Nomantu Nkomo-Ralehoko’s comeback as Gauteng health MEC sparks mixed reactions | News24

Nomantu Nkomo-Ralehoko was first appointed Gauteng’s health and wellness MEC in October 2022.

A long-time ANC member, she previously served as finance and e-Government MEC and has been a member of the provincial legislature since 1999. 

She returns to the critical role at a time when the province’s health department, based on extensive reporting by Spotlight and other publications, remains mired in a chronic cycle of administrative and service delivery dysfunction. 

At just under R65 billion for the current financial year, the department gets a massive slice of the Gauteng budget.

While the national Department of Health leads on health policy, the day-to-day running of public healthcare services is managed by provincial departments of health. 

The Gauteng health department has a high number of vacancies. On the administrative side, this includes the critical position of a chief financial officer (CFO).

The previous CFO, Lerato Madyo, was suspended in August 2022. Her case is still to be concluded.

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Research conducted last year by community healthcare monitoring group Ritshidze found the majority of healthcare facility staff and public healthcare users they surveyed felt healthcare facilities were understaffed. 

Madyo’s case is connected to ongoing investigations into corruption at Tembisa Hospital undertaken by the Special Investigating Unit.

This was also the issue whistle blower Babita Deokaran was investigating before she was killed in August 2021.

Deokaran was acting chief finance director before she was killed.

Since her death, it has been confirmed there was corrupt spending to the tune of R1 billion at Tembisa Hospital. 

When Nkomo-Ralehoko answered 10 questions from Spotlight shortly after her appointment in 2022, she said: “One of my immediate focus areas is to ensure that the department’s systems across delivery areas such as finance, human resources, monitoring and evaluation, risk management, etc. are strengthened so that processes are not dependent on human vulnerability but there are clear checks and balances.

“An environment that has no consequence management breeds ill-discipline and a culture of ignoring processes and procedures as prescribed in our legislative framework.” 

Gauteng also faces mounting surgery and oncology treatment backlogs.

Its clunky supply chains and procurement systems have often left suppliers unpaid and facilities struggling without basic medical consumables as well as not being able to procure large pieces of equipment when it has been needed.

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Some hospitals have had periods when patients have had to go without food. 

There remains questions about governance capacity in the department.

Notable examples from Nkomo-Ralehoko’s tenure so far include inaction over utilising a March 2023 Gauteng treasury allocation of R784 million for outsourcing radiation oncology services.

These ring-fenced funds were secured following sustained pressure and protests by activists and civil society.

To date, this money has still not been spent. 

The department is also still to implement a June 2022 memorandum of agreement with the University of Witwatersrand.

The agreement sets a framework for the department and the university to mutually address many of the health sector challenges in the province, while ensuring the academic training of the next generation of doctors takes place.

Another key challenge for Nkomo-Ralehoko will be how to navigate a changed Gauteng legislature in this seventh administration.

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There is no outright majority and there is no unity government deal that includes the largest opposition party, the DA.

This will represent distinct hurdles for passing budgets or garnering enough votes for approvals in the house. 

Despite these challenges, the reappointment of 58-year-old Nkomo-Ralehoko is being welcomed by some.

They said she brought stability to a portfolio that has been plagued by shaky, short-lived tenures in the top role, adding she had a flexible leadership style, and was open to working with many different stakeholders.

But her critics charged Nkomo-Ralehoko could not deliver the overhaul the department needed, and she had not been tough enough on corruption. 

‘More of the same’

The DA spokesperson for health in Gauteng Jack Bloom said: “I don’t think the present MEC deserves to be reappointed, but that’s for the ruling party to determine.

“What we will get going forward is more of the same. The Gauteng Department of Health needs wholesale change but it’s not going to happen under the present situation.”

Bloom added Nkomo-Ralehoko’s comeback was “cadre deployment and political protection”.

“I’m afraid that the corruption is across the board and the looting is going to continue.”

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He said the MEC slow-walked disciplinary action on many suspended senior staffers and had also failed to tighten up on the likes of pre-employment checks on would-be employees, resulting in weak candidates being appointed. 

The EFF is the third largest party in the Gauteng legislature.

Nkululeko Dunga was contacted to weigh in on Nkomo-Ralehoko’s reappointment, but he declined to take our calls and did not respond to written questions. 

‘Delays that cost lives’

Speaking briefly to news channel eNCA after she signed her oath of office on 3 July, Nkomo-Ralehoko mentioned oncology and radiation services as one of her priority areas.

She referred specifically to the building of bunker-like facilities to house specialist cancer treatment equipment procured for Chris Hani Baragwanath and George Mukhari hospitals. 

However, for Salome Meyer of the Cancer Alliance, the fact equipment has been procured but is sitting in storage amounts to delays that cost lives.

She said there were currently 3 000 patients in the province on waiting lists for cancer treatment. 

“Our facilities are operational, but they aren’t operating at full capacity because the equipment is not in use or we don’t have staff to operate the equipment,” Meyer added. 

She said: