Corruption ‘all but collapsing’ public healthcare, warns watchdog amid coronavirus chaos

Corruption was a “major” contributing factor to continued deterioration of the public healthcare system in 2019, according to the latest annual report from Corruption Watch.

“The state of the public healthcare system in 2019 continued to deteriorate, with services all but completely collapsing across many fronts and provinces. Corruption contributed in a major way, in the form of irregular expenditure, financial misconduct, theft, illegal sharing of patient medical data to third parties, moonlighting and nepotism, to name some of the types of corruption brought to Corruption Watch’s attention during the year,” the non-profit said in a strongly-worded report released on Tuesday.

According to the 2019 report, titled The Writing is on the Wall, nearly 700 reports of corruption were filed in the health sector between 2012 and 2019, with nearly 100 of these filed in 2019. The bulk of the reports were filed in Gauteng.

The news comes amid a national lockdown in a bid to curb the outbreak of Covid-19 infections in South Africa, where there were 1 326 confirmed cases as of Monday. The majority of these – over 500 – have been recorded in Gauteng.

The report also comes as government works towards implementation of National Health Insurance, which aims to improve access to quality public healthcare.

The report notes a total of 673 reports of corruption in the health sector were filed in the last seven years, with 92 in the last year. A total of 52{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2} came from Gauteng, with the remainder coming from the other provinces combined. The next-highest percentage of reports came from Mpumalanga at 11{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2}.

Most reports were regarding employment irregularities (27{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2}) followed by abuse of power (13{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2}) and procurement irregularities (11{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2}).

The organisation warned of the potential dangers of corruption to patients in the public healthcare system.

“Corruption in health procurement can lead to shortages in medical supplies, sub-standard equipment, inflated drug prices and counterfeit medicines, all of which undermine health outcomes,” said Tara Davis, in-house attorney at Corruption Watch.

The report notes South Africa is part of a five-country study and advocacy campaign promoting open contracting in public healthcare procurement. The other four countries are Kenya, Uganda, Zambia and Nepal.

The project aims to ensure transparency and better use of limited public funds in healthcare.

Shrinking budget

The report also argues spending on healthcare declined in
real terms.

“According to the 2019 Budget Review Report, spending
in health was set to grow annually by an average of 7{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2} over the medium
term,” the report reads.

But, it adds, while on paper the health budget grew by 6.6{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2},
“in real terms a 6.6{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2} increase represents a decline in health funding per
person once a standard inflation of 5.2{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2} ins factored in, as well as a 1.6{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2}
growth in population.

“It’s worth noting that medical inflation of the
inflation rate for healthcare products and treatment is usually higher than
this general inflation rate of 5.2{e93887a69cdd95d753f466db084bbc3aa0067124675315461d28d68a72842cc2},” Corruption Watch said.

This year, Finance Minister Tito Mboweni announced that
while the health budget would be getting R230 billion of the R1.95 trillion budget,
there would be a R3.9 billion reduction on spending on the national department
of health over a period of three years. 

Funds for National Health Insurance would be protected, however,
the minister said at the time. 

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