5th consecutive clean audit underlines DoHW’s good governance and quality

5th consecutive clean audit underlines Department of Health and Wellness’s good governance and quality healthcare services   

Today, the Western Cape Department of Health Wellness tabled its Annual Report for the 2022/23 financial year.

During the year under review, the Department once again proved its track record of clean governance, financial prudence and accountable leadership by delivering its 5th consecutive clean audit – the only health department in South Africa to do so.

Additionally, the Auditor-General concluded that our audit outcome had no significant findings, further cementing the department’s year-on-year progress of strengthening its financial mechanisms.

This financial year will also be remembered as a critical point of reflection for the department and, by extension, the healthcare system.

By the beginning of the 2022/23 financial year, the Western Cape had experienced four COVID-19 waves. While the last wave had significantly fewer hospitalisations and deaths, the prioritisation of Covid-19 services over other health care services during the pandemic had impacted society and the health care system.   

Mental Health

One of the most notable effects of the pandemic was that of the impact it had on our residents’ mental health. The Western Cape is currently experiencing an increased prevalence of mental health cases and admissions, which has been exacerbated by increased unemployment, substance abuse and safety concerns. The Department dedicated additional mental health funding of R30 million during 2022/23, which further capacitated our primary health care and acute mental health services.   

Decreasing the Surgical Backlog

The de-escalation of elected surgeries created a large backlog of surgeries during the pandemic. Additional funding in the previous financial year, as well as the acquisition of the robotic surgery systems, continued to improve our progress in reducing the backlog of these surgeries.   

Load shedding

While our Department has made great strides in normalising our service platform, it was during the 2022/23 where South Africa began to experience more extended periods of load shedding.

Load shedding severely disrupts our health services and forces us to use generators to mitigate its impact. By the end of February 2023, we had already spent more than R100 million on fuel supplies in the year under review. This was a significant burden to our budget which could have otherwise been spent on service delivery. Despite these pressures, our department was able to successfully negotiate with Eskom and the City of Cape Town to exempt five hospitals from experiencing load shedding.   

Telemedicine

The use of telehealth services proved to be crucial during the Covid-19 pandemic and has provided us with an expandable platform to render healthcare services, particularly in terms of our services for TB and diabetic patients. With the Telehealth Policy having been finalised during 2022, we are now poised to continue making our services more accessible and equitable going forward through telemedicine.   

Violence Prevention Unit

In line with the Western Cape Government’s Safety Plan, the Department completed the organizational development of the Violence Prevention Unit in the year under review. Based on the Cardiff Model for Violence Prevention, the data found in our healthcare facilities will be used to further capacitate the crime fighting and prevention programmes that are implemented by our stakeholders in civil society and government.   

Notable operational highlights in the Annual Report:

• 202 309 learners were seen through our Integrated School Health Programme, which is an increase from 108 570 in 2021/22;
• 12 062 108 Primary Health Care (PHC) headcounts were seen, which is an increase from 10 949 858 in 2021/22;
• 1 682 629 hospital outpatient headcounts and 995 726 hospital emergency headcounts were recorded, which is a respective increase from 1 571 944 and 885 693 in 2021/22;
• 3 100 705 medicine parcels were distributed via our Chronic Dispensing Unit to both new and existing patients, which is an increase from 2 958 568 in 2021/22;
• 7 342 376 contacts in home and community-based care settings took place, with 7 441 782 taking place in 2021/22;
• 90 631 babies were delivered, which is a decrease from 96 319 in 2021/22; and
• 645 497 patients were transported with Emergency Care Services where 22% of these were priority 1 cases. This was an increase from 618 352 in 2021/22.   

Patients admitted:

• 291 492 patients were admitted across our 33 District Hospitals, which is an increase from 275 166 in 2021/22;
• 127 403 patients were admitted across our 16 Regional and Specialised Hospitals, which is an increase from 120 275 in 2021/22; and
• 130 325 patients were admitted in Central and Tertiary Hospitals, which is an increase from 122 915 in 2021/22.   

Infrastructure which achieved practical completion:

• Karl Bremer Hospital – Nurses Home repairs and renovations Phase Two;
• Ceres Hospital – New Acute Psychiatric Ward;
• False Bay Hospital and Brooklyn Chest Hospital – Fencing projects;
• Gansbaai Clinic – Upgrade and additions;
• Gouda Clinic – Replacement;
• Laingsburg Ambulance Station – Upgrade and additions;
• Murraysburg Ambulance Station – Upgrade and additions, including washbay;
• Nelspoort Hospital – Repairs to wards;
• Nyanga CDC – Pharmacy compliance and general maintenance;
• Observatory – Groote Schuur Hospital – Building management system upgrade;
• Tygerberg Hospital – 11kV Generators replacement;
• Sandy Point Satellite Clinic – Replacement;
• Villiersdorp Clinic – Replacement; and
• Avian Park Clinic – New facility.   

Head of Department, Dr Keith Cloete, added by saying: “We are extremely proud of our team's dedication and hard work in achieving another clean audit. This accomplishment reflects our commitment to transparency, accountability, and responsible stewardship of public resources. It is a testament to the diligence and professionalism of our staff, and we will continue to uphold these high standards to ensure the public's trust and confidence in our operations.”

Minister of Health and Wellness, Dr Nomafrench Mbombo, concluded with: “While 2022/23 will be marked by the beginning of the post-Covid-19 reality, it will equally be remembered for the continued progress made by the Department of Health and Wellness. I know this report represents the foundation upon which future innovation and work can take place in the healthcare system. Finally, I am immensely proud of all the staff within the Department who have worked tirelessly to deliver these results in the year under review. Without these professionals, our work would not be possible.”