PM’S TASK TEAM ON HEALTH WELCOME BUT …

WHEN I read about Prime Minister Sibusiso Barnabas Dlamini’s first official act after his near-death experience on an operating table in a Taiwan hospital was the appointment of a 15-member Inter-Ministerial Task Team on Health Service Delivery, I was reminded of the saying – don’t ask me who its author is because I have no clue whatsoever - that had God appointed committees to perform the mammoth tasks of creation He had accomplished single-handedly within six days we would not be here and neither would be the world as we know it.

No, it is not that the establishment of the task team is a bad idea given how this country is governed. I had thought that for the problem to be resolved needed government reengineering to ensure that people, not the leadership, are central to its existence and operations. The SWOT analysis of the public health sector as defined by the PM is, after all, not likely to come out with anything new that we do not know already.

Looking at the terms of reference of the task team, I find them parochial because the challenges faced by the public health sector are multi-faceted; drug shortages, inadequate personnel, weak institutional framework, inherent weaknesses in recruitment of medical personnel, poor administration and management of health and medical institutions extending to the management of patients. As I see it, part of the problem compromising public health delivery service is the delayed payment of suppliers ostensibly because government’s priorities are focused away from the people. In the event the health sector, like education and agriculture, is periodically under budgeted, thus constituting a major and primary threat to the developmental endeavours of the kingdom.

Secondly, it is also pedestrian that all government institutions are weak on issues of control and accountability and the same applies to public health facilities. I can attest to the fact that private clinics operated by medical personnel in government’s employ are more equipped than public health facilities that are all pilfered from the very government owing to weak or non-existent controls in public health facilities. Hence these professionals under the employ of government routinely refer patients to their private clinics ostensibly because they are better equipped and adequately stocked.

Then there is the general management and administration of public health facilities that is crying out for professionals. The trend in government being that upward mobility for medical professionals is translated by their elevation to management and administrative positions for which they have no training and experience whatsoever. The obvious outcomes of such deployments, if not informed by qualifications in the management of public health systems, are the inevitable collapse of and dysfunctional public health institutions.

While the establishment of the task team may be a public relations coup for the PM, it is not understandable why he limited its scope, a fact to which he was reported to have alluded to during its launch. In the face of government’s traditional apathy to service delivery, the PM should have put in place a multi-sectoral super task team made up of all the social partners with a broad mandate to interrogate all government institutions apropos delivery. As with the forgotten National Development Strategy (NDS), the outcomes could possibly inform the political and socio-economic trajectory of the kingdom in the foreseeable future.

As I see it, while the leadership is given to boasting of a peaceful nation at every available opportunity, the fact is this country is still viewed as politically unstable and unpredictable from the perspective of the international community hence the glut in foreign direct investment. This perspective of the international community is given credence by the fact that instead of investing massively in education, health and agriculture, government is pouring vast amounts of resources on the military yet the country is not facing any external threats. That on itself contradicts the narrative of this being a peaceful nation.

For what it is worth, the PM must be applauded for at least displaying the sort of sensitivities, even if for PR purposes, that we all probably expect of our leaders. But the real challenge would be implementing the findings of the task team since, historically, reports of the exercise of this nature, especially when they are adverse to the conduct of government, are often left to gather dust in some government cabinets. That is why we are still stuck with a dysfunctional political system when the nation had, in one of the numerous vusela exercises, expressed a desire to test multiparty democracy at some stage.

Additionally, it is common currency that projects that directly benefit the people are often stopped and resources redirected to projects with no economic value save to project a superficial picture of a country primed to launch into the realm of First World nations.  Given the many challenges facing the country coupled to bad governance, the time to test multiparty democracy is long overdue. 

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