South Africa: Acting Free State Health Head On His Plans for the Department

interview

On 20 May 2021, amid rising COVID-19 infections, Free State Premier Sisi Ntombela announced that Godfrey Mahlatsi will replace then head of the province's health department Dr David Motau as HOD in an acting capacity.

According to the Premier's Spokesperson Sello Pieterson, Motau resigned from his post and took up the position as registrar of the Health Professions Council of South Africa (HPCSA). Spotlight has reported on various controversies in the Free State during Motau's time as HOD, including questions over medical equipment tenders, an illegal clinical trial, and contracts with a private ambulance company that is currently being investigated by the Special Investigating Unit (SIU).

Mahlatsi is no newcomer to government. According to a Free State government profile of him, Mahlatsi has been head of the Free State Treasury since 2013 before his appointment as acting health HOD.

The current MEC for Health in the Free State is Montseng Tsiu who has been in the job since 2018. According to Mahlatsi, the roles of MEC and HOD are not the same at all. "The role of a HOD is purely administrative," he says. "I am an accounting officer and the MEC is the political head. Her role is to provide political leadership and direction in the department." (We previously explained the differing roles of MECs and heads of departments here.)

Previous experience

In an exclusive interview with Spotlight, Mahlatsi says being appointed as the acting HOD is not a foreign task to him as he has worked as an accounting officer for the department for two-and-a-half years when the department was placed under administration.

The Free State Department of Health previously told Spotlight that it was under administration from 2014 to 2018 (we haven't been able to establish who the accounting officer was for the other year and a half). Spotlight previously reported on how then Free State Premier Ace Magashule effectively took the department out of administration for five days in February 2017, in which time questionable price increases for a private ambulance company were signed off by Motau.

Asked about the ambulance contracts awarded to Buthelezi EMS (currently subject to SIU investigation) and equipment contracts awarded to Mediquip Hub SA, Mahlatsi does not provide much detail.

"There is an irregular expenditure framework that has been drafted by the National Treasury which needs to be followed at all times and so, if we find that processes have not been followed in those tenders, among the things that need to happen is to investigate what could have happened during the awarding of those contracts and also find out who is responsible if there would have been any irregular actions that took place during the process so that they can account," he says. "We will then take the necessary steps which means that there will be people who will have to go through a disciplinary process, and that is what we will do."

The Auditor-General (AG) in the 2019/20 PFMA report for national and provincial departments flagged consequence management as a concern in the Free State stating that there were "inadequate consequences for poor performance and transgressions".

Aims for clean audit

Mahlatsi says he has settled in well and has already started with the work of ensuring that the operations of the department are in order.

One of his top priorities is to obtain a clean audit in the Health Department. Under Mahlatsi's leadership, the provincial treasury in 2019/20 received a clean audit which the AG called "commendable" as it was "a first for the province since 2016/17".

"I have been in this position for three months now, and we cannot obtain a clean audit in such a short period of time because it is a process," he says. Mahlatsi says the department received a qualified audit opinion and at this point in time, the department is going through an audit of what has already happened. "But we are already putting controls into place to make sure that we get back to the unqualified audit opinion that we once achieved when the department was under administration. I believe that once we have reached that point it will be possible for us to be able to move to clean."

The AG defines a qualified audit opinion as when the financial statements "contain material misstatements in specific amounts, or there is insufficient evidence for [the AG] to conclude that specific amounts included in the financial statements are not materially misstated".

Some of the issues Mahlatsi will have on his plate to address include millions of unauthorised and irregular expenditure in the health department. The AG, among others, in the 2019/20 audit report found that there were no "preventative controls in place to ensure that adequate supporting documentation was available so that payments were only made for infrastructure assets actually received".

The health department has been making significant overpayments on infrastructure projects which are still being investigated. The provincial health department, the AG says in the report, also "disclosed significant doubt whether they will be able to continue with their operations as planned based on their current financial position. The biggest risk to this sector's ability to operate is medical claims."

Questions over PPE tenders

Some will be sceptical about Mahlatsi's commitment to clean governance. This is because, as elsewhere in the country, serious allegations have been made about alleged COVID-19 corruption relating to the procurement of personal protective equipment (PPE) and fumigation and disinfection services in the Free State. The procurement in question was run by the Free State Treasury, with Mahlatsi as administrative head. As reported elsewhere, a number of these contracts were given to politically connected persons.

Mahlatsi however rejects the suggestion that people are given contracts because of political connections.

"There is a view that personal protective equipment tenders that were awarded were awarded to politically connected people, but what media and those that are proponents of the idea have failed to do was to go to the more than 200 people and ask them if they are politically connected. Have they ever been to me as the HOD to ask for business and if I gave them business," he says. "The reality is that the Free State is small, and we had a small budget.

We managed to spread it very wide but unfortunately for us, we are administrators and not politicians, so we are not going to select people because they are politically connected or not. If you meet the requirements, you will be awarded [a contract] if you do not meet the requirements you will not be awarded," he says.

"As to whether a person is politically connected or not is not our responsibility. Our responsibility is to take on those that did not declare that they have a relationship with someone who has decision-making powers who may have influence, but it is the responsibility of the bidder to declare. Where they would not have declared, we would want to know," says Mahlatsi. "My message to people is that the procurement processes are not meant to be manipulated for certain people to be favoured. That would be very unfair and the Constitution of the country does not allow people to procure through public entities unfairly and favour others."

Long-standing issues addressed?

Mahlatsi says that the department will not enter into long-term contracts with private ambulance companies and that the long-term contracts that were there had expired. He says they will only make use of private ambulance companies to help out at peak times. This brings the Free State back in line with other provinces where most public sector ambulance and patient transport services are run by the department. Spotlight previously reported on allegations that the state was being overcharged for long-term ambulance contracts with a private company in the Free State and Northwest.

Asked about medicines stockouts, Mahlatsi suggests that it is not a problem in the province. "At our medical depot we have an average of above 80% of medicine availability," he says.

On patients allegedly sleeping on the floor due to a shortage of beds at some hospitals, he says: "This is an issue of the past. If you remember, we had challenges at Pelenomi Hospital, but there has been an expansion of the facility and we have beds as it is now. Even under the COVID-19 conditions, our facilities have sufficient beds at this point to cater for our people in the province. We monitor the bed availability and currently, it is in good shape."

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