Yesterday the heath portfolio committee was informed that the National Health Laboratory Service (NHLS) is owed R1 billion by eight of the nine provinces for services it has provided to them. Only the Democratic Alliance's administration in the Western Cape is up to date on its payments.

This is the second year in a row that the NHLS has had to cope with such enormous unpaid bills, and it is yet another indication of the collapse of most provincial health departments' financial management capacity.

Other provinces must get their acts in order, follow the Western Cape's lead and pay off their debts.

The Democratic Alliance will be asking questions to Minister of Health Aaron Motsoaledi to ask him what he is doing, in his oversight role, to ensure that provincial health departments pay their bills.

Typically, provincial health departments ignore the bills they think they can get away with not paying, until they receive their funds for the next financial year. They then pay the bills, but out of money intended for future services. So they become ever more deeply in debt, until the national government provides a bail-out.

This pattern has to be stopped.

Were the NHLS to become insolvent and no longer able to operate, a critical part of the health service would be lost. The NHLS is responsible for testing samples for diseases, infections and other problems. For example:

• It tests CD4 counts and viral loads for patients with HIV.
• It tests for bacteria in water to determine whether it is drinkable.
• It tests for swine flu, rift valley fever and for any other epidemics that might strike South Africa at any time.

To avoid this situation, the NHLS will now be forced to take out a bank loan to cover its costs until provinces find the money, which will inevitably add to its own costs.

The national health department is required to exercise oversight over provincial health departments, through, for example, obtaining quarterly reports from them and acting on problems identified. But for several years in a row the Auditor-General has reprimanded it for completely failing to carry out this role. The new minister has now had time to settle into his portfolio and take on the failures of his predecessors, and we look forward to hearing what he intends to do.

Statement issued by Mike Waters, MP, Democratic Alliance shadow minister of health, May 6 2010

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