Denise Williams and Katharine Child
WHILE thousands of patients die waiting for life-saving medical treatment, including for tuberculosis and HIV/Aids, several provinces are sitting on a staggering R800-million earmarked to improve health care.
The failure of the Eastern Cape, KwaZulu-Natal, Free State, Limpopo and Northern Cape to spend on vital infrastructure and equipment not only seriously affects basic health care, but could also hamper the countrywide roll- out of the National Heath Insurance (NHI) scheme.
Some of the funds were budgeted for spending on a trauma unit, hospital improvements and preventing the spread of HIV and Aids.
Responding to a parliamentary question, Health Minister Aaron Motsoaledi revealed yesterday that the five provinces had underspent on the cumulative allocation of almost R2-billion for the Hospital Revitalisation Programme.
Worst off was the Eastern Cape – which was criticised earlier this year for failing to adequately care for people living in rural areas – where the Health Department was allocated a budget of R361-million, but underspent by R191-million.
About two months ago, revitalisation work at some government hospitals across the province came to a halt amid a funding crisis. The situation was so bad that the department was struggling to fix broken air-conditioners in operating theatres.
At the time, Eastern Cape Health acting head of infrastructure Mlamli Tuswa said: "Revitalisation projects are at risk. There's just no money."
A recent parliamentary oversight visit to the Nessie Knight Hospital in the Eastern Cape found that the hospital's infrastructure was dilapidated and it was recommended that the nurses' home, ARV TB ward and the engine room be condemned and demolished.
It also found the TB wards were poorly ventilated, the sanitation system needed upgrading and the sewerage system was dysfunctional.
In his written response to DA MP Patricia Kopane, Motsoaledi said the failure to spend was due to, among others, delays in the awarding of tenders, roll-over budgets from the previous financial year, poor performance by contractors, and the termination of contracts and subsequent court challenges.
KwaZulu-Natal underspent by R228-million, Free State by R134-million from an infrastructure budget of R378-million, Limpopo by R89-million from a R323-million budget, and the Northern Cape by R158-million of its R420-million budget.
Kopane slammed the underspending as unacceptable yesterday. "Behind the numbers lies a crumbling infrastructure with serious and, in some cases, life-threatening consequences for patients."
She said the Eastern Cape had a R22-billion infrastructure and maintenance backlog.
It is not the first time millions have gone unspent on hospital revitalisation.
Last year, the Eastern Cape underspent its HIV and Aids grant by R105- million in the first quarter of the financial year, while Limpopo underspent by R49.5- million.
The Eastern Cape also underspent its budget for forensic pathology by R14-million last year, and Limpopo by R1.2-million.
Rural Doctors' Association of South Africa chairman Dr Karl le Roux said: "It is astonishing to hear that the Eastern Cape underspent on infrastructure given the state of many of its hospitals."
He said the Zithulele Mission Hospital in the province "has been waiting for the past four years for the last phase of the revitalisation project and a much-needed pharmacy". The hospital needs a new TB ward and an ARV ward.
Eastern Cape Health spokesman Sizwe Kupelo said infrastructure underspending was due to delays at four main projects, but the budget would be met by the end of the financial year.
Kupelo said that while there were delays, they did not directly affect patients.
Some of the delays were due to labour disputes and contractors not meeting their obligations, he said.
"Our core business is to render health services.
"The infrastructure is not our mandate, so we are now forced to get a third party – which is the Public Works Department and Coega – who get involved in these projects," Kupelo said.