Fred Esbend The provision of primary health care in the Eastern Cape is hanging in the balance after the provincial MEC for Health, Dr Bevan Gogqana, refused to bail out the western district of Nelson Mandela, which encompasses Port Elizabeth, Uitenhage and Despatch. A gloomy picture of the state of health services in the area emerged at a seminar convened by the area’s health director, Dr Mamisa Chabula, who said the district showed a R50-million shortfall. Chabula had intended to solicit funds from the provincial government to top up its meagre funds. However, Gogqana refused to commit himself even to an allocation of R7,4-million desperately needed to save health services in the area from a complete collapse. Gogqana argued that there are sufficient funds for the delivery of health services and the area’s financial problems are a result of “poor management”. He told the seminar that he is considering replacing hospital superintendents with executive officers with a financial background, retaining existing superintendents for health functions in which they have competency.
He also announced the purchase of 39 emergency vehicles that would be distributed to areas of need. The western health district is reeling from a cut in its main source of income in the form of levies, slashed from R143-million to a meagre R12-million. Funds from the European Union could be used to salvage the provision of services in the area, but Gogqana refused to discuss the issue. While the district has a total budget allocation of R33,3-million and is only subsidised to the tune of R25,9-million, the R7,4-million is needed for rural areas falling under its control. Graaff-Reinet’s mayor Jantjie Japhta expressed grave concern that the village of Nieu-Bethesda, which lies 70km outside the town, is worst affected, with not even a nurse to serve the growing community. Last year the province was also faced by crumbling health services at hospitals and clinics; some faced closure and lacked medicines and food for patients. Yet a staggering R33-million in the budget went unspent. Chabula made various cost-cutting proposals, among them to train nurses in forensic nursing, to obtain forensic evidence especially in rape and drunk driving cases. The move would cut down on using the services of 15 part-time district surgeons, whose salaries cost the department R4,7-million. The money, he said, was equivalent to the salaries of 20 full-time doctors with the rank of principal medical officers and could also be used in employing more nurses.