SA needs a permanent health minister now to lead the country through its worst health crisis in a century.
To have an acting minister when the country is in the midst of a third wave of the coronavirus pandemic, which by all appearances is set to be worse than the previous two waves, and when the vaccination rate is lagging far behind other countries at a similar level of development is just not good enough.
Gauteng’s infection rate has soared, its hospitals are under severe strain and other provinces are expected to follow in its footsteps as the Delta variant spreads like wildfire.
To deal effectively with this situation the health minister needs to have a medical background so that he or she can get to grips with the nitty-gritty of the pandemic, how to deal with overburdened hospitals and how to fast-track vaccinations. This requires co-ordinating the work of all the provincial health departments for a frontal assault on the virus. This work is done on the National Health Council, which brings together all the provincial health MECs.
President Cyril Ramaphosa appointed tourism minister Mmamoloko Kubayi to fill the position of health minister Zweli Mkhize in an acting capacity while Mkhize took special leave on June 8 pending the outcome of a Special Investigating Unit (SIU) probe into an irregular R150m communications contract entered into by the health department with Digital Vibes, a company owned by Mkhize’s close associates.
It has been about five weeks that Kubayi has been holding the fort. The SIU submitted its final report to the presidency this week. The report directly implicates Mkhize in the contract in that he pressured the department to appoint Digital Vibes, media reports read.
More required
Saying that SA needs a qualified medical doctor as health minister is not to cast any aspersions on the competence of Kubayi. She is dedicated and industrious, hardworking and smart but she does not have the necessary medical background to deal with a health crisis of this magnitude.
Her frequent public appearances at media briefings and at parliament’s health committee meetings attest to her commitment to transparency and keeping the public abreast with the latest developments, but more is required.
Certainly any health minister, acting or otherwise, is backed by a team of medical experts and a department of professional officials who can advise him or her on what steps should be taken. In the case of the pandemic there is the ministerial advisory committee on Covid-19. But there will inevitably also be occasions when various options are on the table and a qualified decision is required that takes account of medical nuances that might escape an acting minister.
An acting minister can maintain the status quo in a holding operation but is unlikely to embark on a radically new course of action if required to do so and cannot lead from the front with vision and strategic insight.
The same is true of acting directors-general who head government departments. MPs frequently bemoan the length of time that the position is held by an acting official as the individual is reluctant to galvanise the department behind a new strategy that might be overturned by the permanent replacement.
The health department itself needs strengthening and key positions filled. For this a permanent health minister is required.
It is troubling that Ramaphosa did not appoint deputy health minister Joe Phaahla as acting health minister. He is a medical doctor and has been intimately involved in the management of the pandemic since the first day. The reason given by the presidency for this is that deputy ministers are not members of cabinet and so cannot be appointed as ministers.
The sooner the Mkhize mess can be sorted out the better, either by him returning to his post after being found innocent by the SIU or replaced by a permanent health minister.
There are several extremely competent public health doctors able to fill the post, one frequently mentioned being Phophi Ramathuba, who as Limpopo health MEC has done a remarkable job in accelerating the vaccination rollout.
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