SPOTLIGHT ANALYSIS

High turnover of provincial health ministers continues

By Marcus Low for Spotlight 4 March 2021

A high turnover of MECs can be a good thing in some contexts, for example, when removing people facing credible charges of corruption. (Photo: getfive.com / Wikipedia)

Of the nine current MECs, only two have been in their positions for four or more years — Dr Phophi Ramathuba in Limpopo and Dr Nomafrench Mbombo in the Western Cape.

After the 2019 elections, new MECs for health (provincial ministers) were appointed in four of South Africa’s nine provinces. Almost two years later, three of the four are no longer in their jobs. This continues a trend whereby seeing out a four-year term as MEC for health is the exception rather than the rule.

Since the day-to-day running of South Africa’s public healthcare system is devolved to provinces, these provincial ministers have an important role to play in ensuring people in South Africa receive quality healthcare. It is thus critically important that only appropriately qualified and committed persons are appointed to these positions. Where MECs are not up to the job or where there are credible charges of corruption against them, they should obviously be removed from these positions.

A high turnover of MECs can be a good thing in some contexts, for example, when removing persons facing credible charges of corruption. At least two of the MECs, Sindiswa Gomba in the Eastern Cape and Dr Bandile Masuku in Gauteng, who were removed in the past year, were removed for reasons relating to alleged corruption. 

A high turnover can however also be a bad thing — when for example appointments are made, or people are removed, for purely political reasons. It is of course hard to prove that specific appointments were made for purely political reasons, but some appointments certainly do raise eyebrows — especially when the person has little or no health background, such as current KwaZulu-Natal MEC for Health Nomagugu Simelane-Zulu, or if the person is facing serious corruption allegations, such as with Gomba prior to her appointment in 2019.

Either way, in a healthy system you would expect fewer bad or short-term appointments to be made and most MECs to be given at least a full five years in which to get to grips with the healthcare system in their province and to bring about change for the good.

Former Gauteng Health MEC Bandile Masuku. (Photo: Thom Pierce / Spotlight)

The survivors

Of the nine current MECs, only two have been in their positions for four or more years — Dr Phophi Ramathuba in Limpopo and Dr Nomafrench Mbombo in the Western Cape. Both were appointed in 2015. Dr Sibongiseni Dhlomo, who was KwaZulu-Natal MEC for health from 2009 to 2019 and Magome Masike, who was North West MEC for health from 2009 to 2018, also had unusually long tenures.

Apart from Ramathuba and Mbombo, all the current MECs for health were appointed in 2018 or later. Of the nine, one was appointed in 2021, two in 2020, one in 2019, three in 2018, and two in 2015.

As is clear from the below, health MECs quite often stay in the position for less than two years. The Eastern Cape and Northern Cape seem to have particularly high turnovers, while appointments in KwaZulu-Natal, North West and the Western Cape seem to last longer.

Sibongiseni Dhlomo, chair of Parliament’s Portfolio Committee on Health. (Photo: Nasief Manie / Spotlight)
Western Cape MEC for Health Nomafrench Mbombo. (Photo: Joyrene Kramer / Spotlight)

Eastern Cape

The acting MEC for health in the Eastern Cape is Xolile Nqatha. This is after Sindiswa Gomba was fired from the position in February 2021 following the reinstatement of charges against her relating to the Mandela funeral scandal. Gomba was appointed as MEC in 2019 and served in this position for just more than a year and a half. Her predecessor, Helen Sauls-August, was in the position for only a year.

Free State

Montseng Tsiu is the MEC for health in the Free State. She replaced Butana Komphela in 2018. Komphela was in the job for around two years, having replaced Benny Malakoane in 2016.

Free State Health MEC Montseng Tsiu. (Photo: Free State Health / Facebook / Wikipedia)

Gauteng

The MEC for health in Gauteng is Dr Nomathemba Mokgethi, who was appointed in December 2020. Her predecessor, Dr Bandile Masuku, was in the job for only a year and a half, having been appointed after the 2019 elections. Masuku was fired for his alleged involvement in controversial PPE contracts. Prior to Masuku, Gwen Ramokgopa was in the job for just over two years — and prior to that, the MEC was Qedani Mahlangu, on whose watch the Life Esidimeni tragedy took place. (Read Spotlight’s face-to-face interview with Masuku here.)

KwaZulu-Natal

After the 2019 elections, Dr Sibongiseni Dhlomo was replaced as KwaZulu-Natal MEC for health by Nomagugu Simelane-Zulu — who is still in the position. Dhlomo was KwaZulu-Natal MEC for health for a full 10 years from 2009 to 2019 and now chairs Parliament’s Portfolio Committee for Health.

Limpopo

Dr Phophi Ramathuba is the MEC for health in Limpopo. She replaced Ishmael Kgetjepe in 2015. Kgetjepe was in the position for only a year, having been appointed after the 2014 elections. Ramathuba and Nomafrench Mbombo of the Western Cape are the longest-serving health MECs.

Mpumalanga

Sasekani Manzini is the MEC for health in Mpumalanga. Manzini replaced Gillion Mashego in 2018. Mashego was in the job for about four years, having been appointed after the 2014 elections.

Northern Cape

Maruping Lekwene is the MEC for health in the Northern Cape. Lekwene replaced Mase Manopole in June 2020. Manopole, appointed after the 2019 elections, was in the position for only a year. She replaced Fufe Makatong who also lasted only around a year. (Read Spotlight’s face-to-face interview with Manopole here.)

Northern Cape’s current health leadership Maruping Lekwene, Health MEC (right), and the head of the provincial health department Dion Theys. (Photo: NC Health / Twitter / Wikipedia)
Former Northern Cape Health MEC Mase Manopole. (Photo: Emile Hendricks / Spotlight)

North West

Madoda Sambatha is the MEC for health in North West. Sambatha replaced Magome Masike late in 2018 — Masike was in the job for more than nine years, having been appointed after the 2009 elections. (Read Spotlight’s face-to-face interview with Sambatha here.)

Western Cape

Dr Nomafrench Mbombo is the MEC for health in the Western Cape. She replaced Theuns Botha in 2015. Botha was in the job for 5½ years, having been appointed after the 2009 elections. Mbombo and Health MEC Phophi Ramathuba of Limpopo are the longest-serving MECs in their respective provinces. (Read Spotlight’s face-to-face interview with Mbombo here.) DM/MC

This article is published by Spotlight — health journalism in the public interest.

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