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More than 25 years into the democratic dispensation, South Africa is still failing to provide a comprehensive healthcare package to all its people. In the Eastern Cape, the implementation of access to quality healthcare is inhibited by; inter alia, poor or no infrastructure. Where the government has attempted to bridge the gap between.com munities and primary health care facilities through the distribution of mobile clinics, these mobile clinics are not reaching the communities they are supposed to serve and members of the population, who live more than 5kms from a hospital or clinic, still do not have access to primary health care services. Healthcare is an affirmed right. Section 27 of the Constitution guarantees this right and places an obligation on the Government to take legislative and other measures to progressively realise this right within its available resources. The Eastern Cape Department of Health ECDoH , in the year of the 6th administration, must ensure that this right is realised. This must be done by exercising sound financial administration, through a clear outline of their strategic plans and through a continued analysis of any failures to achieve their strategic plans, more so if they lead to service delivery failure. Lack of accountability and public engagement are examples of poor transparency. The ECDoH received an appropriation of R 23.7 billion for the 2018 19 financial year. The department's budget allocation was adjusted in the amount of R 24.0 billion with a further projected estimate of R 24.5 billion. In the 2017 18 financial year and in the departments third quarter, the department had spent an amount of R 5.9 billion. By the end of the fourth quarter, the department had failed to utilise the entirety of its allocated budget. The Department is recorded as having spent R 6.1 billion in the third quarter of the 2018 19 financial year, 2% more than it spent in the third quarter of 2017 18. It is unlikely that the department will spend the entirety of its revised estimated budget by the end of the fourth quarter according to its spending patterns. This may result in further underspending by the department, which may result in the inability of the department to spend its budget effectively, efficiently or appropriately. In the Eastern Cape Provincial Development Plan, the Premier, outlined critical health system challenges. These include a dysfunctional health system, socioeconomic conditions, limited financial resources and poor management, dilapidated health infrastructure along with the rural conditions of the province and inaccessibility in some areas, which leads to difficulty in providing healthcare services, poor infrastructure and dispersed settlements. It is concerning that four years after the Provincial development plan was introduced, many of the challenges faced by the health system have not changed. Primary healthcare is the closest link to the community and as such, the best avenue to respond to the healthcare needs of the community in preventing further ill health. The Eastern Cape has the second lowest primary healthcare expenditure with Limpopo province having the lowest. To improve primary health care to overcome the challenges outlined in the Provincial development plan, there needs to be an improvement in the equity and efficiency of resources. During the 2017 18 financial year, the Eastern Cape Department of Health reported that the Emergency Medical Services programme had spent R 1 million, 99.9% of its budget for emergency transportation but failed to reach their target to respond to emergencies under 40 minutes in rural areas, the areas that need them the most. In planning and budgeting for the EMS programme, it is imperative that the ECDoH to take into consideration factors such as population migration, the number of children born, and the standard for emergency medical service ambulances outlined in the 2017 Emergency medical service regulation. The Province needs an adequate number of EMS ambulances and staff to ensure that no one is denied EMS services. During his 2019 State of the Nation address, the President informed the nation that the NHI detailed plan of implementation is in a stage of advanced revision. During this time, it is incumbent on the ECDoH to create platforms to disseminate information surrounding the NHI Bill and what it will mean and to what extent it will affect the citizens in the province. We acknowledge that the ECDoH, as part of the 6th administration, come into office to inherit a state of healthcare in crisis and that they bear a heavy duty of creating institutional frameworks to address the current state of healthcare in South Africa in hopes of making it more equitable to all. In doing so, the department must endeavour to be transparent in its planning and use of public funds. Tlamelo Mothudi is a health researcher at the Public Service Accountability Monitor PSAM Public Service Accountability Monitor.
Created at 2019/07/02 04:04 PM by Mediclinic
Last modified at 2019/07/02 04:04 PM by Mediclinic