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Disconnect between national and provincial health departments‚ SAHRC hears

mental health
mental health
Image: Stock image

It was impossible to say how much the state spent on care for mentally ill patients each year‚ because there was no set budget for this in the provinces‚ the national Department of Health revealed on Tuesday.

“Provinces do not have a mental-healthcare budget in one place‚ so that they can determine what is being spent on what‚” said Jeanette Hunter‚ deputy director-general of primary healthcare at the Department of Health.

She was speaking to the South African Human Rights Commission‚ which is probing the status of mental healthcare following the demise of 143 mental-health patients who died after being moved from the Life Esidimeni facility to unlicensed NGOs.

Hunter said there were some “definite areas of weakness” in the administration of care for the mentally ill.

She said it was important for the provinces to determine exactly what they are currently spending on mental-health services on all levels‚ to determine whether there is a funding gap impacting on how all services are delivered.

Commission chair Bongani Majola questioned Hunter about what level of oversight the national department exercised over the provinces.

Hunter said they were thoroughly committed to their oversight role‚ but at times‚ “things did not work out as planned”.

“At the moment‚ the fact that implementation in provinces does not happen the way that it should puts an extra burden on the national [department]‚ for them to step up and increase their monitoring role – to the extent that in some areas‚ [the national department] even becomes the implementation agent‚” Hunter told Majola. “We have neither the human resources nor the budget for that. So we [over]-extend ourselves.”

She stressed that while money was released by Treasury for the care of mentally ill‚ the funds were not always used for this purpose.

“You find out that implementations are not happening at [provincial level]‚” Hunter said.

“It has happened that when we send money down [from Treasury to the provinces]‚ it gets absorbed into areas that were not agreed upon. So now we have found a solution‚ where we ring-fence money to become conditional grants – which is a very onerous way of administrating resources.”

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