Political appointments cripple Lesotho hospital

Wage bill at flagship Queen ‘Mamohato Memorial Hospital balloons by R48-million over a year as politicians appoint family members and friends

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Queen Mamohato Memorial Hospital in Maseru is Lesotho’s flagship hospital. Photo courtesy of MNN Centre for Investigative Journalism

Senior politicians in Lesotho’s health ministry parachuted friends, family and party comrades into jobs at the flagship Queen ‘Mamohato Memorial Hospital (QMMH) in 2022, swelling the hospital’s wage bill. Many of the new appointees were not qualified.

The first quarter of 2022 saw the highest staff intake in the hospital’s history, with 248 people being hired. This surpassed the previous record of 27 hires in the same period in 2021.

As a result, the wage bill leapt from M6.5 million in January 2021 to M13 million in January 2022 and the hospital was left with more administrative staff than technical staff. (M1 = R1. The Lesotho Loti and South African Rand are pegged.)

The government has acknowledged that the huge rise in employment was the main cause of salary payment delays, over which staff went on strike this year.

The 425-bed Queen Mamohato ‘Memorial Hospital was opened in 2011 and run, along with three other clinics, as a public private partnership between the Lesotho government and the Tšepong consortium. The main shareholder in the Tšepong consortium (M1.7-billion (US$100 million), was South Africa’s Netcare Group and the contract was supposed to run to 2026. But, in August 2021 the Lesotho government terminated the contract with Tšepong early and took over the management of the hospital as well as the three clinics.

The health minister who presided over the hospital’s transition to public private partnership was Semano Sekatle, a representative of the All Basotho Convention party which was leading the governing coalition and took the decision to end the public private partnership at QMMH. Sekatle as well as his principal secretary at the time, Khothatso Tšooana, are now accused by hospital staff of using this management change for their personal and political gain.

Many of the new appointees from last year are either relatives, friends, or fellow members of the All Basotho Convention (ABC) from Lebakeng and Abia constituencies, the political strongholds of Sekatle and Tšooana. Both were appointed by the ABC-led government to lead the Ministry of Health and oversaw the termination of the Tšepong contract.

Sekatle defected from the Democratic Congress (DC) party to ABC in December 2018 and was immediately appointed Minister of Health.

One of the committee members from Lebakeng said that as health minister Sekatle had hired many people from his constituency and nearby constituencies to clinics and hospitals in and outside Qacha’s Nek district. “When you ask them how they were hired, they will tell you, ‘Re kentsoe ke Ntate Sekatle”. Loosely translated this means that they were hired by Sekatle.

Notably, Sekatle’s daughter, ‘Maphakisane Sekatle, got a top post in the hospital: finance manager. When we asked Sekatle how she had been hired since positions had not been advertised, and whether her father had influenced her appointment, she redirected us to Thakane Mapeshoane, the hospital’s Public Relations Officer. Mapeshoane said: “The management of the hospital said they do not know how she] was hired … just as we do not know how the others were hired.”

The daughter of ‘Malisebo Makhetha, who is the chairperson of Lebakeng ABC Constituency Committee, was hired as Maphakisane Sekatle’s junior in the finance department. Makhetha acknowledged that her daughter had been hired through a list that her committee had submitted to the office of the Member of Parliament for ABC in Lebakeng: Sekatle.

Examples of other appointments that are directly linked to Sekatle include his relative Molefi Sekatle who was appointed as a driver; his former driver’s son, Lehlohonolo Mosala, who was appointed as an administration officer, and Mohau Mabeli, appointed as a help desk officer, whose mother was Sekatle’s aide and also a political candidate in Qacha’s Nek. The father of Rabele Nchochoba, who was appointed as an assistant accountant, is Sekatle’s friend.

Tšooana is also believed to have played a role in these appointments. But he refused to answer any questions on the role he played in hiring staff for the hospital. He said the new office bearers should respond. But Tšooana’s successor, ‘Moliehi Ntene, said every official should account for decisions they made while in office, otherwise “people will continue to get away with murder”.

The positions were not advertised.

Hospital staff who attended the briefing by Tšooana to explain the termination of the Tšepong contract said the appointments came as a surprise. They understood from the briefing that there would be a 12-month transition and no new staff would be hired during this time. But six months into the transition in February 2022, the hiring spree started.

Most of the 248 new hires during that time were lower-level workers like assistants, cleaners, cooks, and gardeners; only 117 of them earned a basic salary of more than M10,000, compared to 159 new hires paid in that range in the second quarter of 2021, which comprised mainly senior staff. Workers at the hospital, who asked to remain anonymous out of concern for their jobs, claim that there was an influx of new employees after the government took over, as if they had just been offloaded “from a political campaign truck and dumped at the hospital”.

“People began arriving out of the blue and were immediately assigned to positions that had not existed before. Some old staff members had new people invading their offices and being paid more,” said one staff member. “Some of these people were fresh out of school, while others had not even graduated, even though they had completed and were still waiting for graduations and certificates, but they were appointed into high ranking positions.” The staff member indicated that there were neither advertisements nor memos regarding the appointments, just knocks on the door announcing their presence.

Sekatle did not respond to numerous calls and ignored messages sent to him via WhatsApp requesting comment on the new staff’s lack of qualifications and their political or personal connection to him and to Tšooana. Tšooana said only that the current administrators at the ministry of health, who are from the ruling Revolution for Prosperity Party (RPP), should answer for the appointments.

In an interview, the current Principal Secretary in the health ministry, Ntene, admitted that the appointments in question had been “irregular”. The former managing director of the hospital, Dr Chale Moji, in response to a May 2023 letter listing staff grievances, admitted that the appointments were “flawed”.

The hospital public relations officer Mapeshoane said the payroll had increased because vacancies had been filled. But attempts to get details of the vacancy list from human resources manager, Thenjiwe Dlangamandla, were unsuccessful. Hospital staff say only about ten of these positions had in fact been vacant after Tšepong left, and the rest were newly created.

Principal secretary Ntene said administrative staff now far surpassed technical staff because recruitment procedures had not been followed. Hiring more staff than needed causes challenges, including salary delays, she said.

In May this year a strike over delays in salaries affected all departments, including the maternity ward, emergencies and the kitchen. In July, the hospital staff threatened to strike over unresolved grievances, including backlog payments, night-duty allowance arrears and unpaid leave.

Examination of the appointments suggests that most of the new employees had jobs created for them, many positions that were created had no formal job descriptions, and many of the new positions duplicated work already being done by existing staff.

For example, during Tšepong’s tenure, the hospital had a support services manager. After the government took over, the positions of administrative manager, administrative officer and administrative assistant were also created to accommodate new employees.

Hospital staff say the admin officer and admin assistants had no experience but earned R15,000 and R12,500 respectively. The payroll corroborates this.

In the finance department, two accountant positions were created over and above the two existing finance clerks in the department

Hospital staff said since the payroll manager position held by Tsietsi Polane was created in February 2022, they had experienced delays in salaries. They said hospital staff are paid after other public servants’ salaries have been paid.

Polane, was fired from Standard Bank Lesotho and hired as payroll manager at the hospital in the first tranche of 154 people hired in February 2022. Asked about the salary delays, Polane said that there had been no salary delays since April this year. He said previous delays had been caused by a communication problem between the hospital and health ministry.

Under Tšepong management, the hospital experienced never-ending nurses strikes. But employees say things have become much worse since the government took over. “Tšepong had its flaws, but there was never this much corruption,” said one employee.

This article was produced by the MNN Centre for Investigative Journalism and syndicated by the IJ Hub on behalf of its member centre network in Southern Africa. It is co-published by GroundUp.

TOPICS:  Health

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