Organised labour and opposition parties in the Northern Cape are raising the alarm over the impact leadership instability in the provincial health department has on public healthcare services.

The Northern Cape department of health has been without a permanent head (HoD) since July 2020. An acting HoD was suspended after being arrested in August last year on charges of fraud and corruption. A second acting HoD is now in place.

A timeline of charges

Dr Dion Theys was the acting HoD until about August/September last year (we haven’t been able to get the exact date of his suspension). Theys, with the department’s chief financial officer Daniel Gaborone, appeared in the Kimberley Magistrates’ Court in August last year. They were released on R20,000 bail. 

The two officials are facing charges relating to procurement irregularities in a personal protective equipment (PPE) tender from 2020 valued at R43-million. 

Spokesperson for the NPA in Northern Cape, Mojalefa Senokoatsane, said the PPE case involving Theys and Gaborone was postponed to 13 April 2022 for a pre-trial hearing. A trial date would then be set down.

Theys is no stranger to controversy. In March last year, he appeared in the Kimberley Magistrates’ Court on unrelated corruption charges and was released on R30,000 bail. Those charges involve a 2014 lease agreement with the JP Hugo residence (nursing students’ accommodation) amounting to R96-million.

Northern Cape Health MEC Maruping Lekwene (right) and suspended acting head of the provincial health department Dr Dion Theys. (Photo: NC Health / Twitter)

The last permanent HoD of the province’s health department, Dr Steven Jonkers, is now the deputy director-general for policy and governance in the premier’s office — but he too is facing charges.

According to a statement released by the Hawks, Jonkers appeared in the Kimberley Magistrates’ Court in October last year on charges of fraud and contravening the Private Security Industry Regulation Act. He was released on R50,000 bail. 

“It is alleged that in 2017 between August and October, while Jonkers was the health HoD, he fraudulently awarded a security tender for the department to Defensor Electronic Security Systems for an amount exceeding R384-million. 

“It is further alleged that the directors of the company submitted fraudulent documents in order to gain an unfair advantage over others to be awarded the tender as the highest bidder,” the statement reads.

Remain ‘full employees’

Provincial health department spokesperson Lebogang Majaha says the two officials, Theys and Gaborone, would remain suspended until the court process was concluded. 

“We cannot comment further on this matter except for the fact that the two officials are on suspension with their full salaries and benefits.” Majaha also says the two officials remain “full employees of the department”.

In the meantime, Majaha says that two officials within the department have been appointed to act as HoD and CFO, to enable the department “to continue to operate and provide quality service to the people of Northern Cape”.

Northern Cape Health MEC Maruping Lekwene gets his Covid-19 jab with NC Premier Dr Zamani Saul. (Photo: Northern Cape Health / Facebook)

Although Majaha declined to identify the acting CFO and HoD, a report by Health MEC Maruping Lekwane to the provincial legislature presented in September last year, said that Riaan Strydom was the acting HoD and a certain P Ngcoboti the acting CFO.  

When Spotlight asked Majaha why he was unable to reveal the names of the two acting officials, he said, “The reason is that it is difficult for us to reveal names of acting positions, especially HoD and CFO, since the positions are not sustainable. These are month-to-month contracts, and the acting person may be removed at any time. So, until the posts are permanently filled, we cannot confirm names.”

Bronwyn Thomas-Abrahams, spokesperson for Northern Cape Premier Zamani Saul, confirmed that Strydom was the acting HoD, but that she was unable to comment further on health matters as the premier was responsible only for the appointment of the HoD. 

Saul has on numerous occasions been outspoken about fighting corruption in the province. 

Trade unions not happy

Cosatu provincial secretary Orapeleng Moraladi accused the Northern Cape health department of practising double standards when it came to disciplining employees.

“It is clear that some employees are better than others. Our view is clear — Theys and Gaborone should be held accountable. Had it been any other ordinary employee, they would have undergone the formal disciplinary process and then eventually been dismissed, but for top managers such as Theys and Gaborone, they are placed on suspension with their full salaries. It is worse because these two officials are facing criminal charges,” he said. 

Moraladi says the union has on several occasions warned the government to stop employing “people with tainted names in the name of deployment”. 

“The department of health must institute disciplinary processes for Theys and Gaborone. It is standard procedure.”

Nehawu’s provincial secretary in the Northern Cape, Moleme Moleme, said: “Six months later, Theys and Gaborone are still enjoying employment benefits, and that unfortunately amounts to fruitless expenditure for the department because these people are not working, but they are receiving a full salary with all benefits. 

“As Nehawu, we are hoping for a speedy trial and we hope that justice will take its course.”

According to the Public Service Act, vacant posts must be filled within six months and a person could not remain in an acting capacity for more than a year.

After first being advertised in August 2020, the HoD post was readvertised with a closing date for applications of 31 December 2021.

Thomas-Abrahams told Spotlight that the recruitment process to find a suitable candidate for the position of HoD was under way.

Impact of leadership instability 

Patients wait outside Alheit Primary Health Care Clinic outside Kakamas in the Northern Cape. (Photo: Thom Pierce / Spotlight)

According to DA provincial spokesperson Izak Fritz, the health department is largely lacking strategic direction. 

“This leads to delays in decision-making and especially the finalising of submissions,” he said.

“Certain financial and human resources delegations are also largely centralised, due to a critical management vacuum at some facilities,” he said, pointing out that as a result, payments were delayed. 

“Ordering of medicines and supplies is affected, causing suppliers not to deliver. Payment for the repair of equipment and maintenance is delayed and service providers, in turn, withdraw certain services. Even staff appointments get delayed, despite critical shortages of nurses and emergency care practitioners. 

“Ultimately, health professionals who want to work for the province’s health department wait so long to get feedback on their applications that they get appointed in other provinces and the Northern Cape loses out,” he said. 

The leader of the Freedom Front Plus in the Northern Cape, Wynand Boshoff, said they too were concerned about the instability of top management positions in the provincial health department. 

“The bungling of the (Kimberley) mental hospital is only the most expensive error in a department which just seems to be unable to rid itself from corruption and mismanagement.”

Boshoff said that suspending the head of the department was a radical step, but a necessary one, if they wanted to get to the root of the problem. 

“Of course, it is a huge disruption for a department to function without a [permanent] head, but if the head is too corrupt or unable to manage the department correctly, it is better off without one,” said Boshoff. However, he warned that it might be a problem if only one individual was used as a scapegoat for a systemic lack of accountability.

Health service delivery amid suspensions

Brandvlei Clinic in the Northern Cape. (Photo: Tom Pierce / Spotlight)

In the strategic overview in its quarterly performance report (July to August 2021) tabled in the provincial legislature, the department acknowledges that “the one thing that has been an Achilles’ heel of the department in the latter years, including in the financial year 2020/2021, is the continued instability and vacancies in key senior management positions”.

“There have been too many changes at this level. There was again a change in the position of Head of Department. This invariably has had negative extrapolations for the strategic direction of the department. There is increasing realisation of the need to stabilise this level of leadership in the department,” the report reads.

The report also hints at the ripple effect on health services.

For example, the report notes that “the non-filling of administrative and support posts still has an effect on performance” and replacement clinical posts are still done at a slow pace. The report also notes various challenges with the availability of medicines. 

“On district level, access to medicine was negatively affected by the closing of facilities due to Covid-19; local municipal strikes in the sub-districts; local floods in some districts as well as challenges with the delivery and distribution of stocks by the depot to and within the districts,” the report reads. 

It also notes that due to a limited cash flow, the depot and districts suffered certain stockouts. Ensuring continuous cash flow to pay suppliers within 30 days and to redistribute medicine stocks in the districts were listed among the measures to address the situation.

The central chronic medicines dispensing and distribution programme is an important means of getting medication to people, but all the districts performed poorly on this. The report notes the need for an “urgent resuscitation of this programme”.

Health infrastructure is another area where the department is found lacking, since many projects are years behind schedule, often due to delayed payments by the department. 

For example, the Bankhara Bodulong Clinic project reportedly began in September 2017 and was due to be completed in 12 months. The report notes it “is currently 32 months behind schedule”. 

“The contractor did not return to site in January 2020 until May 2021, citing perpetual delays in the processing of payments. The contractor is back on site to complete the outstanding works,” the report notes.

The Boegoeberg Clinic project, among others, faced similar challenges and is 24 months behind schedule.

‘I’m cleared’ — Thys

Responding to the allegations of corruption, Dr Theys said he had been cleared by the SIU in the report that was released. 

“My arrest was a waste of money and resources and I am supposed to go back to work. The SIU report has cleared my name of all the charges of corruption, money laundering and fraud. So now it is interesting to see what is going to happen in court when we go back on 13 April. Will the charges be thrown out? I don’t know.”

Theys says his suspension was based on the Hawks’ charges and now “the SIU has cleared me of these charges”. 

“So what does that say about the system? It does not make sense that I am still on suspension. It is actually very embarrassing to the system.” 

Theys says he has heard nothing from the department since the SIU report. “It is unfortunate, because my name has been tarnished. We saw the headlines when I appeared in court for corruption, but now there are no headlines stating that the SIU has cleared my name.”

From what Spotlight could establish from the SIU’s final report on PPE corruption released in December last year, Theys and Gaborone are mentioned once in the SIU’s referrals to the provincial department to take disciplinary steps against the two officials.

Hawks provincial spokesperson, Nomthandazo Mnisi, declined to comment on Theys’ claims and referred queries to the SIU. 

When asked if Theys and Gaborone had been cleared by the SIU, the spokesperson for the unit, Kaizer Kganyago, said, “Our report has not cleared any individual or entity that we are investigating. The R23 of 2020 proclamation investigation is still ongoing and our deadline is 31 May 2022 for investigations to be finalised. The criminal matter involving Dr Theys and Mr Gaborone is being dealt with by the Hawks. The disciplinary proceedings involving Theys and Gaborone are also still ongoing.”

Spotlight also approached Thomas-Abrahams to allow Riaan Strydom to respond, but we did not receive feedback by the time of publication. Gaborone was also given the right of reply, but did not respond. DM/MC

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

[hearken id=”daily-maverick/9264″]