HEALTH director-general Precious Matsoso has defended the surprising findings of a health facility audit commissioned by her department.
The audit, which Ms Matsoso presented to Parliament last week, ranked Gauteng the best in the country for the quality of its care and for its infrastructure, with the Western Cape ranked third and fifth in these categories, respectively.
The finding was described at the time by the Democratic Alliance as implausible, given the Gauteng health department’s widely reported problems. Ms Matsoso subsequently responded to Business Day, saying "no data has been manipulated in any way".
"The rural districts in the Western Cape performed poorly in the national facilities audit in comparison to the urban districts. This obviously affected the overall performance of the provinces. In addition, 21 health facilities in the City of Cape Town metropolitan municipality were not audited because the director of health services for the municipality declined to participate in the audit," she said in a letter addressed to Business Day.
The research was conducted by a consortium including the Health Systems Trust, the Health Information Systems Programme, Exponant, Arup and the Medical Research Council. Data were collected from the 3,880 facilities involved in the audit by district officials and consortium staff.
The audit data for each facility were derived from the answers to questions that were weighted according to how important they were. The quality questions covered staff attitudes, patient safety and security, infection prevention and control, cleanliness, the availability of medicines and supplies, and waiting times. The infrastructure questions covered three broad categories — the physical condition of buildings, management and space standards.
Ms Matsoso said the Western Cape scored poorly in many of its primary healthcare facilities, which on average performed much worse than its hospitals.
Since it had many more primary healthcare facilities than Gauteng, this affected its overall score. For example, the Central Karoo health district scored just 8% (out of a maximum possible score of 100%) for staff attitude and just 37% for cleanliness. The 328 primary healthcare facilities in the Western Cape received an average score of 34% for staff attitudes to patients, compared with 45% in its hospitals. Gauteng scored 59% and 52%, respectively.
The summary report of the audit was now available on the websites of the Department of Health and the Health Systems Trust, she said.
The report was not publicly available when Ms Matsoso made her presentation to Parliament’s select committee on social services last Tuesday, and Business Day’s request for this information from one of her officials on the day was declined.
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