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 who are back at work after suspension, but concerns remain over the impact of the leadership instability on public healthcare in the province.

In March 2021, the then acting head of health Dr Deon Theys and CFO Dan Gaborone were suspended after they were 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 a year-long suspension. Theys said it would be business as usual and there were “no hard feelings” from his side. His first day back at work was on Monday, 23 January.

“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.”

Cleared – for now

Kaizer Kganyago, the SIU spokesperson, told Spotlight: “With regard to the criminal matter, the SIU referred it to the National Prosecuting Authority and it is still ongoing. With regard to the SIU’s disciplinary recommendation, the matter was referred to the Office of the Premier.”

The spokesperson for the National Prosecuting Authority in the Northern Cape, Mojalefa Senokoatsane, said the PPE case against Theys and Gaborone was provisionally withdrawn on 8 December 2022. Senokoatsane said it would be premature for the prosecution to fully disclose the reasons.

“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 that 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 did say, however, that they were trying to get more evidence and should they find more evidence, the case can be reinstated.

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

“The internal human resources procedures have been followed,” she said. She did not respond to requests to clarify what the procedures entailed and what the outcome was.

30 months and no permanent HOD

According to the Public Service Act, a vacant head of department (HoD) post must be filled within six months. However, the Northern Cape health department has now been without a permanent HoD for more than 30 months. The department last had a permanent HoD in July 2020 — Dr Steven Jonkers, who is now working as deputy director-general in the Office of the Premier. Jonkers is also facing corruption charges. 

Spotlight previously reported that the Hawks said it is alleged that Jonkers fraudulently awarded a security tender for the department in 2017 to Defensor Electronic Security Systems for an amount exceeding R384-million.

According to the director-general of the Northern Cape government, Justice Bekebeke, Jonkers has not been suspended because they are waiting on the outcome of his court case.

Meanwhile, Theys did not return to the acting HOD position but is back in his former position as provincial medical director. Gaborone took up his old CFO post. Riaan Strydom has been acting as HOD since Theys was suspended in March 2021.  

In March last year, Northern Cape Premier Dr Zamani Saul’s spokesperson, Bronwyn Thomas-Adams, told Spotlight the recruitment process of a new HoD was in its “final stages”. 

This week, however, 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.”

Concerns mounting

Like other provinces, the Northern Cape health department is beset with several serious health 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,” said Andrew Vassen, the provincial secretary of the union 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,” said 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 like a headless chicken where 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 said. 

Vassen said Denosa was 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 kind of things that are delaying the process of appointing more staff members and improving the infrastructure of facilities.”

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 parliamentary question posed by DA MP Michele Clarke.

Among the vacancies at the time were: deputy director-general; chief director in the office of the MEC; chief director of the 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 of facility planning and maintenance; director of quality assurance; director of rehabilitation; director of financial accounting; director of communicable diseases; director of human resources; director of legal services; and director of maternal, child, youth and women’s health and nutrition.

By the time of publication, Mxekezo had not responded to Spotlight’s questions on which of these posts had been filled in the meantime.

The Northern Cape leader of the Freedom Front Plus, Wynand Boshoff, said it is the people depending on public health services who suffer because 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-19. 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,” said Boshoff.

The DA’s spokesperson for health in the Northern Cape, Dr Isak Fritz, agreed that the department was in critical need of stability that can only come with stable management.

“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. 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 said.

No consequences?

The opposition parties were also 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,” said 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.