Response to Frans Cronje: Western Cape is not another country

In an article titled "Western Cape in a bubble" in BizNews this week the Institute of Race Relations' (IRR) CEO Frans Cronje wrote the "Western Cape is another country".

He says so after visiting the South Cape town of Swellendam where residents spoke favourably of the services from the South African Police Service and government health clinics. 

The IRR, aka South African Institute of Relations, describes itself as a "classical liberal” think-tank.  While its reports are authoritative and well-researched, most of its members who frequently write in the media are anti-ANC government and its policies with an unashamedly laissez-faire free-market bias, ideology and narrative.  (There's a contradiction in their position because based on many of their articles, they have little understanding of how the free market in modern economies operate.  Their position is to support the continuation of the apartheid-era concentrated, isolationist high-profit, high-cost and inefficient economic model the ANC inherited with thanks and collusion from apartheid’s mining industrial oligarchs.)

Cronje wrote:

“The Western Cape is another country. You sense it just by driving around. Last night (Wednesday 10 April) I spoke in the town hall of Swellendam and started my remarks by saying what an extraordinary place Swellendam seems to be. The streets are spotless. Earlier, townsfolk told me local officials and even the police are efficient and caring. A resident explained to me how she would happily go to the government-run clinic. A clinic staff member I asked about this answered that they ran a top-class facility. 

The secret of their success? Appoint competent people and work hard. The budgets, salaries, staffing, and other resources, I was told, are the same as those of government clinics and hospitals in the rest of the country. It proves again that the formula for our country’s success is deceptively simple. No need for “national development plans” and “presidential commissions”. Just appoint the right people, do your job, and stop stealing.

“It is tragic to consider the contrast between towns in the Western Cape and those in other parts of the country. I travel very widely and many small towns are in ruination. It is no exaggeration to say that had some been carpet-bombed, the damage would be less severe than that caused by 20 years of ANC rule.”

Now while I have a bias, with reason, against the DA's and its supporters’ narrative, I agree the Western Cape is better run than ANC-run provinces. 

But there's a lot of misinformation the DA nationally and provincially including Premier Helen Zille promote that all services are exceptional and better than other provinces.  Zille, party leader Mmusi Maimane and others in the party repeatedly make these claims.  One that they and lately DA MP Geordin Hill-Lewis make is the DA have “created” hundreds of thousands of “new jobs since 2009 when they gained power.  This is an unverified and unverifiable, and false, claim as I've repeatedly disproved (see here).

Regarding health, in her From the Inside column on Daily Maverick, Zille frequently sings her and the province’s successes while never mentioning their faults and failures.  In this article (13 November 2017) she wrote:

“Now and again I hear affirming accounts of the quality of our public health service, from middle class and wealthy families too. During the past week, a relieved grandmother (who is a medical doctor) told me that her premature granddaughter, who had developed pneumonia, would probably not have survived had she been anywhere else in the world.”

However, at the time in response to that article I informed her, after copying her emails since August, of the Western Cape Health Department’s (WCHD) persistent failures including Groote Schuur Hospital’s CEO and head of health Dr Beth Engelbrecht, to investigate complaints about my mother’s care and suspicious death and other worrying anecdotes I’d heard.  She promised to investigate but later recanted for no good reason.

So, Cronje’s findings from second hand reports are tendentious and suspect.  As usual commentators praise the DA and Western Cape without independently applying their minds to the facts.  Here is my rebuttal to Cronje's perceptions of the DA well-run bubble.

He visits one town and deduces province-wide government facilities are all as good as Swellendam's. First, he is a researcher so it's inexcusable to make unsupported claims and generalise, in this case about its health and police. About the police, MEC for community safety Alan Winde is always complaining about its poor service. The Zille government-initiated Khayelitsha Commission of Inquiry disproves Cronje's assertion of an “efficient and caring” service. It's anything but.

About health, the TAC reported on the WCHD’s facilities “people dread attending the over-crowded and under-resourced clinics” and the "service is failing the people it serves".  Also see the South African Health Systems Trust’s annual survey of national health and the user satisfaction survey and other reports of Cape Town's public healthcare.

The WCHD’s patient complaints mechanism including its much-vaunted independent complaints committee obstructs, obfuscates and denies patient complaints. It's always patients' fault and never the hospital's and clinic's and their staffs'.

It goes to the very top of the WC government too.  In late 2017 the head of health Dr Beth Engelbrecht told me the committee had unspecified “logistical problems”. Since its entirely resourced and supported by the WCHD, one must assume the department had logistical problems too. I have no reason to believe it's changed for the better.

In fact, the Health Professions Council of South Africa and Office of Health Standards Compliance are investigating serious allegations against WCHD (our case) that Zille herself refused to. Anecdotally, the health service is patchy – good in some instances and bad to horrifying in others.  My suggestion is for Cronje to speak to the WC's private and public health professions for an objective view rather than this suspect account.

It's common cause ANC-run provinces, cities, etc are mostly in a bad way and WC better and even far better.  But presenting a tendentious view as Cronje’s where there was no attempt at an objective assessment of the WC's service delivery, which he sugar-coated, undermines his and IRR's credibility and instead presents his and their political agendas.

He's extrapolating Swellendam to the rest of the province and deducing it's all “caring and efficient” based on a few second hand accounts.  But his supporters (see comments to the article) insist it means that town only.

I spoke to a medical practitioner yesterday (see here) about another matter and in passing mentioned the article vis-à-vis the state of WC's public healthcare.  He replied, “If he [Cronje] wants to see it for himself, he can visit the waiting room of any clinic, or go there as a patient and say he has pain and needs attention.”  

But of course, Cronje has medical insurance, and he's writing about matters he's perhaps not directly observed or experienced.  Also, what is his experience of SAPS, a national competence, including in the Western Cape?  For most people including me it's not good.

If the province's public services are as good as Swellendam's, which incidentally is a lovely part of the province, are as good as he says, it's a desirable place to live.  But based on second hand reports, he misrepresents what life is like for most people who must rely on them.

If he was writing only about the town only he shouldn't have included the sentence “Western Cape is another country”, and the article shouldn't have been titled “Western Cape is a bubble” (of good governance). But he disingenuously meant it as I understood.

I'm a user of the WC's public health care.  From my, my family's experience and anecdotes I've heard it varies from good, indifferent to “flee in horror”, the last the WCHD including Zille always denies and never takes responsibility for.  

Perhaps it is “hell” as a commentator conceded.  Or more likely, purgatory which is the word I used to a fellow user as we watched the over-staffed Groote Schuur staff duplicate duties, walk around a lot (which I told a nurse; they and doctors wander off to who knows where, perhaps returning with cafeteria to-go coffee and it wasn't even tea time) rather than efficiently and promptly attend to patients who frequently must wait all day and night.  

For example, as I related before, the hospital's clinic “lost” a report and it took clinic staff five hours to get an unsigned copy from the issuing department about 20 metres down the corridor. Apparently, email and MS Word haven't arrived at WCHD despite the tech they have.

The problem is they – WCHD and staff – don't care and are not afraid to show it: the attitude is it's a state service so be thankful. And don't complain because you'll get an amazing run-around; it's easier to send a manned spacecraft to Mars than get a straight answer about poor care and negligence from WCHD. Imagine if McDonalds, never mind a fancy restaurant, treated customers that way.

I don't agree WCHD – nationally too probably – has a shortage of nurses, doctors, administration staff and resources.  To me – I've seen it – they have twice or even three times more than they need.  All that's happening is they get in each others’ way.  So they twiddle their cell phones, chat on the phone or walk about, ignoring patients while patients wait as happened to me last week.  Of course, most staff do go about their business. But there's too much rotten and dead wood and it rather than an overburdened service is sinking the ship.

Other matters raised about service delivery – good and bad – in the province are true.  But Cronje et al who falsely and tendentiously say the Western Cape is a pearl among the swine must not present the DA-run province is something it's not.  I doubt he and others who glowingly write of its public service will dirty their designer shoes and trousers going where ordinary citizens do daily.

Since I know firsthand a little about the WC's public healthcare, I challenge him and any DA mouth piece to arrange a visit to its facilities to see for themselves.  Call the head of department Dr Beth Engelbrecht for permission. (She, Zille, a few of their department colleagues and I are old sparring partners about healthcare.)

Cronje and his DA-supporting ilk speak with authority about health and social issues but it’s arguable they’re activist.  Some of them are interchangeable and anonymous drones spouting party slogans.

Postscript: See BizNew's summary of responses to Cronje's article.