From the very onset, the National Council of Provinces' (NCOP's) permanent delegates were made aware of the undesirable infrastructural and recurring service delivery issues experienced by a number of clinics in the Letsemeng Local Municipality. This was early morning on Tuesday, 16 May, when the Mayor of the Letsemeng Local Municipality, Hon Thandiwe Reachable, addressed the NCOP delegation during the very first briefing session to kick-start the NCOP's preliminary oversight visits currently taking place in the Xhariep District Municipality from 15 to 19 May, in preparation for the NCOP's annual Taking Parliament to the People Programme (TPTTP) to be held in Mangaung, Bloemfontein, in August 2017.

In her welcoming speech, the Mayor alerted the NCOP delegates of the three main constant and disturbing service delivery issues that are always raised by the local communities in the respective wards of the municipality for the past five years. The first is the shortage of medical doctors being the most prevalent as all the six wards of this local municipality are entirely dependent on the service of one doctor. Secondly, the shortage of professional nurses in all the clinics and this results in the long waiting periods that patients have to endure when visiting clinics. Thirdly, the Mayor mentioned a demoralising and deplorable staff attitude of all the primary health care professionals when serving patients and this also being one of the pertinent cries from the respective communities of the Letsemeng Local Municipality. In most cases, patients would sit for long hours waiting to be just given a new check-up date, she said.

On their first site to be visited, the NCOP delegates witnessed Hon Reachable's painful experience when visiting the local clinics. The nurse in charge at Ethembeni Clinic in Koffiefontein and her assistant tried their level best to respond to probing questions but this could not help as all members of the NCOP delegation were not happy with the conditions and the manner in which senior personnel staff inadequately responded to simple questions. Even though the purpose of the visit was explained in detail, they seemed not to clearly understand or deliberately did not cooperate to the satisfaction of the delegates.

It was at the same clinic, after having been briefed by the senior personnel, Hon Raseriti Tau, the leader of the NCOP delegation took the opportunity to talk to the patients in the waiting room. He thoroughly explained the reasons for the NCOP's preliminary oversight visits to the Xhariep District Municipality, particularly the Letsemeng Local Municipality. He asked the patients about the waiting periods and if they were happy about the service rendered by the clinic. They all complained in a sombre mood about the long hours they have to wait before they can receive medical attention � and willingly wanted to raise more issues but they could not due to time constraints. Referring to the walkabout and displeasing conditions at the Ethembeni Clinic, Hon Lungelwa Zwane, Co-leader of the NCOP delegation, said: We thank you for walking us around and informing us of your issues but we are worried about your answers as you responded differently to the same questions.

The second site visited was the Koffiefontein Emergency Medical Services (EMS) station. The NCOP delegation was very much concerned when they were informed of the many challenges facing the station. The EMS station is responsible for all the referral patients referred to faraway hospitals such as Diamant District Hospital in Jagersfontein, Pelonomi Private Hospital and National District Hospital in Mangaung. This EMS station is serving all the clinics in the Letsemeng Local Municipality, that is, Ethembeni Clinic, Jacobsdal Clinic, Luckhoff Clinic, Oppermans Clinic and Bophelong Community Health Centre. Adding to various other challenges is the fact that ambulance services for all these local clinics are provided from Koffiefontein via the EMS central control room in Mangaung.

The NCOP delegates were shocked to hear that a station with such a huge responsibility is experiencing similar challenges faced by the local clinics of the municipality. This very important EMS station has no security at all, the front main door has no key, and there is shortage of staff and fleet to properly service the local clinics. As a result, local community members are daily complaining about the poor ambulance services, not understanding the number of problems faced by the station, to an extent that they sometimes physically go to the station as they could no longer wait for the ambulance and demand to be assisted.

One scary and discouraging example to the employees at the station is when one of the community members with multiple stub wounds was brought to the station instead of being taken to a nearby local clinic or hospital.

To this end, the leader of the NCOP delegation Hon Tau recommended to the senior officials from the Provincial Department of Health to ensure that some of the pertinent issues are promptly attended to. He said: As the NCOP delegation, we urge all the local councillors, policing forums, and so on to meet on Wednesday or Thursday and reach a collective agreement going forward to the NCOP debriefing meeting on Friday, 19 May, that will be deliberating on the consolidated Taking Parliament to the People Programme preliminary oversight visits report to be tabled for debate in the NCOP before the main event in August.

The last site visit on the day was the Oppermans Clinic. Here, the delegation enthusiastically commended all the personnel staff at this clinic. The delegation was very delighted to see a happy, honest, well-represented and motivated staff at the smallest of all the local clinics in the local municipality. Like all the other primary health care facilities in the area, this clinic too is faced with infrastructure challenges such as the current building structure not meeting the requirements for an ideal clinic, things like proper storage space, consultation rooms, emergency room, security room, waiting room for patients and most importantly, transport challenges for farm community visits by community health workers as the clinic is deeply situated in the farms.

Earlier on the day, the Provincial Department of Health in the Free State confirmed all these challenges when it tabled its presentation to the NCOP delegation, saying: 'The most pressing challenges are access to primary health care in the Letsemeng sub district which does not have a 24-hour service facility, lack of mobile clinics and this is hampering access to farming communities, inconsistent water supply in the entire district, shortage of transport in a large geographical area, primary health care facilities that are extremely small, particularly Luckhoff and Oppermans clinics, and maintenance and refurbishment of facilities.

Source: Parliament of the Republic of South Africa

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