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Ministry of Health and Social Welfare right but . . .

THE decision by the Ministry of Health and Social Welfare to decentralise some of its services and place them under Local Councils reaffirmed hope that decentralisation in Lesotho is a government policy. 

Other Ministries do not show even signs of elementary understanding that local government is not a ministry per se but rather a level of governance under intergovernmental relations.

Local Government as a concept is the government at locality.

Government at locality empowers communities to have control over the services and functions of state in their locality through legal, policy and institutional framework that embodies such functions.  The reason why local government is associated with power of governance being restored to the people is because it minimizes the decision making monopoly of the central government over issues which people themselves can competently decide upon. 

Government is better understood as a key to state power. 

The state is an organisation of various agencies led and co-coordinated by the leadership (executive authority) that has the authority to make and implement binding rules for all the people as well as the parameters of rule making for other social organisations in a country, using force if necessary to have its way. 

The state is a product of political development process to satisfy human needs. 

An irresistible desire for rational freedom in man can only be achieved within the framework of state.

This explains the power based struggle by political parties to control the state and also defines the pressure launched by interests groups on the state to adopt certain policies and reject others. 

The Local Government Act and the Local Government Elections Act define what local government means in the context of Lesotho. 

They define the functions of the local authorities in terms of what they can administer and control in their jurisdictions.

These functions are however limited to those listed in the first and second schedules of the Local Government Act.

Under this law community Councils are barred from dealing with issues such as gender based violence, agriculture, community based organisations that include cooperatives and burial societies, sports, culture and HIV and AIDS. Yet these are real issues that affect people’s lives.

It is a mockery to Basotho who for long have been waiting for local government to have structures that are so limited.

It is true that Basotho would like to see community councils having jurisdiction over agric extension officers, cooperatives officers and health personnel operating within their jurisdiction.

It is actually the expectation that all ministries should decentralise their functions as well as human and financial resources to the local authorities. 

This is exactly the explanation for the applause given to the Ministry of Health and Social Welfare for decentralising.

According to Minister of Health and Social Welfare Mphu Ramatlapeng the Ministry is decentralising clinics and health posts as well as the personnel to local councils.

In this way nurses shall in terms of their work (not technical/professional stuff) report to the councils under whose jurisdiction they fall.

No nurse shall therefore close the health centre for several days without having reported and convincingly explained the decision to the local council.

People go through untold sufferings particularly in the rural and remote areas where health centres operate in the communities but are not accountable to the people.

Ramatlapeng is right to put this and other clinics under the local authorities. 

The question however to the decision of Ramatlapeng is: To what extent does it conform to the law?

The Local Government Act does not empower community councils to deal with Health.

The district councils are only empowered to deal with public health (e.g. food inspection, refuse collection and disposal). 

Because the government does not operate like a stokvel which depends on the desire, wishes and whims of the owners but functions within a set of rules in a legal framework, this decision cannot just be implemented.

No local authorities can handle health issues unless the government finds it convenient to undermine the current law.

A democratic government cannot thrive on undermining the laws of the country just to get things done.

 It is surprising that the legal division in the Ministry of Local Government did not advice when the Ministry adopted the Essential Package Services because that as well as the Gateway approach were politically good and very relevant policy responses but against the law.

It is the similar case with recent handling of passports by the councils.

It is important to change the law where it is a barrier.

In order for us to legally implement the decision to decentralise the health services the Local Government Act must be amended.

First, those amendments must include the removal of schedules.  Secondly, the amendments must define the scope of the work of local councils in terms of the compatibility with the national policy/laws and the limit to engage in relations beyond the national boundaries without consultations.

As long as we treat local councils like a mother hen does to her chicks local government will not be what Basotho expect.

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