Dear President Zuma, Premier Magashule, and Secretary General Mantashe
We have in recent years engaged both with government and ANC leadership regarding the mismanagement of the Free State healthcare system. Most recently, we raised this issue in a meeting with Deputy President Cyril Ramaphosa on 26th February 2016. The Deputy President was also present when the TAC’s National Chairperson spoke about the Free State healthcare crisis at the opening of the South African AIDS Conference in July 2015. Prior to that, we also raised the issue with ANC leadership including Secretary General Gwede Mantashe, Minister of Health Aaron Motsoaledi, Deputy Secretary General Jesse Duarte, and ANC spokesperson Zizi Kodwa on 29th July 2014. We have also twice raised our concerns in meetings with Minister of Health Aaron Motsoaledi on 12th June 2015 and 3rd December 2015.
The Free State health crisis has been extensively covered in the media.
We also refer you to the findings of the People’s Commission of Inquiry into the Free State Public Healthcare System. Many individuals and organisations testified at the commission’s hearings in June 2015. The commission’s report, published in November last year, provides ample evidence of the crisis in the province’s public healthcare system. We urge you to read the report and to engage with its findings. The evidence is there if you care to look. The commission’s findings included that “there is ineffective, unresponsive and unaccountable leadership, particularly from senior officials in the provincial Department” that contributes to widespread and ongoing human rights violations.
We also note with grave concern a report in the SA Health Review that the Free State public healthcare system lost a quarter of its public sector doctors from 2014 to 2015. This unprecedented exodus of doctors should be understood in the context of various calls for help from doctors in the province in the last two years. A group of doctors wrote to Minister of Health Aaron Motsoaledi raising a series of concerns early in 2015. Whistle-blower doctors also published a disturbing open letter in the media. A number of doctors have also reached out to TAC directly. That whistleblowers are stepping forward in this way is especially remarkable in the context of the commission’s finding that “whistleblowing and indeed even candid engagement with the provincial Department on the part of healthcare personnel and/or the public is discouraged and at times met with severe intimidation.”
You will also be aware that early in 2014 over 3,000 community healthcare workers (CHWs) were dismissed in the Free State – in our view unfairly. CHWs who took part in a peaceful night vigil to protest their dismissals were arrested. They have since been convicted of taking part in a prohibited gathering – a ruling that we are helping them appeal in the High Court. We stress to you that these are mostly poor and middle-aged women who have been loyal public servants for many years. The way they have been treated by the state is a disgrace. Attempts to have the charges against them dropped were spurned.
The MEC for Health in the Free State, Dr Benny Malakoane, has not come to the assistance of the CHWs. Neither did he listen to the calls for help from the public sector doctors. He also did not take up invitations to address the People’s Commission of Inquiry or to comment on a draft of the commission’s report. When TAC has attempted to engage with him directly, he has always given us the run-around. When some women TAC members managed to get a few minutes with him at an AIDS conference, he was patronising and dismissive.
When we demand that MEC Malakoane should be removed, we make this demand based on two broad reasons.
Firstly, MEC Malakoane has failed to effectively address the crisis in the Free State public healthcare system. This is evident from the evidence we refer to above, but we are also gathering fresh evidence that we will present at the AIDS conference should Malakoane still be in place at that time.
Given the defensive and aggressive way in which MEC Malakoane has responded to the crises with doctors and CHWs, we do not believe he is capable of turning the province’s healthcare system around. After years of attempting to engage with him, we have given up. It is clear to us that he is not committed to improving the quality of healthcare services provided to the people of the Free State.
Secondly, there is ample evidence that MEC Malakoane is not a fit person to hold office. He is currently facing very serious fraud and corruption charges in Bloemfontein related to his time in local government. The police are also investigating charges of corruption laid by the TAC related to MEC Malakoane’s misuse of an ICU bed at Dihlabeng Hospital for his own personal gain. In this instance, MEC Malakoane ordered the ICU to admit a relative of former MEC of Agriculture and Rural Development in the Free State, Msebenzi Zwane, who did not qualify for admission.
We consider the situation regarding MEC Malakoane and the Free State health crisis to be emblematic of a wider cancer in our healthcare system where uncommitted people are appointed or retained primarily for political reasons. This is fundamentally undermining our combined efforts to improve the quality of healthcare services provided to our people. We do not see how we can bring an end to our HIV and TB epidemics if uncommitted, and likely corrupt, people like MEC Malakoane are in charge of our provincial healthcare systems.
Both government and the ANC has failed to intervene effectively despite the various meetings and ample evidence we and others have presented. We are tired of promises of behind the scenes interventions and requests for more and more information. There is a crisis in the Free State public healthcare system and nobody in government or the ANC is willing to take responsibility for it.
We understand very well that MEC Malakoane is appointed by Free State Premier Ace Magashule. It is natural for the public to suspect that the reason the ANC has failed to intervene in regards to MEC Malakoane is related to the fact that Premier Magashule is a loyal supporter of President Jacob Zuma. It appears that the ANC is placing internal ANC politics ahead of the interests of the people of the Free State.
We will not stand for this any longer.
If MEC Malakoane is not removed before the end of June 2016, we will make sure every single delegate and journalist attending the International AIDS Conference in Durban is made aware of the crisis in the Free State and the ANC and government’s abject failure to respond to it effectively. We will explain to people that Malakoane is protected for political reasons and that this is emblematic of a wider politicisation and capture of our healthcare system. It may be one MEC in one province, but we will help people understand that this is the mismanagement by which our healthcare systems and our AIDS response stands or falls.
We therefore appeal to you to urgently remove Malakoane from his post as MEC of Health and point somebody fit and competent to carry out this important responsibility. We also call on you to submit our complaint regarding the MEC to the ANC’s Integrity Commission. We are happy to provide further information should you require it.
Together with our partner organisations, we are hard at work mobilising across the country. Our branches are meeting to discuss the crisis in our provincial healthcare systems. We are coming together to hold district health assemblies and then provincial health assemblies. If needed, we will do in other provinces exactly what we are doing in the Free State.
TAC General Secretary
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