It may be business as usual in the Northern Cape Department of Health for the former acting head of health and the chief financial officer (CFO) who are back at work after their suspensions, but concerns remain over the impact of leadership instability on public healthcare services.

In March last year, the acting head of health, Dr Dion Theys, and CFO Daniel Gaborone were suspended after being implicated in fraud and corruption relating to a R43-million personal protective equipment (PPE) tender.

When Spotlight caught up with Theys this week, he was back at work after his yearlong suspension. He says that it will be business as usual and that there are “no hard feelings” from his side.

“I am excited to be back at work. My name has been cleared by the Special Investigating Unit (SIU), as I indicated to you last year when we spoke. Right now, I am looking forward to going back to serving the people of the Northern Cape.”

So, that’s Theys in the clear – for now.

SIU spokesperson Kaizer Kganyago told Spotlight that “with regard to the criminal matter, the SIU referred it to the National Prosecuting Authority (NPA) and it is still ongoing. 

“With regard to the SIU’s disciplinary recommendation, the matter was referred to the Office of the Premier.”

NPA spokesperson in the Northern Cape Mojalefa Senokoatsane says the PPE tender case against both Theys and Gaborone was provisionally withdrawn on 8 December 2022. 

Senokoatsane says it will be premature to fully disclose the reasons behind the decision to provisionally withdraw the case against the officials. 

“What the NPA can confirm is that the matter is still being investigated, as we believe that there is a case that needs to be answered by the accused. 

“To ensure that the investigations are carried out with the sensitivity they deserve, we will not be able to share any additional information regarding any additional charges or people involved in this matter at this stage.”

Senokoatsane added that should more evidence come to light, the case could be reinstated.

Meanwhile, the spokesperson for the Northern Cape Department of Health, Lulu Mxekezo, confirmed to Spotlight that the two officials returned to work in January. 

“The internal human resources procedures have been followed,” she says.

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

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Thirty months and still no permanent HOD

According to the Public Service Act, a vacant post must be filled within six months. Also, the position cannot be held in an acting capacity for more than a year. However, the provincial health department has been without a permanent head of department (HOD) for more than 30 months.

The department last had a permanent HOD in July 2020. That was Dr Steven Jonkers, who is now working as a deputy director-general in the Office of the Premier. Jonkers is also facing corruption charges.

Spotlight previously reported that the Hawks alleged Jonkers had fraudulently awarded a departmental security tender to Defensor Electronic Security Systems for more than R384-million between August and October 2017.

Read more in Daily Maverick: “Almost two years later, NC health department is still without a permanent head”

This week, Hawks spokesperson in the Northern Cape Captain Tebogo Thebe told Spotlight that Jonkers’ case is set down for trial in the Kimberley High Court from 6 to 21 March this year. 

According to the Director-General of the Northern Cape government, Justice Bekebeke, Jonkers has not been put on suspension because they are waiting on the outcome of the court case. “He couldn’t interfere with investigations or intimidate any witness. In the meantime, he has positively contributed [through] the execution of his duties in the Office of the Premier and the province,” she says. Bekebeke also says the premier evaluated the charges against Jonkers and didn’t deem it necessary to suspend him.

Meanwhile, Theys did not return to the acting HOD position, but is now back in his former position as provincial medical director. 

Gaborone returned to his CFO post.

Riaan Strydom has been acting as HOD since Theys was suspended in March 2021. 

Lulu Mxekezo told Spotlight that the recruitment and appointment of an HOD is the responsibility of the premier’s office. She would not be drawn on the progress being made, or lack of it, to recruit a permanent HOD.

In March last year, Thomas-Adams told Spotlight the recruitment process for a new HOD was in its “final stages”. This week she said “the recruitment process for an HOD is under way and we expect a permanent head to be appointed in a month or two. 

“The reason why it took so long is because we had to organise the right panels and ensure that everyone is available at the same time.”

Citizens wait for healthcare at Augrabies Health Care Clinic outside Kakamas. (Photo: Thom Pierce / Spotlight)

Concerns mounting

Like other provinces, the Northern Cape Department of Health is beset with serious challenges, including staff shortages, public health infrastructure issues and problems with patient emergency transport services.  

Not having a permanent HOD in the most important health administration post in the province is not helping, according to organised labour and opposition parties in the province.

“In the end, it will lead to the suffering of healthcare services,” says Anthony Vassen, provincial secretary of the Democratic Nursing Organisation of SA (Denosa).

“Riaan Strydom has embarked on various service delivery improvement programmes, together with the MEC, but all efforts could be of no relevance should a new HOD be appointed tomorrow,” says Vassen. 

“The fact that there is no permanent HOD in the department of health is putting a strain on healthcare services. The department is running around like a headless chicken … it is uncertain whether a plan – good or bad – will be implemented should a new head be appointed. 

“The inconsistency of not having permanent senior managers has a bad influence on service delivery,” he says.

Vassen says Denosa is now working with the department on an organogram. 

“It is not only the HOD that is acting … there are many chief directors and senior managers that are in acting positions. These are the things that are delaying the process of appointing more staff members and improving the infrastructure of facilities,” he says.

As of September last year, there were 17 vacancies in key senior management positions in the provincial health department, according to a response to a written parliamentary question posed by DA MP Michéle Clarke.

Among the vacancies at the time were: Deputy Director-General; Chief Director, Office of the MEC; Chief Director Robert Mangaliso Sobukwe Hospital; Chief Director for Priority Programmes; Chief Director for District Health Services; Chief Director for Corporate Services; Chief Director for Provincial Hospital Services and EMS; Chief Director for Strategic Planning and Analysis; Director in the Office of the DDG (DDG position also vacant); Director Facility Planning and Maintenance; Director Quality Assurance; Director Rehabilitation; Director Financial Accounting; Director Maternal, Child, Youth and Women’s Health and Nutrition; Director Communicable Diseases; Director Human Resources; and Director Legal Services.

By time of publication, Mxekezo had not responded to Spotlight’s queries on which of these posts had since been filled.

According to Wynand Boshoff, provincial leader of the Freedom Front Plus, it is those who depend on public health services that suffer as a result of inadequate top management.

“There was joy when the previous HOD and CFO were arrested for corruption for the acquisition of PPE equipment during Covid. 

“The acting HOD, Riaan Strydom, was generally well accepted and our sources within the department are praising his work ethic. However, acting in a position is always an impediment to doing great work,” says Boshoff.

The DA’s Northern Cape spokesperson for health, Isak Fritz, agrees that the department is in critical need of stability, which can only come with stable management and the decision-making powers that come with a fixed appointment.

“The fact that government continues to drag its feet in respect of this appointment is very concerning. The quality of health in the Northern Cape continues to decline,” said Fritz. 

“Emergency medical services are hampered by a lack of operational ambulances and emergency practitioners; the province’s only tertiary facility – Robert Mangaliso Sobukwe Hospital – has a growing surgery and treatment backlog due to limited operational theatres because of serious nursing shortages, and the districts have severe staff shortages and shortages of life-saving equipment,” he says.

(Photo: Emile Hendricks /Spotlight)

No consequences?

Meanwhile, opposition parties are concerned about the return of Theys and Gaborone.

“The charges that these officials were facing relate to irregularities in PPE and are serious. What is disturbing is that the department does not seem to have instituted any further internal disciplinary procedures against them, other than their suspension with full pay,” says Fritz. 

“Now they welcome them without any mention of internal investigations. Given the deep-seated rot within this department, it is worrying that both Dr Theys and Gaborone get to return to influential senior management positions as if nothing has happened.”

Although the department claims that HR processes were followed for the return of Theys and Gaborone, Theys told Spotlight there were no internal processes against him. 

Mxekezo did not respond to follow-up questions to clarify this. DM/MC

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