TLC’S E15M PARTIAL ALLOCATION

Sir,

When motivating for the adoption of the report of the select committee, mandated to investigate the bottlenecks and disharmony between the Ministry of Health and The Luke Commission (TLC), the obvious frustration being felt by the chairperson of the seven-member select committee was apparent for all to see. A frustration clearly shared by other Members of Parliament. A frustration, which I suspect, will also be shared by TLC and most certainly by all underserved emaSwati, who are so dependent upon TLC for their medical needs.

Remind

With only E15 million being released to TLC, the chairperson took the opportunity to respectfully remind the minister of Finance that the Appropriation Act of 2024, needed to be respected when it came to the releasing of funds. The request from the Ministry of Health for only a partial payment, seeming also to take the minister of Finance by surprise in his statement “They could have asked for the release of the whole budget, but they (Ministry of Health) only asked for the payment of E15 million and I do not know why.”

The reasons given by the Minister of Health, Mduduzi Matsebula, not to request the release of the full amount of E30 million, but the partial  payment only, with any future payments to be based on the invoices submitted by TLC, do not stand up to public scrutiny and are inconsistent with the policy adopted on government hospitals. The questions raised for the non-payment in full by the Deputy Speaker Madala Mhlanga and Minister of Tinkhundla Sikhumbuzo Dlamini were well made and only further raise concerns about the unhealthy influence other unnamed individuals continue to have on the government policy and ultimately health needs of ordinary emaSwati.

It did not go unnoticed by the select committee that the former Health minister decided not to honour an invitation to appear before the select committee, to shed light on the real reasons ‘which prevent her from attending’ (Finding 19). According to the select committee’s findings, the issues between government and TLC began when the decision was taken to transfer the oxygen hub to the Manzini referral hospital. Even though according to the chairperson of the select committee, TLC was asked to build the commercial oxygen hub by the previous Health minister, at a time when government did not have enough oxygen producing plants, with TLC more than capable ‘of supplying the entire country with locally produced oxygen’ (Finding 23).

Understand

The report now makes it easier to understand how we have gone so quickly from the 10-action point plan announced by the new minister of Health, which included the establishment of clear working relationships between the ministry and NGOs such as TLC to a situation where ‘the working relationship between the director of the health services and the executive director of TLC is at an all-time low’ (Finding 26).  Is it just possible that the obvious breakdown in the working relationship is due to the fact that TLC has higher standards for their VIPs (very important patients) than some senior officials within the ministry of Health?

Speaking from personal experience, I have absolutely no doubt that TLC’s commercial oxygen plant was a lifesaver during the global pandemic, saving thousands of lives including my own. So I can totally empathise with Member of Parliament Futhi Ngcamphalala’s own personal experiences of the level of care she received at TLC and the ready availability of oxygen during the COVID-19 pandemic. Perhaps, the previous Health minister would be kind enough to provide reliable data on the number of deaths at TLC during her time in office, due to the provision of a contaminated oxygen supply of questionable quality?
Which may also raise questions among some readers, in the current climate of ‘zero tolerance’ towards corruption, about the possible existence of a cartel in the supply chain, the ministry of Health instead preferring to offer its support to the suppliers of oxygen whose headquarters is not in-country and charging premium prices. Indeed, the select committee alludes to the possibility ‘that there are very senior individuals in government who are hell-bent on blocking any assistance to TLC for their own selfish reasons that are contrary to the wellness of the sick, the weak and the elderly in our country’ (Finding 21).
I am, therefore, at a loss to make any sense of the submissions made by Principal Secretary Khanya Mabuza during an interview with the House of Assembly Select Committee, noting his concerns that TLC supposedly offers ‘incentives’ to patients to prevent competition from other government health facilities. If that includes the ready availability of oxygen and essential drugs at no cost to their VIPs, then guilty as charged. All based on the misperceptions being peddled, that TLC benefits from unlimited donor funding from international donors such as USAID or PEPFAR.  

A situation further compounded by the recent ultimatum from the Global Fund threatening to withdraw funding, unless Eswatini restructures the Central Medical Stores (CMS) based on the Lesotho model. A decision clearly based on the glaring mismanagement of funds, which was captured in the report compiled by Funduzi Forensic Services Pty Ltd, after its probe into the drugs shortage and the alleged corrupt procurement practices in in-country. This is no idle threat and has huge consequences for a Ministry of Health clearly devoid of any workable plan as to how to address the required benchmarking exercise, when the solution is staring them in the face.

Winner

At significant cost, TLC has also introduced the best-in-class LUVELO digital system and is now a worthy winner at the Africa Supply Chain Excellence Awards Ceremony being held in Johannesburg. A communications platform to ensure robust drug procurement controls are in place. A system which already has the built-in technology to comfortably take the procurement role of the CMS to a whole new level of excellence, with the required audit controls already in place to satisfy the Global Fund. Here is a system readily available with greater efficiency and, therefore, less opportunity for corruption and with additional capacity to resolve the problem, but the question is; do certain individuals really want the issue resolved?

Though not being specific, the Select Committee does make reference to the fact that ‘the highest authorities in the land intimated to government way back in 2023, that urgent steps should be taken to provide the much needed assistance to TLC’ (Finding 5). This presented an opportunity for a more enlightened minister of Health, to build a more meaningful collaborative partnership with like-minded organisations such as TLC and its commitment to innovation.

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