National health director general Precious Matsoso raised fears this week that the burden created by non-communicable diseases may pose a threat to the future National Health Insurance system.
National health director general Precious Matsoso raised fears this week that the burden created by non-communicable diseases may pose a threat to the future National Health Insurance system.

Western Cape health director general Craig Househam is widely tipped to take over the running of the National Department of Health after the axing of former health minister Manto Tshabalala-Msimang’s much-disliked department head, Thami Mseleku.

Interviewed this week, Househam said he had not been formally approached about the position and refused to say if he had been approached informally.

However, he said he would consider applying once the post had been advertised.

“Whoever gets this position faces a major, but worthwhile, challenge. It’s imperative to ensure a good state health service,” he said. Major challenges included ineffective management and inadequate budgets.

A paediatrician with 30 years’ public health experience, Househam has run into flak for cutting the budgets of tertiary hospitals in the Western Cape. But his consistent backing for the HIV/Aids treatment programme has won him the support of influential health lobby groups, such as the Treatment Action Campaign (TAC).

Said the TAC’s Vuyiseka Dubula: “Househam’s department is one of the only ones that have never experienced interruptions in anti­retroviral treatment.

“We therefore have faith in him, even though he’s cut the budgets of tertiary hospitals — with which we don’t agree.

“We’d like to see an appointment based on competence and not politics this time around.”

Professor Bassie Wessels, one of Househam’s former colleagues at the Mangaung Health Project in Bloemfontein, said he is convinced that the project’s former director has the qualities to be health director general.

“He led and founded this project during the early 1990s when he convinced highly conservative University of Free State officials and Mangaung township activists to work together to build community health centres that still operate today,” Wessels said.

“He’s brilliant at bringing diverse stakeholders together and in helping them work towards a shared vision.”

Other figures mentioned as possible candidates for the health director general’s job include Limpopo’s former head of health, Nicholas Crisp, and ministerial adviser and former South African Medical Association secretary general Aquina Thulare.

The departing director general is widely regarded as one of the “political leftovers” of the much-maligned department. Mseleku will leave the department at the end of the month.

Meanwhile, activists have lauded health minister Aaron Motsoaledi for axing Mseleku. Dubula said the move showed Motsoaledi’s willingness to take “unpopular decisions in an effort to clean up the health department and make it efficient”.

Last month Motsoaledi said he would not hesitate to rid his department of “incompetent” officials.

Jonathan Berger, head of the Aids Law Project’s law and treatment access unit, said Motsoaledi’s move could be the result of ministers’ new powers to hire and fire directors general.

“Previously, this was a responsibility that former president Thabo Mbeki reserved for himself,” Berger said.

Activists hold Mseleku, with Tshabalala-Msimang, responsible for the deterioration of the National Health Department, for fostering “denialist” Aids views and for preventing millions of South Africans from accessing treatment.

Dubula said Mseleku should “now go home, stay there and — stay as far away from public service as possible”.

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Mia Malan is Bhekisisa's editor-in-chief and executive director. Under her leadership, Bhekisisa’s online readership increased 30 fold and its donor funding eightfold between 2013 and 2019. Malan has won more than 20 African journalism awards for her work and is a former fellow of the Reuters Institute for the Study of Journalism at Oxford University.