In recent years the North West Department of Health has struggled with a variety of challenges, including poor infrastructure, shortages of healthcare workers and medicine stockouts at its facilities. It has also been involved in several high-profile cases of alleged corruption.
It is against this backdrop that Sello Lehari is starting his stint in the province’s top health job. The opposition DA and EFF say they have little faith that Lehari, who has no healthcare background, can turn the situation around. Nevertheless, Lehari has promised to provide hands-on leadership and prioritise implementation of the National Health Insurance (NHI).
He takes over from Madoda Sambatha, who was health MEC from late in 2018.
Lehari was until recently North West MEC for community safety and transport management. In that position Lehari faced public backlash after 20 government-funded donkey carts were handed over to residents of Dibono and Mmanawane. The carts, which cost about R800,000, reportedly broke down weeks after delivery.
Lehari also served as North West MEC for education and sports development from May 2016 to May 2019. Before that he was mayor of the Moretele Local Municipality.
‘Hands-on leadership’
Speaking to Spotlight, Lehari promised to provide hands-on leadership. “This means working closely with the management team of the department to tackle all impediments to health service delivery to ensure that patients have access to health facilities, to medicine, medical equipment and all the basic necessities that our health workers need to perform their daily duties,” he said.
In keeping with national health priorities, Lehari said his foremost priority will be to lead the department in the implementation of NHI. “I am going to need the support of all key stakeholders to realise this important objective.”
Other key priorities, said Lehari, are responsive emergency medical services, medicine availability and implementation of the National Strategic Plan for HIV, TB and STIs 2023-2028, which he said requires him to work closely with the provincial council on Aids and civil society.
Equally important priorities also included health promotion, education and awareness to prevent diseases, maintenance of health facilities, improved patient filing systems, expanding specialised tertiary services to more districts and ensuring the security of health facilities.
In the shadow of national administration
The North West Health Department has been at the centre of several high-profile cases of alleged corruption. These include the purchase of mobile clinics from the Gupta-linked company Mediosa and a related prepayment of R30-million before delivery and alleged irregularities relating to contracts for private ambulance services.
Asked about his plans for fighting corruption, Lehari said he will keep track of the effectiveness of internal controls and ensure the implementation of preventative pre-audits as well as demand adherence to applicable prescripts.
The North West Department of Health was among 10 departments in the province placed under national administration from 2018 to 2022. That followed several governance failures and allegations of fraud and corruption that resulted in widespread service delivery protests in the province. This was done in terms of Section 100 of the Constitution, which allows the national government to intervene in the running of provincial departments when a province cannot fulfil its functions.
In terms of section 100 (1)(b), the national Department of Health assumed the role and obligations of the provincial health department to ensure the province meets the national standards for providing healthcare services. Spotlight previously assessed whether administration had the desired effect on the province’s health department.
Lehari is positive about the national government intervention in the province. “Fortunately, the department was placed under Section 100 (1) (b),” he told Spotlight. “Moreover, Section 100 (1) (b) put measures in place to strengthen financial management, internal controls and supply chain management with a view to prevent corrupt practices.”
Preventing corruption and ensuring good financial governance will be particularly important in the coming years, since, as in other provinces, the North West Health Department is facing the dual challenges of health worker shortages and a budget that has been shrinking in real terms.
Regarding the problems of nurse shortages and some nurses struggling to find jobs, Lehari said he aims to ensure the department continues to train and retain nurses. “I am aware of the challenge of unemployment faced by some of the nurses after they complete their community service and internship programme. The department is in the process of appointing them through concurrence with the provincial treasury and I will follow up on this,” he said.
Lehari also said he would lobby for a budget that is consistent with the province’s population growth. “The general shortage of staff in the North West Department of Health will be approached through prioritisation of critical posts in respect of the budget cuts or a limited budget for compensation of employees,” he said.
‘Doesn’t instil any confidence’
The DA in North West is not inspired by Lehari’s appointment and says it will be monitoring his performance closely.
“Moving Mr Lehari from community safety and transport management, where he did a terrible job, as witnessed in the province’s failure to manage the scholar transport system and to keep residents of North West safe, his deployment doesn’t instil any confidence,” said the party’s Freddy Sonakile.
A department such as health, he said, requires an executive authority with some level of technical know-how or background within the sector. “Expecting him to learn on the job and experiment with the well-being of residents is a serious red flag.”
The EFF’s Papiki Babuile too was sceptical, saying Lehari’s appointment is “a step backwards as he failed to provide our people with quality service” in his previous portfolios.
“It is now going to be worse as the department of health is the most complicated and sophisticated department which requires someone with basic knowledge of health. This clearly shows that the ANC-led government has no clue what they are doing and do not have any interest of the people of this province at heart,” said Babuile.
Unions weigh in
The National Education, Health and Allied Workers’ Union in North West called on Lehari to prioritise working conditions. The trade union’s provincial secretary, Ntombizodwa Moepeng, said emergency services workers should be paid their overtime allowances, and nurses should be paid in line with the remuneration structure of the Occupation Specific Dispensation.
“The new MEC must review all dismissals in the department. He should also review all prolonged disciplinary cases and absorb community healthcare workers into the department,” she said.
The Democratic Nursing Organisation of South Africa in the province said the health department faces a number of complex issues, including unsafe working conditions.
“As the majority union of nurses in the department, we are willing to work with the new MEC and assist him as he navigates his way through the department,” said provincial secretary Reuben Molete.
He added that “nursing is the backbone” of the health department and Lehari must move with speed to employ more nurses. “The new MEC must ensure that he applies his wisdom to expedite the employment of nurses, [including] issues of medicine shortages and infrastructure challenges,” he said. DM
This article was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.
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