President Thabo Mbeki is not about to intervene in the rapidly deteriorating relationship between Health Minister Manto Tshabalala-Msimang and her deputy, Nozizwe Madlala-Routledge — despite their clash over conditions at the Mount Frere Hospital in the Eastern Cape.
Madlala-Routledge described conditions at the hospital as a national emergency after a surprise visit, after media reports of a dire shortage of equipment and clinical and support staff, lack of infection control and lack of management action on baby deaths there.
A few days later Tshabalala- Msimang visited the hospital and said her deputy’s comments were based on untruths.
The Mount Frere spat was the latest in a series of public clashes between the two. However, the president’s spokesperson, Mukoni Ratshitanga,was adamant, in an interview with the Mail & Guardian, that the presidency was not aware of any tension between them and saw no need to intervene.
The turf war is causing increasing concern and embarrassment in government circles. A senior government official suggested that Mbeki was the only person with the power to call the two to a meeting and ask them to sort out their problems.
Madlala-Routledge was widely hailed for supporting civil society in its push for a comprehensive HIV/Aids national plan, while Tshabalala-Msimang has been roundly attacked as an Aids denialist after prioritising nutrition over a drug treatment strategy.
Madlala-Routledge, Deputy President Phumzile Mlambo-Ngcuka and representatives of civil society eventually agreed on the strategy while Tshabalala-Msimang was ill in hospital.
Madlala-Routledge’s political profile was boosted by her election to the South African Communist Party’s central committee two weeks ago, where she came in at 11th position. Tshabalala-Msimang is a member of the ANC’s national executive committee.
Commented one government official: ”The deputy minister is trying to carve out a niche for herself, but you can see the minister is not happy.
”The problem is that there are no clear guidelines on the responsibilities of deputy ministers. They do whatever they are assigned to do. Ideally the president should call the two to a meeting and tell them to sort out the mess.”
Another government official said Madlala-Routledge should never have used the terms ”crisis” or ”emergency” in referring to Mount Frere Hospital.
”We can’t [force] statements to sound good. All she should have said was that we are concerned because we have a problem, but here are possible solutions. If you say ‘crisis’, it puts government in a difficult position.”
Madlala-Routledge provoked the wrath of senior ANC officials by suggesting, in a memorandum in March this year, that there are fundamental problems in health policy and proposing a policy overhaul.
The memorandum was written when Tshabalala-Msimang was on leave and addressed to then-acting health minister Jeff Radebe. Radebe, who is also the ANC’s policy chief, sharply rebuked her.
Madlala-Routledge also drew fire when she proposed the involvement of the World Bank in her new plan. Many ANC members blame the bank for plunging African countries into deep debt.
ANC deputy secretary Sankie Mthembi-Mahanyele wrote on the ANC website that she found it ”strange and instructive” that the Democratic Alliance should support Madlala-Routledge’s appointment as acting health minister, while objecting to Mbeki’s delegation of this role to Radebe.
Mthembi-Mahanyele added, without elaborating: ”This is not the place for me to explain my understanding of this Democratic Alliance vote of confidence in the deputy minister, which, I am certain, both the president and deputy president of the country also understand.”
Health department spokesperson Sibani Mngadi said Madlala-Routledge had designated responsibilities that included mortuary services, health technology and laboratories. Mngadi would not comment on what she had done in those areas.