Child healthcare close to Western Cape Health MEC’s heart

The experienced Mireille Wenger, who was recently appointed to the Western Cape’s top health job, tells Spotlight’s Biénne Huisman that she’s passionate about child health and about policy development.

Appointed on 13 June by Western Cape Premier Alan Winde, the new MEC of Health & Wellness comes with two years’ experience as MEC of Finance & Economic Opportunities, bolstered by dollops of pragmatism and a head for numbers.

Appointed DA chief whip of the legislature in 2019, Wenger has served on the provincial Parliament’s Health Standing Committee, chaired its ad-hoc Covid-19 committee from 2020 to 2022, and spearheaded the parental leave policy for Western Cape parliamentarians.

Focus on policy development

“I joined politics because I’d like to bring change in the world,” she told Spotlight. “I suppose if you ask any politician, they will say the same thing… But I’ve thought long and hard about how I can make that contribution real. And the best way I can do that is with policy development. In the health space – I mean, that is the area that touches people’s lives, from birth to death, and everything along the way.”

On her new beat and as a mum to a nursery school-going boy, Wenger says child health is close to her heart.

“South Africa has many children who are malnourished and with other health implications. What is the Health Department’s response to that? How can we make a difference to make sure they are nourished and can develop, and are able to reach their dreams and aspirations. How can I, through policy development, help children have a future?”

She doesn’t respond with specifics on these interventions, but on budget cuts at the Red Cross War Memorial Children’s Hospital, she says: “Creating a sustainable budget for the health departmentm so that across the board we can make sure we expand access to quality healthcare for … in particular, children.”

Previously, Wenger served as chairperson for the Western Cape’s standing committee on community safety. In 2011, she helped to develop the original pilot for the “walking bus” initiative in Delft – a collaboration that saw community members and volunteers walk children to school to ensure their safety.

The project continued for around a decade, she said, with reasons for it ending being unclear. “I think it ran for about a decade (under) the Western Cape Government; eventually it was moved over to the City of Cape Town, a number of years ago; and I don’t think it runs anymore.”

Health and budget cuts

Wenger notes the challenge posed by the Western Cape’s rapidly growing population.

“One of the important challenges I’ll be faced with is making sure the budget is sustainable. On the one hand, the Western Cape is the fastest growing province in terms of the population, but unfortunately, the equitable share is not keeping pace with that population.”

As with the country’s other eight MECs for Health, Wenger faces the tough challenge of maintaining and improving healthcare services in a context where provincial health budgets have been plunging for several years.

Wenger says she inherited the only provincial Health Department to receive consistent unqualified or clean audits. Indeed, in the 2022/23 financial year, the department scored its fifth consecutive clean audit, in contrast to poor financial controls and corruption in most of the other provinces.

Last year, as MEC for Finance, Wenger was outspoken against national government’s “unaffordable” public-sector wage deal – which culminated in a R1.1bn shortfall across Western Cape Education and Health – and which the provincial government was “expected to magically fund”. Along with Winde, she declared an intergovernmental dispute.

To Spotlight, she explains: “With the Premier, I led the intergovernmental dispute against the public wage deal (against Finance Minister Enoch Godongwana), which was a part of the source of the pressures on health, because there was that deal that was negotiated at national level, and then imposed on the Western Cape.

“And after the fight, we got 78% (of the R1.1bn shortfall) of the funding, but we were still short for the rest, which is why there were those acute pressures last year, particularly in health and education…”

Each of South Africa’s nine provinces gets a slice of the national budget which it then distributes between its provincial departments.

How big a slice each gets is determined by the equitable share formula, which considers several factors, including the size of the school-going population and usage of the public healthcare sector.

While provincial health departments get some funds via other channels, most of their funding flows via the province and is thus affected by how the equitable share is calculated.

Progress on parental leave

Wenger played a critical role in the development and adoption of the Provincial Parliament’s policy on parental leave for parliamentarians in late 2019.

“It was 2017, 2018; and I was the first in our legislature – that I could find – to be pregnant and to be confronted with just no maternity leave policy,” she recalled.

“At the time, I was tasked to lead a sub-committee on developing a maternity leave policy – obviously a multiparty committee – and we did a lot of homework about South Africa’s legislation, how it works elsewhere in the world… I was very pleased to help develop this policy, to make it easier for other mums and dads to be parents.”

The parental leave policy document states the Western Cape provincial parliament is taking a “bold step” to ensure rights for parliamentarian parents for maternity, paternity, adoption and surrogacy leave. “This policy is an active step to ensure public representatives are able to serve their province and look after their families. It should not be a zero-sum equation where parents, and in particular, women, are forced to choose between a career or family.”

Stipulations include that the primary care giver gets four consecutive months’ parental leave after birth, while the baby’s non-primary care giver has 10 days’ leave. Then, after the adoption of a child under two-years-old, the primary care giver is granted 10 weeks’ leave.

Additionally, an MP who has a miscarriage during the third trimester, or who bears a stillborn child, is entitled to maternity leave of six weeks.

Born in Johannesburg, Wenger holds an MA in international relations from the University of Stellenbosch and a MPhil in criminology, law and society from the University of Cape Town. She lives in Cape Town’s southern suburbs with her husband, former executive director for corporate services at the City of Cape Town, Craig Kesson.

In 2017, Kesson levelled allegations of misconduct against then-mayor Patricia de Lille. De Lille rejected the claims.

Building partnerships

Wenger stresses the importance of building partnerships with academic institutions and the private sector, noting a project with Gift of the Givers, which donated a 10-bed overnight ward at the Eerste River Hospital and which opened last month.

Another collaboration between the government and an academic institution was the nearly-R300m Observatory Forensic Pathology Institute officially opened by then health MEC Nomafrench Mbombo in April at Groote Schuur Hospital.

Replacing the outdated 1957 Salt River Mortuary, described as a health hazard, the shiny new three-storey building integrates provincial health’s Forensic Pathology Service and university training, with capacity for up to 20 autopsies a day.

Wenger said she was pressed for time, a month into her tenure still meeting health stakeholders on her “listening and learning” tour – which she said included “behind the scenes” infrastructure services.

After our interview, she is off to visit Tygerberg Hospital to inspect its in-house laundry service, which employs more than 90 people.

Spotlight article – New Western Cape health MEC Mireille Wenger says child health is near her heart (Creative Commons Licence)

See more from MedicalBrief archives:

No health qualifications for SA’s nine MECs

Proposed budget cuts disastrous for health sector, activists warn

Western Cape experts appeal for end to health budget cuts

Theatre lists cut as Western Cape hospital battle slashed budgets