The Limpopo health department, for example, recently revealed that it is facing negligence claims close to R14-billion because of medical negligence from its facilities. The two largest hospitals in the province – Tshilidzini and Donald Fraser – have made a substantial contribution to this shocking tally, with R2.5-billion in claims against the two institutions.

In her 2021 Public Finance Management Act (PFMA) report, Auditor-General (AG) Tsakani Maluleke expressed great concern for healthcare as one of three key service delivery departments with the poorest financial health of them all. The other two are education and public works. This situation affects the department’s ability to deliver essential health services to citizens, especially during a pandemic.

Maluleke said provincial health departments paid out R1.76-billion in negligence claims in the financial year under review, but the estimated value of unpaid claims by the end of 2021 was sitting at R124.15-billion. This amounts to 75% of total unpaid claims against the state. She raised further concerns that by year-end, seven provincial health departments had unpaid claims that exceeded their entire operational budget for the next year.

The AG cautioned against a common trend among departments of using the next year’s budget to pay the current year’s expenses and negligence claims, as this negatively affects their ability to pay creditors and has an undesirable impact on service delivery.

Neil Shikwambana, a spokesperson for the health department in Limpopo, told News24 that while the number of claims in the province is high, not all the claims are genuine and therefore the department will defend some of them. The spokesperson also claimed that the amounts of the claims are usually inflated and the department is likely to end up paying a lesser amount. In addition, said Shikwambana, the R14-billion is a figure that has accumulated since 2014 – meaning that some claimants have been waiting for eight years for relief.

The DA in Limpopo province reiterated Maluleke’s concerns that the rising amount of negligence claims against health departments is a potentially crippling crisis. The DA’s Risham Maharaj said the most unfortunate part is that the provincial department does not have the budget to settle the claims, should they lose in court.

He included staff shortage and equipment, incompetence, and lack of professionalism among the reasons for the rising number of litigations against the department.

Maluleke in her PFMA report also listed incompetence as one of the reasons the health department is facing these problems. She said the health sector received a portion of the R34.32-billion grant to fund infrastructure and to build healthcare facilities. However, the AG’s findings reveal delayed project completion, financial losses, increased project costs, and defective buildings. This means that citizens are not getting the services the state is expected to deliver during a pandemic. The state therefore is at even more of a risk of facing further claims of negligence and incompetence.