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41 Assaults on hospital staff in Gauteng last year

Forty-one health staff in Gauteng public hospitals were assaulted last year, the vast majority by psychiatric patients.

This is revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Gauteng Legislature.

According to Masuku “in almost all the cases reported the perpetrator was a patient and the majority were psychiatric patients …The main reason identified is that the patients are most times confused and do not know what exactly they are doing … 95% of assaults are by patients with a Psychiatric Diagnosis.”

George Mukhari Hospital had the most assaults – there were 10 attacks, including one where three security guards were bitten by a psychiatric patient.

The Bheki Mlangeni Hospital in Soweto had 8 attacks, 6 of which were perpetrated by psychiatric patients. It is very disappointing that this hospital has still not taken effective security measures as a psychiatric patient allegedly murdered another patient there recently.

Other health facilities that suffered attacks on staff include the following:

Tembisa Hospital – 5 injuries reported

Mamelodi Hospital – 5 injuries reported

Leratong Hospital – 1 human bite injury

Bertha Gxowa – 1 assault reported

Johannesburg clinics – 3 assaults recorded

It is really shameful that following the Life Esidimeni tragedy the facilities for psychiatric patients in our hospitals are still inadequate to prevent harm both to themselves and to others.

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Psychiatric medicine shortages disrupt patients in Gauteng

Psychiatric patients in Gauteng have suffered over the past year from shortages of nine drugs due mostly to manufacturing constraints and tender issues.

This is revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Gauteng Legislature.

The medicines in short supply include three anti-depressants, three anti-psychotics, and two epilepsy treatments.

According to Masuku, although the items were out of stock “the suppliers were delivering limited quantities which were evenly distributed to the facilities. Patients were given limited quantities so that they do not go home without medication. Where there are alternatives patients were given the alternative medication.”

Masuku claims that the impact on treatment of patients was “minimal”. I disagree as I have had many complaints from psychiatric patients that they had adverse reactions from the switching of medicines and sometimes ran out of medicines for a period of time.

It is unfortunate that Gauteng is dependent on national health tenders for psychiatric drugs as they are often badly handled.

The Gauteng Health Department needs to be more nimble in finding alternative suppliers to ensure that there is always a full range of drugs for vulnerable psychiatric patients.

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DA calls on Gauteng Department of Health to make a decision about Kempton Park Hospital

The Democratic Alliance (DA) has learnt that the Gauteng Department of Health is considering a range of options with regards to the future of the abandoned Kempton Park Hospital building.

This was revealed by the Gauteng MEC for Health, Bandile Masuku in a written reply to the DA questions tabled in the Gauteng Provincial Legislature.

According to MEC Masuku, there were three options which included the following:

  • Renovation of the existing hospital and re-opening it as a district hospital;
  • Renovation of the existing hospital as Folateng Hospital and,
  • Demolition of the existing buildings and building a compliant District Hospital.

The MEC indicated that the Folateng Hospital proposal was rejected by the private health sector in Kempton Park and a decision was taken to renovate the existing hospital buildings and convert them to a district hospital.

The estimated cost for the demolition of the hospital is R127 729 665,36 and the estimated cost for the new District Hospital is R1 569 850 810,52.

The DA calls on MEC Masuku to make a decision as a matter of urgency as Tembisa Hospital is struggling to service people from Kempton Park and neighbouring suburbs.

If this hospital is refurbished and re-opened it will help to ease pressure at Tembisa and Edenvale Hospital respectively which are currently overcrowded and unable to render adequate health services to our people.

Overcrowding at Tembisa Hospital has resulted in the death of the 10 babies which is an example of how the hospital is struggling to cope.

I will continue to put pressure on the MEC for Health, Bandile Masuku to ensure that this hospital is revamped and re-opened as people in this area are in dire need of this facility.

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Joburg hospital psychiatric ward delayed yet again after 11 years and 4 contractors

The badly needed renovation of psychiatric ward at the Charlotte Maxeke Johannesburg Hospital is now due to be completed on 31 January next year after missing the latest promised deadline of 31 October.

This was revealed by Gauteng Health MEC Bandile Masuku in an oral reply to my questions in the Legislature last week.

Work on the ward started in February 2008 and was supposed to be finished in 2014, but three companies had to be fired and the fourth company could not provide needed mechanical equipment that had to be imported from France at an extra cost of R4 million.

Two years ago, then Health MEC Gwen Ramokgopa disclosed that the cost of the ward had tripled to R34 million and she promised that it would be finished in March 2018.

This highlight yet again the incompetence of the Department of Infrastructure Development which is repeatedly incapable of choosing building companies that can do the job properly.

Meanwhile, psychiatric patients at this major hospital continue to suffer in unsuitable facilities despite lessons that should have been learned from the Life Esidimeni tragedy.

I hope that the new Psychiatric ward, which will increase beds from 20 to 40, is indeed opened in January next year.

 

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Gauteng hospital private wards owe R56 million

The Gauteng Health Department’s Folateng private wards, which were supposed to be closed down but still operate at the Charlotte Maxeke Johannesburg Hospital (CMJH), are owed R56.5 million in patient fees from private patients.

This is disclosed by Gauteng Health MEC Bandile Masuku in a reply to my questions in the Gauteng Legislature.

According to Masuku, the Folateng wards at CMJH have 137 approved beds, but currently only 37 are used for private patients while the rest are used for state activities.

Last year, R20 035 027 was spent on goods and services for these private wards, which brought in R20 932 467 in revenue. The surplus was R897 440, but staff and machinery costs are not given, so there was certainly a large loss.

At 31 March, which is the end of the last financial year, R49 780 114 was owing from medical aids and R6 757 154 in cash, the vast majority longer than 120 days. This means that R56 537 267 is owed in total and is likely to be written off as uncollectible.

Masuku says the following lessons have been learned:

  • Proper operating costs of the unit should have been done and reviewed;
  • The process of integrating private and public service staff should have started earlier;
  • Staffing of the billing office to ensure all monies owed are recovered;
  • A different model of contracting doctors to ensure continuity of treatment;
  • The full review of whether the ward met the objectives of what it was intended for, risk identification and project management skills would have assisted in defining clear milestones to be achieved and risk mitigation.

The Folateng private wards were launched in 2002 and were supposed to provide revenue for public patients but failed dismally. They were supposed to be closed in 2014 when then Health Minister Aaron Motsoaledi complained about them.

The major problem was poor costing and collection of patient fees, which resulted in R569 million written off.

The real lesson to be learned from this expensive failure is that the state is a very poor administrator and should not be entrusted with running a complex NHI where the risk of disaster is high.

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Gauteng hospitals won’t be safety compliant for many years

Gauteng Health MEC Bandile Masuku is reported today (see https://ewn.co.za/) as saying he would be working with the Infrastructure Development Department to make sure that all hospitals complied with safety standards by the end of next year.

He was reacting to the experience of Ms Yolisa Jiyane, a pregnant woman who was trapped inside a toilet at the Thelle Mogoerane Hospital in Vosloorus for more than an hour while she was in labour.

The reality, however, is that Gauteng public hospitals will not be compliant with safety legislation for many years as there is insufficient money and a lack of capacity to do quality building work on time and within budget.

This is illustrated by Thelle Mogoerane Hospital, which opened five years ago after taking 8 years to build at more than double the original budget. The hospital should be safety compliant but according to a recent report by the Department to the Gauteng Legislature’s Health Committee an estimate to fix it is not yet available as they are “investigating risks and root causes of structural cracks in the building.”

The total amount to ensure all 32 hospitals are compliant with the Occupational Health and Safety Act is estimated at about R6 billion. The Department has requested priority funding of R1.7 billion for nine hospitals next year, but it is unlikely they will get this from the National Treasury.

It is unfortunate that patients are suffering from many years of neglect and mismanagement that needs to be reversed as soon as possible

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Tara Mental Hospital is understaffed with an absentee CEO

The Tara Mental Hospital has 9 vacancies for day staff and is short of 19 out of 50 required night staff, but the CEO has been absent for 94 days this year.

This information is revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Gauteng Legislature.

Key vacancies include the Head of Clinical Department, 3 Professional Nurses, a Risk Manager, Clinical Training Coordinator and a Computer Operator.

Extra staff required for night duty are as follows:

12 Professional Nurses

3 Security Officers

4 Cleaners

Hospital CEO Florence Otieno has taken 70 days annual leave from January to August this year, and 24 sick leave days. MEC Bandile states: “Upon requesting reasons for the high figure, it was stated that some of the days related to previous years. Notwithstanding this, I have written to the Head of Department to request a detailed report on whether all days were taken in accordance with HR policy.”

Bandile has also undertaken to investigate whether the finance and administration managers are properly qualified for their positions. He says that the reasons given for their appointments are “unsatisfactory”, and he has asked the Head of Department to report back to him on this by 29 November 2019.

I welcome the MEC’s undertaking to investigate possible maladministration at this hospital which serves very vulnerable mental patients.

There are currently 129 patients on the waiting lists for admission, with waiting times varying from 3 to 8 weeks.

I hope that the staff vacancies are filled, and management issues resolved as soon as possible.

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More delays for Joburg hospital psychiatric ward

The psychiatric ward at the Charlotte Maxeke Johannesburg Hospital is in dire need of renovation, but completion of the work has been delayed yet again because the contractor has not been paid.

Renovation of the ward was supposed to be completed in 2014, but this is now the fourth company that has failed to do the job.

Angry workers have flooded the ward with water, forcing the evacuation of medical staff, and mental health patients are now in unsatisfactory temporary wards.

Two years ago, then Health MEC Gwen Ramokgopa disclosed that the cost of the ward had tripled to R34 million and she promised that it would be finished in March 2018.

Earlier this year, Health MEC Bandile Masuku said that the ward would be completed by 31 October, but this deadline has not been met.

This shows yet again the utter incompetence of the Department of Infrastructure Development which is repeatedly incapable of choosing building companies that can do the job or doesn’t pay them on time, so they abandon the project.

The new ward would expand the number of beds from 20 to 40, but psychiatric patients at this major hospital continue to suffer in unsuitable facilities despite lessons that should have been learned from the Life Esidimeni tragedy.

How can it be that no fewer than four contractors have failed to complete the new ward which is more than five years overdue?

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Long waiting times at Joburg Hospital

Patients at the Charlotte Maxeke Johannesburg Hospital (CMJH) can expect to wait for 4 hours at Outpatients and 2½ hours at Casualty as the hospital struggles with more than a million patient visits a year.

This is revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Gauteng Legislature.

I am concerned that these figures underestimate the real time that many patients spend at this hospital, including delays in registering and at the pharmacy.

Last month I visited the hospital early in the morning and witnessed a scuffle as patients fought to be in the front of the queue when the pharmacy opened at 7 am.

Queue marshalls have been placed at the pharmacy and a numbering system put in place for people who are there at 6am, which I hope stops queue disputes.

CMJH is the busiest of the four academic hospitals, seeing more patients than the Steve Biko and George Mukhari hospitals combined, and about 360 000 more patients  a year than Chris Hani Baragwanath Hospital.

A combination of strategies which include health education to communities, infrastructure, strengthening of referral systems and the use of underutilized theater times at private facilities is being looked at by the Department to better the service provided and deal with the high and concerning waiting times and surgical backlogs.

I welcome the promised partnership with private hospitals to decongest this very busy hospital. Computerised patient files and alternative sites for patients to pick up their chronic medicines would also help greatly.

This highlights once again why government’s priority should be fixing the public health system before embarking on its complex National Health Insurance (NHI) plan.

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184 Gauteng Health staff have businesses that deal with Government

184 staff who work for the Gauteng Health Department (GHD) have their own private businesses that deal with government departments, including the GHD.

This is revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Gauteng Legislature.

These employees were identified by the Gauteng Audit Service and the Auditor General’s 2018/19 Report.

They are involved in a wide range of businesses, including medical supplies, food, events management, health publishing, emergency care, security and funeral services.

It is not presently known how many GHD staff get business from the Department itself. According to Masuku, “a detailed report has been requested from the Head of Department. A deadline of Monday the 14th October 2019 has been given. Once the information has been provided it will be forwarded to the legislature.”

I am concerned that employees doing business with their own department has taken so long to uncover. This is highly irregular in a department that has suffered many corruption scandals.

I look forward to the detailed report that has been promised, which should be followed by strict discipline of staff who are caught out in this matter.