KZN Heath MEC warns officials to get their finances in order or face the consequences; as department gives finance and management refresher training for hospital CEO’s and finance managers in order to improve fiscal discipline and audit outcomes
KwaZulu-Natal Health MEC Ms Nomagugu Simelane-Zulu has issued a stern ultimatum to hospital CEOs and finance managers in the province: get your finances in order and help the Department improve its audit outcomes, or face the consequences.
Speaking at a workshop attended by hospital CEOs, finance managers and Treasury officials in Durban earlier today, MEC Simelane-Zulu welcomed the refresher training programme, which entails, among others, a brand new “management reporting pack” and ongoing mentorship to guide CEOs and finance managers and help improve fiscal discipline in their facilities.
The MEC, however, did not mince her words about looming action against those who behaved recklessly with the public purse, and allowed the wastage of scarce financial resources under their watch.
She said KwaZulu-Natal Premier Mr Sihle Zikalala had made it clear that, after years of receiving qualified audits due to irregular expenditure, the Department needed to turn around its financial management as a matter of urgency – or heads will roll.
“These negative audit outcomes have continued for 10 years because there have been no consequences. When the Department started getting them, many of you were already managers. But none of you have had consequences implemented against you. That comes to an end today.
The MEC cited a number of her own personal experiences whereby hospital CEOs had no clue about the financial state of facilities that they were ultimately responsible for.
“I’ve visited a number of hospitals… But the majority of them, when you ask a simple question about finances from the CEO, they don’t know the answer. But in the majority of cases, the managers let the finance manager run the system as if they’re not there.
“In one instance, the CEO was not ashamed to say to me, ‘Yes, I signed, but I did not read the document… He didn’t see anything wrong with the fact that he did not read a document that he’s supposed to account for. So, that says to me, even the finance of the facilities are not really known by our CEOs, because there’s always someone else who will deal with that. It comes to an end today.
“Every single manager according to their delegation is going to see consequence management. Consequence management is one factor that we need to start implementing as the Department of Health. It cannot be that we get negative audit outcomes from the Auditor-General, because of how we manage facilities. There’s one small team of managers at head office, but there’s 73 of you as CEOs.
“So, if you’re given a responsibility, a mandate, and delegations, and you don’t implement them, what must we do with you? Why must we keep you? We’re not going to. It’s a commitment I’m making right here, right now. We’re not going to be afraid to take action.”
MEC Simelane-Zulu also made it clear that she was not threatening staff, but merely asking people to do their job.
“I’m here to say to managers, you have to manage. You get paid to manage. You don’t get paid to be big bosses sitting in big offices. It cannot be that I arrive at some facilities as the MEC, and I ask questions about what is happening… and only someone else knows the answers, but the CEO of the facility does not.
“It cannot be that I get into a facility, there’s equipment that hasn’t been delivered because it hasn’t been paid for, and the CEO doesn’t know why we’ve not paid.
“It cannot be that we get into a facility, and we have paid twice for a particular service, but the CEO does not know why that happened. In fact, the CEO is unable to explain to us why there’s been a double payment. It’s can’t be.”
The MEC said she had officially written to the Head of Department, Dr Sandile Tshabalala, enquiring about what action should be taking about yet another impending qualified audit for the Department.
“My question is… the people who are responsible… what consequences are going to be taken against them? We need to start now. We’re starting now. I’m not being hard on the facilities… We’re doing the same thing at head office, because some of the adverse comments that we are getting from the Auditor-General are not from the facilities, but from our own systems at head office.”
The MEC was at pains to point out that not all CEOs and staff were failing to carry out their duties; and that, in fact, many were punching above their weight, under difficult circumstances.
The MEC continued: “Every single manager that is not managing is going to have to be dealt with. That also means you as managers have a responsibility to implement consequence management in your own facilities. We also need managers who… are not going to be afraid to manage a particular person just because they are said to be better educated than them, for instance.
“We are here to say to you, things are not well. You have to take responsibility to manage, and you have an opportunity to bring about positive change. We need all of you to be able to take that challenge and run with it.”
The MEC said she was extremely concerned that a large number of the healthcare workers who became infected with COVID – 19 had sought medical treatment in the private sector. She described this as an indictment on the state of public health facilities, which needs to change.
“Do you know that the percentage of them who actually came to our facilities was less than 5%? The vast majority did not trust our own system enough to come and be hospitalised in our facilities. Those who did not go to private hospitals requested for beds to self-isolate at home. Those who needed to be hospitalised immediately wanted to go to Inkosi Albert Luthuli Central Hospital, and we questioned that… because they had other facilities closer to them.”
She said good management also entailed hospital managers getting tough on staff who mistreat patients.
“Some of our staff are so unfriendly to our patients it’s sad. The reason why this kind of attitude continues is because there’s no consequence management. The reason why a nurse thinks she can insult a grandmother anyhow is because he or she knows they’ll get away with it. The reason why when a patient asks for tea, and a nurse says to her, ‘You think you’re in a hotel, leave me alone…’ is because she knows nothing is going to happen. And nothing happens because you’re not managing. You, sitting here, are not managing. So, the state of healthcare is where it is, because you are being paid for a job that you’re not doing. Yes, there are challenges that are due to labour issues, which is something we are dealing with. But when we come to your facilities, we must not get there and point our fingers at you for not doing what you’re supposed to do.”
MEC Simelane-Zulu emphasised that help was at hand for CEOs and finance managers who were struggling or felt overwhelmed, for whatever reason.
“We are making a call to CEOs and finance managers to do your job, and make sure your finances are in order. If you don’t understand what needs to be done, ask. Our lines are open. Contact your district manager. If you’re still unhappy, speak to your district. If you don’t get support, go to head office. The CFO is there, so are the Deputy Directors-General, and the Head of Department.
“As MEC I also take calls and texts from everyone, and I always respond. We are here together. We are supposed to turn this vehicle together. It cannot be driven by just one person. If that was the case, then it means you’re not needed. The fact that you’ve been employed is a clear indication that for us to be able to keep this vehicle on the road, all of us are needed.”
