Are new hospital beds in Gauteng ready for January Covid-19 wave?

Gauteng Premier David Makhura promised that 2000 new beds would be built at existing hospitals to treat COVID-19 patients.

These beds were all supposed to be ready for an expected surge in August/September, but by this time the first surge of cases was on the way down.

According to the latest figures there are currently 2549 COVID-19 patients in Gauteng hospitals, both public and private. At the peak of the surge in July there were 7500 COVID-19 patients, so the extra 2000 beds should significantly ease the strain if they are properly staffed and equipped.

Reconfiguration has added 282 general beds at the Discoverers, Tembisa, Lenasia South, and George Mukhari hospitals, and 254 more High Care/ICU beds at the Tembisa, Helen Joseph, Charlotte Maxeke Johannesburg, Chris Hani Baragwanath, Tshwane District and Kopanong hospitals. Another 176 ICU beds were supposed to be completed at the Anglo Ashanti Hospital in Carletonville.

1400 completely new High Care/ICU beds were promised at the following hospitals:

Chris Hani Baragwanath Hospital – 500
Jubilee Hospital – 300
George Mukhari Hospital – 300
Kopanong Hospital – 300

In addition to this, there are 1000 low-level beds at the NASREC field hospital which has been largely empty, and fewer than 10% of its beds were used at any one time. The poorly-drafted 6 month contract for this facility ends on 31 January next year and more than R200 million has been paid for hundreds of empty beds. A more rational and cost-effective contract is needed for any beds that may be needed there after January.

Mistakes have been made with wasteful spending on beds that may not be used fully because of their location and lack of staff – this is particularly the case with the Anglo Gold Hospital which was renovated at the exorbitant budgeted cost of R589 million.

The big challenge is proper staffing, equipment and oxygen supplies for all the extra beds.

I welcome the 246 extra staff that will start work in January at the Chris Hani Hospital, and I hope the other hospitals have enough staff to cope with the expected surge of COVID-19 cases next year.

I have requested the Chairperson of the Gauteng Legislature’s Health Committee for an urgent meeting to get a full briefing from the Gauteng Health Department on their state of readiness for the surge to come.

We need to ensure that everything is done to ensure we have enough hospital staff with sufficient resources, including decent Personal Protective Equipment (PPE).

Water in Emfuleni under lockdown while country experiences second wave of Covid-19 pandemic

The Democratic Alliance (DA) in Gauteng is deeply concerned that residents of Emfuleni have, for the past few weeks, been unable to wash their hands regularly because the water pressure has decreased by 20% as the Emfuleni Local Municipality owes Rand Water R1 billion.

This is worrying given the fact that South Africa is in the grips of a second wave of the Covid-19 pandemic and one of the ways in which the spread of this virus is curbed is by regularly washing your hands.

In addition, in some parts of Emfuleni like Evaton and Sebokeng, residents have to walk long distances to fetch water for doing laundry, drinking, cooking and bathing.

Emfuleni has been placed under administration, yet the water situation has still not been resolved. Service delivery while this municipality is under administration has completely collapsed and it is clear that it is failing to resolve the financial issues facing this municipality.

The DA is calling on the administrators to ensure that an agreement is reached between Rand Water and the Emfuleni Local Municipality where the water pressure is restored so that residents are able to have access to a normal flow of water, especially during the second wave of Covid-19.

R380 000 a day for empty beds at Nasrec field hospital

Only 34 patients have been admitted to the 1000-bed NASREC field hospital so far this month, but R380 a day is being paid for each empty bed.

Acting Gauteng Health MEC Jacob Mamabolo revealed this yesterday in an oral reply to my questions at a virtual sitting of the Gauteng Legislature.

According to Mamabolo, there is a fixed cost per bed of R380 a day, and R390 a day for each patient.

This means that about R380 000 a day is being paid for 1000 empty beds in terms of a 6 month contract with the Johannesburg Expo Centre. The contract expires on 31 Januarynext year so the last three months of the contract is likely to cost more than R32 million.

This is extremely wasteful and cannot be justified even if we had a second wave of COVID-19 infections as fewer than 10% of the NASREC beds were used at the peak of the epidemic in July.

It would be far better to contract with private hospitals to take public patients if state hospitals ever overflow with COVID-19 patients.

I have requested the Auditor-General to investigate the NASREC contract which I suspect contravenes good practice and is possibly corrupt.

Gauteng can’t fight Covid-19 with fake figures

Gauteng’s officially recorded COVID-19 figures are becoming more and more ludicrous, providing little guidance in tracking the epidemic to prevent hotspots developing further.

According to the latest figures from the National Health Department, there are only 283 active cases in Gauteng, the lowest in the country despite having the highest population.

It is simply not possible to have so few active cases when there have been 1887 new COVID-19 cases recorded in the last ten days.

Furthermore, there are 1624 COVID-19 patients in Gauteng hospitals according to the National Institute for Communicable Diseases (NICD).

The Gauteng Health Department used to give a daily breakdown of cases by district, but has not given any update since 4 November 2020.

It is essential that accurate figures are available for the districts so that any spike in cases can be combatted quickly.

Acting Health MEC Jacob Mamabolo needs to act urgently to ensure that real infection statistics are available and monitored closely to manage this epidemic properly.

Gauteng’s Department of Health criticised for poor planning of Covid Infrastructure

The Democratic Alliance (DA) in Gauteng is not surprised that the Health Portfolio Committee, during a recent committee meeting, questioned the planning and quality of Covid-19 infrastructure projects.

The first question which the department could not answer satisfactorily was how it came about that the province was spending more than R2 billion on 5 facilities that are meant to provide 1575 high care beds, the majority of which are not yet available.

The five facilities, which include Chris Hani Baragwanath; Kopanong; George Mukhari; Jubilee and the Anglo-Gold Ashanti hospitals, have not yet been completed and have not been utilised in the fight against the pandemic. The excuse presented by the officials is that the pandemic peaked earlier than expected and that the initial planning was not as stringent as it could have been due to dealing with an unknown situation.

Even now, there are no publicised plans as to how these high care beds will be repurposed in the event that, as seems likely, they will never be used for Covid patients. In addition, there is no information which indicates whether the equipment, staff and finance required to run the hospitals is available.

The officials could also not explain why a whopping R589 million was budgeted to set up 175 high care beds at the AngloGold Ashanti hospital in Carletonville, when by their own admission, a new facility could have been built at a lower cost. Clearly no feasibility or cost-benefit analysis had been done.

An SIU report in terms of the AngloGold Ashanti project highlighted the risk to the project when the department, without solid justification, stopped paying the contractors. As a result, the project was stopped due to strike action by the contractors and the subsequent threat by contractors to remove or damage high value medical equipment. The department was also criticized for not providing sufficient security.

The Gauteng Department of Health is dysfunctional and will remain so unless certain steps are taken. The Premier must appoint an MEC who is more than an ANC cadre with purely ideological objectives, who in turn must appoint skilled administrators. Failing this, the department will continue to limp from crisis to crisis.

No proper records kept of sundry payments for emergency procurement during Covid-19 pandemic

The Democratic Alliance (DA) in Gauteng is concerned that the Department of Social Development and Provincial Treasury do not have clear lines of communication regarding sundry payments as it relates to emergency procurement during the Covid-19 pandemic.

Conflicting information was given to me when I tabled questions for written reply to the MEC for Finance Nomantu Nkomo-Ralehoko regarding Covid-19 funding and procurement.

According to the MEC, suppliers for the Department of Social Development for Covid-19 procurement were paid through sundry payments amounting to R825 390 000.

In addition, the MEC indicated that the reason for the sundry payment could be obtained from the Department. Further questions were then tabled to the MEC for Social Development, Dr Nomathemba Mokgethi regarding the reasons for the sundry payments. According to MEC Mokgethi, no sundry payments were made for Covid-19 procurement.

The conflicting replies are extremely concerning as it indicates that there is no system in place to keep track of goods and services that were procured for use during the Covid-19 pandemic. This clearly indicates that there is an opportunity for fraud and corruption to take place.

I will be tabling further questions, to ascertain why Provincial Treasury would indicate that sundry payments were made by the Department of Social Development and why this department has no record of this payment.

It is time to plug the holes in the Gauteng budget or risk going over the fiscal cliff

Today’s second adjustment budget tabled by the MEC for Finance and e-Government, Nomantu Nkomo-Ralekho has allocated funding that must prioritize economic recovery and fiscal consolidation. COVID19 has indeed had a significant impact on the functioning and performance of Gauteng Government departments and we expect that to remain the case for as long as we have to deal with the impact of the pandemic on efforts to bolster the Gauteng economy and ensure fiscal prudence.

During her adjustment budget speech today in the Gauteng Provincial Legislature, the MEC highlighted the need for the boosting of the township economy. However, the DA remains concerned that subcontracting remains an issue and that the provincial government does not have a hold on ensuring that main contractors pay subcontractors on time. This is a clear indication that contract management is lacking, which can be used as a tool to ensure that the main contractors pay subcontractors, instead of drafting more legislation to manage timeous payments. In many stakeholder meetings where the DA was present it is evident that SMMEs are worried about late payments, as it is hurts their cash flow and is even destroying the sustainability of their enterprises.

Furthermore, in order to get the private sector involved in assisting government to deal with critical infrastructure projects effectively, there needs to be a trust relationship built on government’s commitment to eradicate corruption, stop the mismanagement of funds and show solid procurement plans to ensure infrastructure projects are completed.

For the 2020/21 financial year an amount of R65.5 million has been approved for rollovers for the following departments:

• Health- R50.9 million

• Human Settlements- R7 million

• Community Safety- R5.5 million

• Sports, Arts, Culture and Recreation- R2 million

These rollovers are due to slower spending as a result of the lockdown, and accruals, mainly because of invoices that have been paid late.

It is also concerning to note that the Community Library Services grant has been reduced by R1.5 million by national government to fund the business rescue plan for SAA, with a total of R94,1m cuts in Conditional Grants to contribute towards rescuing SAA. The DA condemns this as the ANC has chosen to fund public transport for the rich instead of building schools, hospitals and providing water for the millions of poor South Africans.

In addition, the MEC confirmed the focus on Special Economic Zones, Industrial Hubs, and Agri Hubs but it is worrying that these zones are still not all fully operational. Whilst the DA believes that the establishment of these zones, and hubs will indeed create longer term sustainable jobs, more needs to be done to ensure that these zones become fully operational.

The MEC further stressed the need for Public Private Partnerships (PPP) to ensure maintenance of our current infrastructure, however, the Gauteng Province is not known for many successful PPPs. PPPs are often very complex in nature and without a strong relationship with private sector to collaborate government on PPP’s nothing much will happen.

We concur with the statement that the Gauteng government needs to be more transparent in the way it deals with various SIU investigations into alleged corruption and financial mismanagement, as final reports and recommendations are often clouded in secrecy.

In total there were will be a reduction of R5 billion in equitable share, to accommodate consolidation of the public sector wage as Minister Mboweni plans to freeze increases for the next three years. Trade unions will definitely be making their voices heard on this matter and Gauteng can expect protests and disruptions in this regard.

In addition, the DA is calling on the MEC to not only present the Provincial Economic Review and Outlook but also consider presenting a Municipal Economic Review and Outlook as Gauteng municipalities are in serious trouble when it comes to financial sustainability and continuous delivery of services to their residents in the midst of COVID19 and declining revenue collection and increasing debt.

It is important now more than ever that everything possible is done to avoid falling over the fiscal cliff. If anything goes wrong now it will happen easily, and it will be the most vulnerable in our society that will suffer the consequences

Latest Gauteng Covid-19 figures make no sense

According to the latest figures released by the National Health Department there are now 1384 active COVID-19 cases in Gauteng, but according to the National Institute for Communicable Diseases (NICD) there are 1781 COVID-19 patients in Gauteng hospitals.

This is clearly not possible and the real figures need to be clarified urgently.

The Gauteng Health Department last reported on 4 November that there were 229 490 confirmed COVID-19 cases with 209 243 recoveries, 1730 patients in hospital and 4845 deaths. This works out to 15 402 active cases at that date.

How could active cases have gone done so dramatically while hospital cases have apparently increased slightly?

The NICD figures are taken from 128 health facilities in Gauteng, and record 349 COVID-19 cases in Chris Hani Baragwanath Hospital alone.

Anecdotally I have not heard such high figures from hospitals, but the estimated total number of active cases seems far too low as well.

It is vitally important that we have accurate figures so that we can track this epidemic and intervene rapidly at hotspots.

Is Gauteng underestimating Covid-19 infections?

The recorded active COVID-19 infections in Gauteng have come down dramatically from 15 402 a week ago to 1984 cases now, but there are still 1858 patients in Gauteng hospitals with this disease according to the National Institute for Communicable Diseases (NICD).

This can be compared to the Western Cape which has 4577 recorded active cases but only 625 COVID-19 patients in hospital.

It can normally be expected that 10-20% of COVID-19 cases would end up hospital, which is what we see in the Western Cape, but in Gauteng nearly all the recorded cases are hospitalized.

Previously in this epidemic the Gauteng hospital figures were in the range of 10-20% of total active cases, so there is evidence of a huge undercount of current infections.

According to the National Department of Health, there has been a total of 230 559 COVID-19 infections in Gauteng, with 4870 deaths and 223 705 recoveries, which means a recovery rate of 97%.

The Gauteng Health Department last gave figures for Thursday 5 November when it reported 1730 patients in hospital.

It is important that we have accurate figures about current infections in order to detect trends and intervene early in hotspots.

I suspect that we are not doing enough tests in the right places, and this needs to be fixed urgently.

 

 

125 staff and 64 patients got covid-19 at Sterkfontein Hospital

The Sterkfontein mental hospital has suffered a high number of COVID-19 infections, with 125 staff and 64 patients infected by the end of August this year.

This is revealed by Acting Gauteng Health MEC Jacob Mamabolo in a written reply to my questions in the Gauteng Legislature.

According to Mamabolo, one of the infected staff died, but other staff at the hospital say that there were two COVID-19 deaths.

COVID-19 infections at the hospital affected nearly one in five (17%) of the 720 staff and about 11% of the 560 patients. This is disturbingly high as this hospital only treats mental patients and has a lower risk than other hospitals that treat all other patients.

There was a protest by 25 staff members about inadequate infection control at the hospital on 19 May, and they were dismissed but reinstated recently after referring the matter to the Bargaining Council for arbitration.

Although Mamabolo claims that sufficient Personal Protective Equipment (PPE) was supplied to the hospital, an investigation is needed as to why there was such a high infection rate.

It seems that the Gauteng Health Department neglected a mental health facility during this pandemic despite the lessons that should have been learned from the Life Esidimeni tragedy.