Eastern Cape Provincial Government on its COVID-19 response plans

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Cooperative Governance and Traditional Affairs

16 July 2020
Chairperson: Ms F Muthambi (ANC)
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Meeting Summary

The below is compiled based on the Committee’s official minutes

 

Meeting report

NOTE: PMG was not present at the meeting. The below is compiled based on the Committee’s official minutes.

 

Opening and Welcoming

The Chairperson opened the meeting and welcomed all present. She noted the apology from Deputy Minister Bapela. The Premier of the Eastern Cape also tendered an apology and the Eastern Cape MEC for Cooperative Governance and Traditional Affairs, Mr Xolile Nqatha, will lead the delegation.  The Chairperson conveyed the condolences to the province for the loss of the Agagabe Queen, Noloyiso Sandile, and to the family, friends and colleagues of Mr George Seitisho. She further noted that the Committee called on the province as it is responsible for key services in the fight against the pandemic, including public health services, schools and social welfare services. Provincial functional services were facing challenges, even before the outbreak of the pandemic, which escalated after the outbreak. education, social services etc. The Committee had invited the provincial government to ascertain the provinces assistance in fighting the pandemic. 

The Committee recently met with three metros in the province where it observed the enormity of the challenges faced by the province in fighting the pandemic. These challenges include numerous allegations of corruption involving the spending of COVID-19 funds. The situation in the health sector is alarming in respect of the infrastructure of health care facilities, vacancies in the sector and the number of fatalities that is increasing.

The presentation of the province indicated that assistance is required in fighting the pandemic. 

Presentation by the Eastern Cape Government on their response plans for COVID-19

MEC Nqatha led the oral submissions on behalf of the ECPG. The MEC handed over to the DG in the Office of the Premier, Mr Sigoni, to make the presentation.

The DG gave an executive summary highlighting the following:

  • The province developed its Covid-19 response strategy that was informed by the national Covid-19 risk adjusted strategy.
  • The province has set up functional institution arrangements in which a wide range of stakeholders participate. The campaign integrates the efforts of national, provincial and local government, traditional leadership structures, business, religious leadership and education system.
  • There is a marked improvement in the recovery rate which is at 69% and contact tracing which stands at 92.7%. The Personal Protective Equipment (PPE) availability has also improved as it currently sits at one to two weeks’ surplus across all institutions in the province.
  • Thus far R2.2bn (of the required R4.1bn) has been allocated towards the Covid-19 health strategy response. As a result of this, the province is continuously revising financial projections;
  • Of the targeted 7 624 health professionals, 42% (3 459) have been recruited. The risk of infection of health care workers remains high at 2285 and 28 demised;
  • The foregrounding of the Integrated Service Delivery Model (Masiphathisane) remains a fundamental pillar of the disaster management effort, through the roll out of Ward Based Rapid Response Plan;
  • Significant progress has been made to support communities with access to water especially targeting the informal settlements
  • Partnerships remain key in the realisation of the provincial Covid-19 strategy and objectives; and
  • The province has made great strides in strengthening communication and enforcing regulations.

In his extensive presentation, the ECPG Director-General (supplemented by the relevant MECs and HODs), took the Committee through the presentation, highlighting the following focus areas in response to COVID-19:

  • District analysis of Covid-19 status as at 14 July 2020
  • Overview of the Provincial Covid-19 Disaster Response Strategy
  • Update on the implementation of the strategy
  • Investment into health infrastructure
  • Integrated human settlements
  • Education
  • Psycho-social services
  • Ward Based response plan
  • Economic recovery plan
  • Partnerships 
  • Government business continuity

See presentation for further details. 

Discussion 

Following the progress report by the ECPG in relation to the state of readiness in the province in response to Covid-19, the Committee deliberated, and sought clarity:

Regarding issues of health:

  • It was noted that the Eastern Cape Department of Health was not handling infrastructure issues properly as it had not filled the positions of Chief Director for Infrastructure and Quality Control for a long time. How the Department could provide accurate information on field hospitals if it had no management that was looking into this. When is the Department of Health envisaging filling these positions?
  • How is the Provincial Government addressing the serious vacancies in its health facilities? The presentation indicates that the province has so far only managed to recruit only 42 percent of the required 7 642 health professionals. According to the Provincial Legislature’s Health Portfolio Committee, there are 2 000 vacant posts in the Eastern Health Provincial Department alone. Staff shortages have become worse as the infections started hitting healthcare workers.
  • Can the Provincial Government confirm whether there is an investigation into the R10m tender to supply 100 ambulance scooters to the Provincial Department of Health? If yes, what are the reasons for the investigation?
  • What is the quality and specification of the PPE equipment provided to health care workers, and to what extent does it relate to the exponential increase in the rate of infections and the resultant high absenteeism?
  • It was reported by the Minister of Health on 10 July that the EC only has one field hospital that was donated by the private sector and the presentation received is that 5 000 beds are envisaged - how will the province address this; how many hospital beds are available now and how many still needed to procured?
  • Out of 768 clinics only 370 meets the “ideal clinic status” (according to NHI) - what measures are in place to raise the status of the remaining 398 clinics to ideal status?
  • Community health workers have been employed by the Department of Health on a casual basis since 1992. Why have they not been insourced into the Department? The same community health workers are embarking on the protest action in Bisho as the meeting in progressing and it was reported that police opened fire on them. It was reported that the Superintendent-General that is present in the meeting gave an order to open fire on them.

Regarding issues of education:

  • How is the province mitigating comorbidities in the education sector?
  • What contributes to the high number of deaths in the education sector of the province?
  • The Department reported that 488 schools have been equipped whit toilets - can the Committee be furnished with the list of schools that benefited?
  • The anomaly in numbers reported in the presentation and response by the MEC. 

Regarding issues of transport:

  • In April, a Civil Society Forum blew the whistle on a secret government quarantine facility in rural Cala. The site of the facility, which admitted 18 COVID-19 patients, was a guesthouse (Mioca Lodge) belonging to the family of the MEC for Transport. A guesthouse charging R500 a night would make R126 000 if it housed 18 patients over a 14-day isolation period. It was unclear why the Provincial Government would use this facility to house people from larger towns far away and whether it was properly equipped to do so. While the Provincial Government closed down the facility two days after the news broke out, it is not clear whether there was any consequences management in relation to this incident. The Provincial Government must explain.
  • The Mioca Lodge was again in the spotlight on 01 May when the Eastern Cape Premier announced a forensic investigation into allegations of an improper contract between the Department of Transport and the Lodge to accommodate employees of the Department’s roads section for a period of more than a year. It is now more than two months since the announcement. The Provincial Government must provide an update on the status of the forensic investigation.
  • The Department of Transport was also under investigation for the alleged improper procurement of sanitisers, corruption in spending related to funds allocated for the funeral of 26 people who died in March in a bus accident in Centane, and paying R47 million for footbridges for which no construction had taken place. The Provincial Government must also provide an update on this.

There were further observations relating to:

  • The relationship between provincial and local government in fighting the pandemic;
  • MEC's address at a funeral - people involved in corruption should not be processed as their immune systems are weak;
  • The supply of water in the province, R100m tender for water plant at ???Local Municipality. The court ruled that the tender was awarded without proper procedure - what consequence management was instituted to officials involved?
  • Dr Beyers Naude Local Municipality was granted R30m for drought relief, but only R5m was accounted for. The remaining R25m does not reflect on the books of the municipality.
  • What have the command councils in the province been doing to ready the province for the fight against the pandemic;
  • Credibility of the information given at the meeting versus the information received by the Minister of Health in July, and media reports on the state of the province.
  • Why should the Eastern Cape not be placed under S100 of the Constitution to prevent the total collapse of the health care system in the province?
  • How has the piloting of the DDM in the OR Tambo District fared and what differences are evident?
  • Provision of food and social services to vulnerable communities as part of proper nutrition in the fight against Covid-19;
  • Lack of water in Nquthu municipalities. What measures are in place to provide potable water?
  • Decontamination of informal settlements;
  • What has the MEC of Cooperative Governance done in terms of intervention in the corruption happening in the OR Tambo District Municipality?
  • Serious crimes – 1 June to 15 July 631 rape cases reported. How many GBV and femicide cases were reported for the same period? How is the province addressing these issues; How many facilities are available for victims of these crimes?
  • What was the R2.2bn of Covid-19 funds spent on?
  • In which wards were the Ward Based Response Teams implemented?
  • What were the increases in rates and taxes per municipality as part of the economic recovery plan?

Response by Eastern Cape Government on its response plans for COVID-19

​Health-related issues:  

  • Province has tracing teams, that are supported by the National Department of Health they are all over the province conducting, screening, testing etc,  The information provided to the Committee is what the province received from those teams. Capacity in the Department of Health. The R4.1bn in question is for the use of the Department of Health. Recruitment of health care workers the Department has a report on how the integration has progressed, but the available funding is not sufficient.
  • BBC video – the issues around this have been solved but the issues keep coming back to the media. At Livingston Hospital the challenge there was that they were mixing waste and could not distinguish between medical and food waste. The service provider refused to collect waste if it was not medical waste. The Department has procured the services of another service provider for the collection of food waste.
  • During the lockdown the province concentrated on upgrading its current health facilities and identifying spaces where field hospitals can be erected. The province wants to ensure that the current facilities must meet the ideal clinic status post-Covid-19. 
  • PPEs – is not just for use in Covid-19 
  • Testing of corpses – people are dying at home and testing should be done to confirm the cause of death.
  • Track and testing system – there is a system where people testing positive are sent an sms immediately to inform them.
  • The loss of test samples – the company that was instructed to transport the samples by the NHI. The company gave a report to NHI and they confirmed that the contract with the company was terminated.
  • Oxygen: country has shortages due to the outbreak of the pandemic. A canister that in the past could cover a person for 2hrs is not possible. The province is looking for facilities where oxygen can be installed in bulk.
  • Province decided because of the pandemic not too hastily employ people on a permanent basis as they do not want to be accused of not following proper procedure. The province is creating a situation where there are contract workers for the duration of the pandemic. The idea is to have enough temporary workers to assist with the fight against the pandemic. The Department is looking at filling the vacancies after the disaster and is in the process of advertising the positions already. The Chief Director post has been filled and the incumbent will start on 1 August 2020.
  • Hospitals in the Eastern Cape are problematic and there are lots of challenges that the Department needs to address. One of the biggest challenges at hospitals is the anxiety of nurses about the pandemic.
  • Scooters are not an issue of corruption - the Department has not spent a cent on this. It was a pilot idea to reach people that do not have access to travel to and from hospital. It was thought the scooters could come in handy to access people where roads are not accessible for emergency transport. People did not like the idea of the scooters and hence the Department did not procure them. The Department is still looking at ways to assist the communities as they do not want a situation where the elderly come to clinics and sit the whole day just to collect medication.
  • With regard to the community health workers – there is a national process underway that is at a bargaining council level making recommendations on the conditions of the community health workers. What the national process has agreed is that community health workers must be paid an amount of R3 500 per month accompanied by a one-year contract renewal. All community health workers must be assigned a persal number. There is a further national process that is looking at the absorption of community health workers into the system. This is an ongoing process in the bargaining councils of the sectors.

MEC of COGTA

  • The statement made by the MEC of Cogta was taken out of context. As the MEC of Cogta, he does not condone corruption, but merely noted that whilst busy with investigations, the official being investigated tested positive for Covid-19 and was self-isolating. The MEC thought it would be inhumane to continue the investigation whilst the official is sick.
  • The support provided by the province to the OR Tambo District Municipality on the suspension of the municipal manager is that the municipality should follow due processes. If an illegal decision is taken, then the municipality can be subject to law processes. The municipality took the MEC's advice and the suspension has now followed due process. The issue of the R4.8m of Covid-19 funds paid for the awareness campaign is under investigation and the MEC is awaiting a report on the outcome of that investigation.
  • To place the province under S100 has lots of challenges, but the history of the province must be taken into account on this. The province has weaknesses like its health sector but improvements are evident. The MEC is of the opinion that the province does not need the S100 intervention but more assistance from national government to get the province on par.
  • DDM as it relates to OR Tambo District Municipality:  the DDM was validated in the municipality, it was well communicated and well consulted. There is a plan in place at the municipality which will be executed. The province and municipality have met with DBSA for assistance in the execution of the plan. With DBSA partnership, nine engineers and financial experts were appointed that will form part of the DDM technical task team implementing the DDM. 
  • There is a MM in the Enoch Mgijima Local Municipality.

Education

  • The opening of schools while in the peak of the pandemic: issues of national calendar is not provincial competence. This depends on the strategy of the Ministry of Basic Education. Provinces can just request a deviation having looked at the analysis of the province.
  • Comorbidities at schools – 5 303 applications received, 1 339 approved, 519 disapproved and others pending. Requested the assistance of substitute teachers from the Funza Lushaka and Matthew Goniwe projects and the unemployed skilled workers in the area. This needs collaboration with a number of departments as there needs to be a process of public service bargaining council.
  • Infections of learners change daily - the current number is 191.

Recommendations

  • The province must submit a report on the implementation of the DDM in OR Tambo;
  • Provincial Cogta must make a full presentation on the OR Tambo District Municipality; the MEC must speak to all problematic municipalities stemming from the AG's report. Report must include the actions taken by the Provincial Cogta to ensure that there is good governance in municipalities;
  • Provincial Cogta should also brief the Committee on S106 interventions, if there are any in the province, including the number of forensic investigations that the Department is undertaking in municipalities in the province;
  • Province should send a breakdown of how the Covid-19 funds have been spent;
  • Provincial Cogta must submit a report on how the R200m was distributed between the amalgamated municipalities;
  • Follow up meeting with the province where the Committee hopes that the Premier will be available
  • Comprehensive report on what led to the situation with the community health workers
  • Written report on the Buffalo City Metro Municipality Covid-19 expenditure;
  • A report on the use of Mioca lodge
  • Report on the 488 schools where sanitation was provided.

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