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 over the impact of leadership instability on public healthcare services remain.
In March 2021, then-acting head of health Dr Deon Theys and CFO Dan Gaborone were suspended after they were implicated in fraud and corruption relating to an R43 million personal protective equipment tender.
When Spotlight caught up with Theys this week, he was back at work after a year-long suspension. Theys says it will be business as usual and there are "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 have 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, 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."
Spokesperson for the National Prosecuting Authority in the Northern Cape, Mojalefa Senokoatsane says the PPE case against both Theys and Gaborone was provisionally withdrawn on 8 December 2022. Senokoatsane says it will be premature for the prosecution to disclose fully the reasons for the intention to provisionally withdraw the case against the accused 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 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 are trying to get more evidence and should they find more evidence, the case can be reinstated.
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. - Mojalefa Senokoatsane, NPA
Meanwhile, spokesperson for the Northern Cape Department of Health, Lulu Mxekezo, also confirmed to Spotlight that the two officials have returned to work in January.
"The internal human resources procedures have been followed," she says. She did not respond to requests to clarify what the procedures entailed and what the outcome of the procedures was.
30 months and no permanent HOD
According to the Public Service Act, a vacant post must be filled within six months and someone cannot be acting for more than a year. However, the Northern Cape health department has now been without a permanent HOD for over 30 months.
The department last had a permanent HOD in July 2020 - 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 in a statement said it is alleged that Jonkers fraudulently awarded a security tender for the department to Defensor Electronic Security Systems for an amount exceeding R384 million in 2017 between the months of August and October.
This week, Hawks spokesperson in the Northern Cape Captain Tebogo Thebe told Spotlight that Jonkers' case is going to trial in the Kimberly High Court from 6 March 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 took up his old CFO post.
Riaan Strydom has been acting as HOD since Theys was suspended in March 2021.
The recruitment process for a HOD is underway and we expect a permanent head to be appointed in a month or two. - Bronwyn Thomas-Adams, NC Premier spokesperson
Mxekezo told Spotlight the recruitment and appointment of a HOD is the responsibility of the Premier's Office and would not be drawn on the progress of recruiting and appointing a permanent HOD.
in March last year, Thomas-Adams told Spotlight the recruitment process of a new HOD was in its "final stages". This week, however, she told Spotlight, "The recruitment process for a HOD is underway 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," says Denosa provincial secretary Andrew Vassen.
"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 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 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 kind of 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 Michele 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.
📍[IN PICTURES📸] - Earlier today, the Northern Cape Health MEC, Mr Maruping Lekwene convened an urgent Senior management hybrid-meeting in the Department to receive an update on the strides made to deal with inherent challenges confronting health in our Province. #NCDOH2023 pic.twitter.com/qrkWR7s4AU
-- Northern Cape Department of Health (@nc_doh) January 27, 2023
By time of publication, Mxekezo did not respond to Spotlight's questions on which of these posts had been filled in the meantime.
According to Wynand Boshoff, provincial leader of the Freedom Front Plus, it is the people depending on public health services who at the end of the day have to 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-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," says Boshoff.
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The Democratic Alliance Northern Cape spokesperson for health Dr Isak Fritz agrees that the department is in critical need of stability that can only come with stable management and the firm 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. 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.
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. - Isak Fritz, DA
No consequences?
The opposition parties are 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," 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.
