‘Ignore the minister’: Premier accused of defying hospital rescue plan

A provincial premier allegedly told Health Minister Aaron Motsoaledi to ignore his instructions on how to spend billions allocated to fix hospitals.

He did not mention the name of the Premier.

The minister revealed the confrontation in Parliament on Wednesday, 28 October.

He was briefing the NCOP Select Committee on Social Services.

Motsoaledi said he had written to every premier. He also copied provincial finance heads.

His letters explained how each province should use its share of R6.7 billion.

The money was meant to address four priorities. These included hiring doctors, nurses and other health workers. Provinces were also expected to absorb community health workers.

The remaining priorities were buying beds, mattresses, linen and blankets, and settling outstanding debts.

But one premier allegedly accused Motsoaledi of acting like a finance minister.

The premier then claimed Treasury had advised the province to disregard his instructions.

“We wrote a letter to each and every premier, copied every HOD of finance, and showed them the amount according to the equitable share distribution for each province,” Motsoaledi said.

He said the letters explained how many doctors each province could employ and how much equipment it could buy.

“One premier came to confront me, saying that I’m trying to be a minister of finance by allocating amounts of money to them.”

Motsoaledi said he explained that he was not allocating funds.

He was reminding provinces of the four priorities agreed upon by the National Health Council.

“The premier then told me that, anyway, he went to Treasury, and they said they must ignore what I’ve said,” he said.

Motsoaledi did not identify the premier or the province.

He said he had tried to get Finance Minister Enoch Godongwana to convert the funding into a conditional grant.

That would have allowed national government to control how provinces spent the money.

Godongwana refused. “Now unfortunately, Chair, we lost the battle,” Motsoaledi said.

He said the finance minister insisted that the money must be transferred through the provincial equitable share.

Motsoaledi said he had pushed hard for national oversight. Godongwana even addressed the dispute in his budget speech.

The minister’s remarks followed concerns about conditions at Livingstone Hospital in Gqeberha.

Committee chairperson Desery Fienies asked him to respond to the Public Protector’s visit to the hospital on 22 October.

She said the visit had raised concerns about delays in implementing recommendations from a 2021 report.

That report dealt with poor conditions at the hospital.

Motsoaledi said Eastern Cape health officials had assured his department that patients were no longer sleeping on floors.

He said officials had reported improvements in the availability of beds and mattresses.

“We informed them. And the HOD told us that no, it’s not true,” he said.

The department was therefore surprised by the concerns raised during the Public Protector’s visit.

But Motsoaledi also acknowledged a major accountability problem.

Provincial governments control their own hiring, finances, maintenance and procurement.

National government is often blamed when hospitals fail. Yet, he argued, it has limited legal authority over these provincial functions.

“Whenever these types of problems occur in provinces, we are the ones who are held responsible, whereas all the authority and legality is sitting with those provinces,” he said.

ANC MP Pat Sibande said provincial officials were escaping accountability.

She argued that the ruling party takes the political blame for failures caused by officials who do not perform their duties.

“Generally, the finger is pointed at the government and the ruling party, while the people who are letting us down are there, relaxing,” Sibande said.

She asked what action had been taken against the officials responsible.

Motsoaledi said his team planned to return to the Eastern Cape.

They would meet the premier and the provincial health and finance MECs.

He did not identify any disciplinary action or other consequences against officials.

The dispute comes amid continuing concerns about conditions at Livingstone Hospital.

In 2021, the Public Protector found that conditions at the hospital failed to meet the Eastern Cape government’s constitutional and legal obligations.

Meanwhile, Godongwana’s 21 October Medium-Term Budget Policy Statement allocated an additional R20.5 billion to the provincial equitable share for health and education.

The funding follows the same channel Motsoaledi had unsuccessfully tried to bring under tighter national control.

The Department of Health and the Eastern Cape health department have been asked to identify the premier referred to by Motsoaledi and explain how the province spent its allocation.