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Bara hospital battles Covid-19 with staff shortages and inferior PPE

The Chris Hani Baragwanath Hospital is currently treating 280 Covid-19 patients, the highest number in Gauteng, but is short of staff, and management is concerned that some personal protective equipment (PPE) is substandard.

This was revealed yesterday in a presentation by the hospital to the Gauteng Legislature’s Health Committee.

The hospital has 7 132 approved posts but 846 (12%) are currently vacant, including 8 out of 19 management posts (42%) and 167 out of 886 administration posts (20%). They are also short of 280 nurses and 71 doctors. This shortage is worsened by the high number of staff off sick because of Covid-19.

More staff is being hired, but according to the presentation “the funds allocated do not meet 50% of what was initially requested”, and the hospital “is trying to do more with less amidst Covid-19 infections amongst staff.”

Problems with PPE for staff include the following:

  • non-availability of stock from contracted suppliers;
  • sub-standard quality; and
  • long lead times of delivery.

This shows how the poor choice of PPE suppliers, which is probably because of corruption, has put the lives of hospital staff at risk.

Contractors are now rushing to complete 500 extra beds at Baragwanath hospital in addition to the 480 beds designated for Covid-19 patients out of 2680 total beds. But these beds will require staff that have not yet been hired by the hospital.

Other public hospitals in Gauteng face similar challenges. The reality is that years of neglect and poor staffing in our hospitals is hindering the fight to save as many lives as possible from the Covid-19 pandemic.

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Bara Hospital has lowest staff attendance

The Chris Hani Baragwanath Hospital has the lowest staff attendance of the seven largest hospitals in Gauteng, with only 72% recorded last year.

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

Helen Joseph Hospital has the highest staff attendance at 93%, followed by the Charlotte Maxeke Johannesburg and Tembisa hospitals with 89% attendance rate.

Other hospitals had the following attendance rates last year:

  • Kalafong Hospital – 87%
  • Steve Biko Hospital – 86%
  • George Mukhari Hospital – 83%

According to Masuku, the low attendance rate is mainly due to “staff who take or are on sick leave including those who are on the PILIR process and Family Responsibility leave”. PILIR is the Policy and Procedure on Incapacity Leave and Ill-Health Retirement to assist departments in managing Incapacity Leave and Ill-Health Retirement.

Masuku is cautious about which category of staff has the lowest attendance, but according to unconfirmed data for the last two years it appears that nurses have the lowest attendance rate.

The Department regards 90% attendance as acceptable, but 6 of the 7 largest public hospitals in Gauteng do not meet this standard which is worrying.

Low attendance rates put a lot of strain on the staff who remain, depressing their morale and the quality of patient care.

There is a particular problem at Chris Hani Baragwanath Hospital where staff attendance is shockingly low, which is probably due to poor management and low staff morale.

Our hospitals are highly stressed environments, so staff need to be managed properly to assist them in their jobs but also disciplined when they are absent without good reason or abuse sick leave.

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Generator failure at Bara Hospital

I am most concerned that Chris Hani Baragwanath Hospital has suffered today from generator failure to supply power to certain operating theatres.

There have also been unexplained power trips of electricity supply since early this morning.

Non-emergency operations at the orthopaedic theatres have had to be cancelled and there have been problems at the maternity unit as well.

It is unclear what has led to the electrical fault and the generator failure, but I hope that it is not due to failure of maintenance or a shortage of diesel.

Eskom’s unanticipated load shedding has led to enormous problems for hospitals which generally only use generator power for emergency operations.

The tragedy is that staff and patients are traumatised by power fails and the surgery waiting list grows longer.

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3294 ops cancelled at Bara Hospital

3294 operations were cancelled at the Chris Hani Baragwanath Hospital from January 2018 to end-September this year.

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

The reasons for cancellation were as follows:

  • Overbooking – 1262
  • Shortage of ICU beds – 926
  • Patient related – 559
  • Shortage of consumables – 210
  • Equipment related – 115
  • Infrastructure related – 312

Most of these factors are avoidable, caused by poor management that overbooks patients or fails to ensure working machinery and surgical supplies. The shortage of ICU beds for post-operative recovery is also of concern.

The high number of cancellations is distressing for both patients and staff and worsens the long waiting times for surgery – more than 6000 patients currently wait more than six months for surgery at this hospital.

According to Masuku, the following steps are being taken to reduce cancelled operations:

  • Improving booking systems, indicating the operating time.
  • Creating ward 7 High Care dependency for surgical department = 22
  • Performing some of the operations in cluster hospitals.
  • Saturday elective list (Extra list).
  • Extending arthroplasty list to 7 to 7 during the week.
  • Strengthening of cluster systems and outreach.

I hope that better management cuts the unacceptably high cancellation of operations at this major hospital.

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5 hour waiting time at Bara hospital

Patients at the Chris Hani Baragwanath Hospital can expect to wait 5 hours to receive a file, see a doctor and get their medicine.

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

The average recorded waiting times at the hospital in August this year were as follows:

To receive a file 29 minutes
Medical outpatients 185 minutes (3 hours 5 minutes)
Pharmacy 90 minutes
TOTAL TIME 304 minutes (5 hours and 4 minutes)

I am also concerned that Priority 2 casualty patients (the “walking wounded”) will have to wait on average for 69 minutes, up from 25 minutes last year.

According to Bandile, the long waiting times are due to “high patient volumes, burden of diseases, defaulting patients and staffing in relation to patient volumes.”

These waiting times are unacceptable, adding extra suffering to sick people.

We need to see efficiency improvements, adequate staffing, and alternative arrangements for chronic medicines so that patients can pick them up at convenient locations rather than a crowded hospital.

Radical improvement is needed at public hospitals if government is serious about implementing the proposed National Health Insurance (NHI).

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85 000 patients treated at Bara hospital casualty

The casualty department at the Chris Hani Baragwanath Hospital treated 84 846 patients last year, which is about 7000 patients a month.

These shocking figures are revealed by Gauteng Health MEC Bandile Masuku in a written reply to my questions in the Legislature.

The breakdown of cases is as follows:

  • Trauma 25 674
  • Surgery 14 232
  • Orthopaedics 16 668
  • Medical 28 284

There were 22 238 cases treated for violence and road accidents, broken down as follows:

  • Gunshots 1033
  • Stabbing 3276
  • Road accidents 4406
  • Burns 1605
  • Assaults 4238
  • Other injuries 7677

There were also 3597 psychiatric cases, 1298 cases of organophosphate poisoning, and 45 suicides by hanging.

These terrible figures are comparable to the injuries in a war zone. Gunshot injuries have gone up from 949 in 2017 to 1033 in 2018, and stabbing wounds from 3235 in 2017 to 3276 last year.

This curse of violence in our society is often fueled by alcohol.

A small sign of hope is that assault injuries at the hospital went down from 5052 in 2017 to 4238 in 2018, and road accident victims down from 4637 to 4406.

Effective action to bring down crime and road accidents would take a lot of strain off this hospital’s casualty ward, which must be one of the busiest in the world.

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Hundreds of beds rust outside at Bara Hospital

2I am disturbed by a widely-circulated video that shows hundreds of steel beds at the Chris Hani Baragwanath Hospital stored outside at the mercy of sun and rain.

    

Many of them look in good condition, but will deteriorate rapidly in unsheltered conditions.

The video was taken last week on Wednesday by a man who was visiting his son in the paediatric ward.

This is a clear waste of state assets as these beds should be put to good use instead of rusting outside. There are hospitals that are short of beds where they could be used or they could be donated to non-profit institutions.

Despite failing to fix healthcare in Gauteng for five years, Premier David Makhura said yesterday that it was a “serious weakness” that would be addressed if the ANC was re-elected.

Only the DA has the political will and commitment to eradicate corruption and inefficiency to ensure hospitals and clinics provide quality care.

Please click here, here and here to download pictures.

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No firm date for new CEO at Bara Hospital

by Jack Bloom MPL – DA Gauteng Shadow Health MEC

The Gauteng Health Department is “quite advanced” in the process of filling the CEO vacancy at the Chris Hani Baragwanath Hospital (CHBH).

Gauteng Health MEC Gwen Ramokgopa said this today in an oral reply to my questions in the Gauteng Legislature, but did not give a firm date for the appointment of a new CEO.

I am disappointed that there has been such a long delay in appointing a capable person to run this hospital which desperately needs strong leadership to provide a quality health service.

There is no good reason why the hospital has been without a permanent CEO since January 2016 when former Health MEC, Qedani Mahlangu, removed former CEO Sandile Mfenyane without explanation.

Yesterday, the unions organized a protest march against Acting CEO Dr Sifiso Maseko, who they blame for alleged corruption and irregular appointments.

Ramokgopa has said previously that the CEO position was advertised with a closing date of 15 December 2016 and four applications were received, so why has it still not been filled?

Poor management is partly to blame for the high number of Serious Adverse Events (SAEs) that have harmed patients at this hospital – 1249 SAEs in 2016 and 2085 SAEs in 2017.

I hope that an honest and effective CEO is appointed as soon as possible as our largest hospital has been rudderless for far too long.

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Bara baby horror

I am alarmed and saddened by the report today of poor care received by a woman in labour at the Chris Hani Baragwanath Hospital that allegedly led to the death of her baby daughter.

Rudzani Molaudzi (22) says that she was “forced” to deliver her baby by herself last week at the hospital after being ignored for hours by staff while she was in labour.

When her baby was born, a doctor pronounced that she was dead without examining her. The baby then started crying and was rushed to ICU, but died nine hours later.

This latest incident comes after the disclosure by Gauteng Health MEC Gwen Ramokgopa in reply to my questions in the Gauteng Legislature that 1338 infants died at birth at this hospital between 2014 and 2016.

The department claims that there is no negligent care at the neonatal and maternity units, but I really doubt this denial.

There are 15 vacancies at these units that need to be filled urgently and answers are needed about the many reports of poor care.

I have requested the Gauteng Health Department for an oversight visit to the hospital next week to find out why so many babies are dying or become brain-damaged because of negligence.

We need to know what the problems are at this hospital and what is being done to fix them.

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Bara Hospital Without A CEO For Nine Months

Chris Hani Baragwanath Hospital

The Chris Hani Baragwanath Hospital has been without a permanent Chief Executive Officer since January this year, but Gauteng Health MEC Qedani Mahlangu says that the hospital is “run extremely well” by an acting CEO.

Mahlangu said this yesterday in an oral reply to my questions in the Gauteng Legislature.

CEO Dr Sandile Mfenyana

She said that the performance of the previous CEO Dr Sandile Mfenyana was rated as satisfactory but he was moved to the head office and his contract will terminate at the end of October this year.

It is still a mystery why Dr Mfenyana was moved as Mahlangu ducked my question on this.

She said that a “very thorough exercise” was being done in looking for a new CEO.

I am appalled that the CEO of our largest hospital was removed without any stated reason and has still not been replaced after nine months.

The delay in filling this crucial post is inexcusable.

There are many staff and patients who are not happy with management at the hospital, which needs a dynamic and competent CEO as soon as possible.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

[Image source]