Health activists and residents who attended the Western Cape Health Budget Indaba earlier this week have described it as “not practical” and nothing but a “box ticking session”. The meeting was meant to unpack the 2024/25 Western Cape health budget with community and health stakeholders. The provincial health department has been allocated R30,489,211 to address challenges facing the health system in the province.

According to Dr Keith Cloete, head of the Western Cape Department of Health and Wellness, its budget was cut and falls short of meeting their commitments. “The reality is that the national equitable formula has decreased the budget allocation for the Western Cape, while the population and the burden of disease is increasing. The Western Cape is the fastest growing province in terms of population, and this happens at the same time as the budget crisis is happening. The biggest shortfalls are in the service delivery sectors, which have the biggest budget allocations,” Cloete told the audience. These sectors have been budgeted as follows: rural health (R187-million), metro health services (R281-million), Groote Schuur and Red Cross War Memorial Hospital (R132-million), Tygerberg Hospital (R109-million).

“The pressure on our system is in these four areas. This budget shortfall affects everyone. I am calling on all of us to treat the health system resources with great care and caution. We must always include people in our work as the department. We have also made a commitment that, every year in November, we will put that month away to engage with civil society, labour and the education sectors. We know there are things we will manage to do and things we can’t do, and we have made a commitment to never run out of money,” Cloete said. 

Some of the community members couldn’t hide their frustration with the budget and lashed out at the MEC, and called on the department to stop playing while people on the ground are dying. “We need to get a direct answer and a way forward, about the building of Gugulethu Hospital. We are tired of the hide and seek. We are fed up with marching to government offices in town. Gugulethu is a TB red zone. You’re not practical, you’re only sharing ideas while people are dying. We’re tired of coming here for nothing,” said Gugulethu resident, Nozibele Mndayi. The budget indaba, she added, dismally failed to talk to the issues they battle everyday in their attempts to access health care. “This was just a tick-box session, for them to say they did it and it’s done. The situation in Gugulethu is very bad. As the community we fight with the hospital staff, but we know the environment they are forced to work under is not ideal,” lamented Mndayi.

Last year, scores of frustrated Gugulethu residents protested for better healthcare facilities. They were calling for the construction of a district hospital in Gugulethu. “We only have one psychiatrist that services both patients from Gugulethu and Manenberg. That situation is bad. The day hospital in Gugulethu is small, and the infrastructure is collapsing. We breathe leaking sewer water in the hospital. I was born in 1964 and the hospital there is still the same size and structure [while] the population has grown so much,” Mndayi told Elitsha. 

Treatment Action Campaign (TAC) district organiser and the sector chairperson for people living with HIV, Neliswa Nkwali, said, “We were hoping the budget would give us an indication of how much the department will allocate per health facility. The language they are using is not suitable for our people on the ground, we don’t understand it. They always invite people to just tell them what is going to happen, but they don’t want to be questioned. They are saying, with or without us, this is what will happen.

“It seems we are preaching to the wrong ears. The issue of safety as I raised it today, is very crucial. The issue of infrastructure and shelters in community facilities is also bad and needs attention. There is a lot but this department doesn’t want to address it. Also, during these engagements we are just thrown with big numbers without any timeframes or sense of when projects will happen.”

Nkwali challenged the MEC on the payment of stipends for clinic committees in Khayelitsha and on the issue of safety in many community healthcare facilities in the Western Cape. Cloete assured community members that, they were working around the clock together with the City of Cape Town to address safety concerns in community facilities.