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Bara maternity faces R1 billion negligence claims but is short of staff and equipment

The maternity unit at the Chris Hani Baragwanath Hospital faces R1 billion medical negligence claims, but is short of staff, operating theatres, and working equipment.

This is revealed in a written reply to my questions in the Gauteng Legislature.

According to the Gauteng Health Department, there are 26 staff vacancies, 4 of the 12 sonar machines are broken, and 2 overhead warmers in the labour ward are not working.

Last month, the cooling unit for two operating theatres was broken for 6 days and patients were operated on in high temperatures, which increases the infection risk. There is also an increased risk of hypothermia (abnormally low temperature) in newborn babies because of the nonfunctional overhead warmers.

Meanwhile, 50 medical negligence claims for a total of R992 million have been filed against the maternity unit in the last four years. Half of these cases are for cerebral palsy in babies, with individual claims ranging from R10 million to R51 million. The amounts claimed are high as they have to cover the cost of lifetime medical care.

There are claims for the deaths of five babies, requesting amounts ranging from R400 000 to R7 million. This is what is regarded as the price of a baby’s life!

The highest claim is R65 million for alleged negligence in treating a pregnant woman which resulted in womb infection, leading to an emergency hysterectomy and heart and kidney complications requiring dialysis.

Other sad claims include alleged negligence leading to removal of the womb, and cases of swabs left inside the patients after surgery.

The Department says there is a low number of deaths and infections in the maternity unit, but the high negligence claims show there are many cases of poor medical care leading to injury and death.

They identify the need for three dedicated obstetric theatres for emergency Caesarean sections, the creation of more posts for all categories of staff including Advanced Midwives, and an increase in theatres from four to five.

The tragedy is that money spent on negligence cases could have been avoided if this busy maternity unit was properly staffed with adequate equipment.

And no amount of money can compensate for loss of life and life-long injuries caused by negligence.

The Bara Maternity Unit needs urgent improvement as it is the busiest in the country, delivering 20 000 babies a year.

The DA advocates a laser-like focus on improving management and resources in all hospital maternity units where so much costly negligence occurs.

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Surgery waiting lists at Bara Hospital jump from 7300 to 11200

The number of patients waiting for surgery at the Chris Hani Baragwanath Hospital has jumped from 7288 last year to 11 194, with some patients told they will have to wait until December 2026 for their operation.

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

There are 3394 cataract patients who will wait for a year to regain their sight.

The worst waiting time is for 1777 people who need hip and knee replacements – they will wait for four-and-a-half years!

And 1304 children will wait 6 months for surgery.

In the case of prostate cancer the delay can be life-threatening as 243 patients will wait for 24-36 months for surgery.

According to Mokgethi, the long waiting lists are due to the following:

  • Inadequate theatre time
  • Non-availability if post-op ICU/HCU bed
  • Infrastructure issues such as non-functioning autoclaves, power outage, dysfunctional boilers
  • Prolonged closure of the Charlotte Maxeke Johannesburg Hospital trauma unit due to the fire
  • Non-functioning of the Bheki Mlangeni Hospital theatres where elective cataract and minor surgery can be done

Another factor is that 1786 operations were cancelled or deferred last year for various reasons.

The department blames the Covid-19 pandemic for the growing waiting lists, but better management would fix issues like broken equipment.

For many patients, it can take many months before they are diagnosed and placed on the waiting list, so their suffering is immense.

Some waiting lists only get shorter because patients die while waiting.

Surgery blitzes in the evenings and on weekends will help to cut the lists, and private hospitals can be paid to do surgery for public patients.

 

 

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870 ops cancelled at Bara Hospital this year

870 operations have been cancelled at the Chris Hani Baragwanath Hospital so far this year because of overbooking, equipment problems, maintenance issues, and shortages of linen.

This was disclosed today by Gauteng Health MEC Nomathemba Mokgethi in an oral reply to my questions at a sitting of the Gauteng Legislature.

According to Mokgethi, the shortage of clean linen occurred because of inconsistent functioning of boilers and frequent breakages of laundry machines.

She said that the department would be buying a new boiler, which costs about R20 million, to cut down on linen shortages.

I am concerned by the high number of cancelled operations as this causes great distress to staff and patients.

Surgeons are hugely frustrated when an operation cannot proceed because of a linen shortage or another avoidable reason.

Some patients have waited years for operations, only to be disappointed at the last moment when their surgery is cancelled.

Hospital CEOs should be given more powers to do maintenance, which is currently done by the dysfunctional Gauteng Infrastructure Development Department.

More use should be made of private laundries as the state-run laundries are notoriously unreliable and are not cost-effective.

Every effort should be made to avoid the cancellation of operations as the surgery backlogs are alarmingly high and patients suffer from long waits.

 

 

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Food supply problems at other Gauteng hospitals

Food supply problems at the Chris Hani Baragwanath Hospital have been highlighted, but other Gauteng state hospitals also suffer from inadequate food arrangements due to expired contracts and poor financial management.

The situation at Heidelberg Hospital is so bad that they have taken food from other hospitals. They have not been able to get dairy products, meat, fruits and vegetables, but are able to get bread.

I have established that the following hospitals have also had bread supply problems:

Far East Rand Hospital
Bertha Gxowa Hospital
Odi Hospital
Pretoria West Hospital
Helen Joseph Hospital

Kopanong Hospital in Vereeniging cannot get fresh milk, so they are using powdered milk instead.

Meanwhile, meals for patients at Charlotte Maxeke Johannesburg Hospital (CMJH) have deteriorated. This is what patients had this weekend:

Saturday lunch – a roll with a margarine tub but no plastic knife to apply it, and a packet of soup with no hot water.

Saturday supper – a roll with a hard-boiled egg.

Sunday breakfast – porridge with a roll, but no water.

Sunday lunch – a tub with dry mixed vegetables, cauliflower and dry cooked mielies.

Sunday supper – an apple and a roll with a margarine tub.

Photos of the meals are available here here here and here

It is not clear why the CMJH meals are so poor, without any meat, chicken or fish.

Patients need nutritionally balanced meals, instead of random food scrounged together by an uncaring and incompetent management.

It’s a terrible way to mistreat sick people.

I will be asking probing questions why this food disaster is allowed to continue.

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Adverse events rise in Gauteng’s worst hospitals

Serious Adverse Events (SAEs) in Gauteng public hospitals have risen from 4170 in 2019 to 4701 last year, an increase of 13%, with Tembisa Hospital by far the worst with 1226 SAEs during this period.

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

A SAE is defined as an event that results in an unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient.

Hospitals with high numbers of SAEs for 2019 and 2020 include the following:

George Mukhari  – 1022

Chris Hani Baragwanath  – 883

Kalafong  – 850

Weskoppies  – 74

Charlotte Maxeke Johannesburg  – 632

Thelle Mogoerane  – 380

Mamelodi  – 362

Sebokeng  – 324

Helen Joseph  – 319

Leratong  – 258

Jubilee  – 204

The Rahima Moosa Mother and Child Hospital has the best record, with not a single SAE in 2019, and only 2 SAEs last year.

Steve Biko had the fewest SAEs of the four academic hospitals (the others are Bara, Charlotte Maxeke and George Mukhari), with 55 SAEs in 2019 and 200 SAEs last year.

Some hospitals saw sharp increases from 2019 to 2020. Edenvale hospital went up from 13 to 129, Leratong from 61 to 197, Helen Joseph from 102 to 217, and Sebokeng from 107 to 217.

The 747 SAEs at Weskoppies mental hospital are of concern as there is no surgery at this hospital.

Tembisa’s very number of adverse events highlights the poor judgement in choosing it as a Covid-19 treatment centre. This was a finding of the Medical Ombudsman when he investigated Shonisani Lethole’s death at this hospital.

Our health sector has been battered by the Covid-19 pandemic, and effective measures need to be taken to ensure medical negligence is minimised as much as possible. Proper staffing and resources is critical, as well as good training, and disciplinary measures for non-performance.

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Gauteng must fix its yo-yo Covid-19 hospital figures

The Gauteng Health Department’s daily figures for Covid-19 patients in hospital lack credibility as they yo-yo up and down and appear to exclude many public hospitals.

Yesterday the hospitalization figure was given as 5007, on Saturday it was 3617, and on Friday it was 7193, whereas it was as low as 2417 on the Tuesday before.

It appears that the large jump last week was because patients from the Chris Hani Baragwanath Hospital were included for the first time. How can it be that our largest hospital was not reporting Covid-19 figures for such a long time?

I suspect the real total figure is closer to 10 000 as most of the public hospitals are not reporting their figures and one can expect that between 15-20% of active cases would be hospitalized.

The department needs to give accurate total figures for Covid-19 hospitalizations so that we can properly track progress in fighting this pandemic.

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675 Bara hospital beds donated to NGOs

675 beds have been donated to NGOs following the public outcry in May this year when a video of hundreds of beds rusting in the open at the Chris Hani Baragwanath Hospital went viral on social media.

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

According to Bandile there were 1 000 beds stored outside from January to July this year. This was because “the storage space available was not enough to keep all beds enclosed due to the high number of beds.”

He said that hospital management took this decision as “the beds were assessed and found not to be fit for purpose in the hospital.”

After the video went viral “various NGOs” got 675 beds, and 325 beds were condemned.

I am pleased that NGOs got these beds instead of the wasteful original plan of hospital management. I suspect that more beds could have been donated in good condition but deteriorated in the sun and rain.

The Gauteng Health Department needs to look after all its assets and make plans to sell or donate anything that it no longer finds useful.

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Baby stolen at Bara Hospital

I am horrified by the kidnapping of a new-born baby at the Chris Hani Baragwanath Hospital yesterday afternoon.

A female suspect was spotted on the CCTV cameras wearing blue jeans, flip-flops and a long-sleeve white top.

This is a particularly heinous crime and I hope that the police are successful in finding the suspect speedily and rescuing the baby.

This incident is hugely distressing and highlights the need to tighten up on security at all maternity wards as baby snatching has happened at other hospitals as well.

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DA supports union demands to fix Bara hospital

by Jack Bloom MPL – DA Gauteng Shadow Health MEC

The Democratic Alliance supports the demands of trade unions who are marching today to draw attention to corruption and short staffing at the Chris Hani Baragwanath Hospital.

Their demands include the release of an investigation report into corruption and irregular appointments, the removal of the Acting CEO Dr Sifiso Maseko and corrupt officials, and the filling of vacant posts.

It is inexcusable that this hospital has not had a permanent CEO for more than two and a half years since former Health MEC Qedani Mahlangu removed the former CEO in January 2016 without explanation.

I suspect that former CEO Sandile Mfenyane was removed because he blocked corrupt contracts.

Gauteng Health MEC Gwen Ramokgopa has said 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?

This hospital desperately needs a competent and honest CEO to effectively manage its R3.5 billion budget and 6 000 employees.

Changes are needed to improve care as 4320 Serious Adverse Events that harmed patients were recorded from January 2016 to June this year.

I hope that the Department responds constructively to today’s march which needs to be peaceful and not disruptive to patients.

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1433 operations cancelled at Bara hospital

by Jack Bloom MPL – DA Gauteng Shadow Health MEC

A total of 1433 operations were deferred or cancelled at the Chris Hani Baragwanath Hospital last year, worsening the long waiting times for surgery.

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

According to Ramokgopa, the cancelled operations were due to the following reasons:

  • Patient Related. Not fit for surgery. Pre- Med findings, defaulting;
  • Infrastructure related e.g. power outage;
  • No ICU or High Care bed; and
  • Patient refused operation

I am concerned by the high number of cancelled operations often for avoidable reasons.

This worsens the surgery backlog which last year stood at 11 736 patients – in the worst case, a patient could wait five years for a hip operation.

Unfortunately, Ramokgopa ducked my question on current surgery backlogs by saying that it is “variable periodically due to ongoing service.”

It is unacceptable to give such a vague answer since figures are certainly available but are probably embarrassingly high, which is why she refuses to give them.

The following trends are identified as contributing towards the surgery backlogs:

  • Patients are coming to CHBAH from outside cluster hospital including other provinces;
  • CHBAH still performs level I and level II and level III types of operations;
  • Not enough theatre time available for elective cases;
  • Availability of ICU and High Care beds in the hospital;
  • Equipment related e.g. limited number of drills, spinal sets, traction tables, microscope; and
  • Increased number of Trauma case eg. MAV, PVA and assault cases

Instead of covering up the surgery backlog, Ramokgopa should ensure that critical posts are filled at the hospital, and rectify the shortages in equipment and ICU beds.