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Auditor-General slams Gauteng misspending on Covid-19 that should have been used to save lives

Auditor-General Tsakane Maluleke has slammed a host of irregularities in the Gauteng provincial government’s spending on Covid-19 activities.

This highlights how misspent money could have been used to save lives as Gauteng public hospitals now struggle to treat a flood of Covid-19 patients.

Special Reports from the A-G’s office were recently tabled in the Gauteng Legislature and included the following findings:

  1. 23 unlisted suppliers were used to procure PPE amounting to R862.5 million.2. 300 000 K95 medical masks were ordered, but KN95 non-medical masks were delivered instead.3. R127 million worth of PPEs were ordered but not received by the Gauteng Health Department.

    4. There were 22 instances where PPE contracts were awarded to suppliers with no previous history of supplying PPE, the total value being R442 million.

    5. There were 6 instances where prices were paid in excess of Treasury regulations, with a potential loss of R182 million because of overpricing.

With regard to the NASREC field hospital which cost more than R260 million, the A-G said that payments of R22.5 million were made to the supplier outside the agreed terms in the signed contract. The Department paid for the purchase of items that were leased by the supplier, and did not invite as many suppliers as possible, with no prior approval from Treasury.

With regard to the refurbishment of the Anglo Ashanti mine hospital, the A-G says:
“There were 6 instances where emergency procurement awards amounting to R495 million were not reported to the provincial treasury within the required 30 days.”

According to the A-G, the root cause of all this malfeasance is the tone and culture at the top, which led to “a breakdown in the organisational level controls to enable an ethical and effective control culture, including leadership effectiveness and conduct.”

This is a devastating indictment of Premier David Makhura who has presided over all these irregularities without taking any accountability for his failure to prevent them.

The problem has not been a shortage of money but it has been spent poorly instead of properly preparing health facilities for the expected third wave of Covid-19 cases.

Going forward, we can do so much better as shown by the Western Cape Health Department which gets a clean audit every year and has better served patients affected by the Covid-19 epidemic.

 

 

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Mental health patients in Gauteng suffer from late payments

Late payments to more than 100 NGOs are causing suffering to thousands of mental health patients as staff go unpaid and even food is in short supply.

These NGOs were supposed to be paid on 7 May but have still not been paid their subsidy of R4900 per patient by the Gauteng Health Department.

The delay is due to new Service Level Agreements that should have been signed earlier, and also because of the new financial year which started in April.

Every year there is a so-called “dry season” where payments are delayed because the department is short of funds as the new financial year starts.

Legal action has even been used in the past to get the department to pay.

Meanwhile, the welfare organisations struggle to provide for vulnerable patients on top of the extra expense in dealing with the Covid-19 epidemic.

I have communicated with Health MEC Nomathemba Mokgethi on this issue, and officials promised to pay by the end of last week, but this has not occurred.

It is really appalling that mental health patients are treated so badly even after the Life Esidimeni tragedy.

The department needs to get its act together and pay on time!

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How can Joburg Hospital CEO also run Tembisa Hospital?

The Chief Executive Officer (CEO) of the Charlotte Maxeke Johannesburg Hospital (CMJH), Ms Gladys Bogoshi, has a demanding job and now has to deal with devastating fire damage, but she also been the Acting CEO of Tembisa Hospital since February this year.

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

According to Mokgethi, Bogoshi is one of only two officials in the whole department who perform two jobs because they are acting in another position to their normal job.

In the case of Mr S Sithole, he is the Tshwane District Manager Emergency Medical Services, and he is also the acting Principal of the Lebone College of Emergency Care since June 2020.

Bogoshi was appointed as the Acting CEO of the Tembisa Hospital after the Health Ombudsman’s report on the death of Shonisani Lethole, which led to the suspension of the CEO Dr Lekopane Mogaladi.

Mokgethi says that “Both officials have the ability to manage both posts, there is no effect on performance, they possess both management and technical aptitude and the
capability to carry out both functions adequately.”

I do not share the MEC’s confidence that anyone can successfully run two large hospitals.

Questions are also now raised about Bogoshi’s own competence and her accountability for the fire at CMJH.

Both CMJH and Tembisa Hospital need a full-time CEO who can concentrate on fixing the deep-rooted problems at both hospitals.

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Joburg Hospital fire is a huge blow to health services in Gauteng

The terrible fire at the Charlotte Maxeke Johannesburg Hospital (CMJH) has dealt a huge blow to health services in Gauteng.

I commend the heroic effort to transfer nearly 700 patients to other hospitals after the decision was taken to close CMJH for seven days, but I suspect that certain specialist services will be disrupted for far longer.

Cancer patients will suffer worst as the oncology department is near the parking lot that has collapsed. Expensive radiation machines may have been damaged or will need to be salvaged for a new place to operate.

I am concerned that large parts of the hospital may not be structurally sound after this fire and will not be safe for patients.

This hospital has been poorly maintained for years, with frequent water leaks and a ceiling that collapsed in March 2017.

Another problem is that the COVID-19 crisis has worsened the waiting times for surgery, and thousands of patients will have to wait even longer for operations.

There may also be a shortage of medical supplies, including Personal Protective Equipment (PPE) and medicines, because of the fire which destroyed storerooms.

As CMJH is an academic hospital it will not be easy to provide certain specialist services elsewhere in the province for extended periods of time.

The Gauteng Infrastructure Development Department should speedily assess whether the structural integrity of the building as a whole is safe.

We need an investigation into the cause of the fire and why safety measures were not able to prevent it or stop it sooner.

It appears that fire hydrants were broken at the hospital building, and water had to be obtained from elsewhere.

This is the second fire this year at a Gauteng public hospital, and questions need to be answered about safety measures at all our public hospitals.

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107 attacks on Gauteng Hospital staff

10 May 2017

Staff in Gauteng hospitals have been attacked 107 times since January last year, mostly by patients or their relatives.

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

Tembisa Hospital had the most attacks on staff (16), followed by Weskoppies with 13 attacks, Leratong with 12 and Pholosong with 8 incidents.

The Chris Hani Baragwanath, George Mukhari, Helen Joseph and Far East Rand hospitals all experienced 7 attacks on staff in this time period.

Charlotte Maxeke had no reported attacks, and the figures for other hospitals are as follows:

Kalafong and Sterkfontein – 6
South Rand – 5
Steve Biko, Mamelodi and Tambo Memorial – 3
Thelle Mogoerane, Bertha Gxowa, Carltonville, Odi and Pretoria West – 1

The assaults range from verbal threats and abuse, to physical attacks and a disturbing number of bites (13 in total).

At Tembisa Hospital, the recorded incidents were as follows:

Verbal assault from visitors – 1
Verbal assault from patients – 2
Physical assault from patients – 7
Human bites from patients – 3
Physical assaults from visitors – 2
Physical assault from fellow colleagues – 1

At the Chris Hani Baragwanath Hospital, an employee accused a colleague of being a witch and a nurse threatened a fellow employee with a knife.

According to Ramokgopa, the identified reasons include frustrated or traumatized patients, alcohol abuse, bad attitudes and some psychotic mental health patients. Many attacks take place at night or over the weekend, particularly at the casualty department.

I am shocked at the high level of violence inflicted on health workers who are trying to heal the sick.

Increased security can assist in bringing down the attacks, but the underlying cause is unfortunately the general violence and intolerance in our society.

Media Enquiries

Jack Bloom MPL
DA Gauteng Shadow Health MEC
082 333 4222

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Psychiatric patients can’t wash at Joburg Hospital

09 May 2017

Psychiatric patients at the Charlotte Maxeke Johannesburg Hospital cannot bath or shower at the Psychiatric ward because the water leaks into other wards.

The washing facilities at Ward 487 are barred to 20 psychiatric patients who are forced to use basins or go to another ward to clean up.

Patients have endured this unacceptable situation for about three months, but hospital management has failed to fix the problem.

I have complained before about the unsuitable conditions at this ward which is drab and depressing, and male and female patients are not properly separated.

I was told last year by former Health MEC Qedani Mahlangu that a new 40-bed psychiatric ward would be completed in September last year at a cost of about R10 million.

The new ward should have been completed six years ago but has been delayed because of problems with contractors and incorrect tender specifications.

This incredible incompetence needs to stop otherwise the new ward will never be finished and patients will continue to suffer in the old ward.

It is really shocking that water leaks have not been stopped at this flagship hospital which recently had a roof collapse that endangered lives.

Meanwhile, Gauteng Infrastructure MEC Jacob Mamabolo dithers in releasing a report on the roof collapse which was promised by the end of March.

I am going to report this latest infringement of the rights of psychiatric patients to the Health Ombudsman who played such a crucial role in uncovering the deaths of more than 100 Esidimeni psychiatric patients sent to unsuitable NGOs.

Media Enquiries

Jack Bloom MPL
DA Gauteng Shadow Health MEC
082 333 4222

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Blood test delays at Bara Hospital

I am concerned that patients have to queue for hours to get blood tests at the Chris Hani Baragwanath Hospital as there are only two staff members to attend to more than 150 patients a day.

The blood tests are done by the medical emergency unit (MEU) of the National Health Laboratory Services (NHLS).

The unit is usually very crowded and patients who arrive early in the day at the hospital have to wait more than four hours to get their results.

Patients can be further inconvenienced because the pharmacy has closed by the time they get results and they have to come back the next day.

The Gauteng Health Department should pressure the NHLS to increase staff as soon as possible to cope with the high patient numbers at this hospital.
 
Media Enquiries
 
 
 
Jack Bloom MPL
DA Gauteng Shadow Health MEC
082 333 4222

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Tembisa Hospital manager disciplined for abusing cellphone to support ANC

I am pleased that a manager at the Tembisa Hospital has been disciplined for abusing state resources to support the ANC in the local government elections in August last year.

This follows my complaint to the Public Service Commission that Tembisa Hospital Corporate Manager Lina Mmatli posted the following ANC message on an internal management Whatsapp group on Friday 29 July 2016 during the election campaign:

The TRUTH is, the ANC fought for your right to vote! Stay FREE, vote ANC! #stayfreevoteanc

The PSC found that Ms Mmatli’s conduct in forwarding a “political message” to an official communication platform which seemed to be promoting a political party as inappropriate and in contravention of regulations and policies that prohibit public servants from acting in such a manner.

The PSC recommended that the head of the Gauteng Head Department should consider corrective measures against Ms Mmatli in this regard.

In a written reply to my questions on this matter Gauteng Health MEC Gwen Ramokgopa says that Ms Mmatli had been charged with misconduct arising from abuse of state resources and her disciplinary hearing was finalized on 17 March this year.

She also said that there was “continuous training of employees on the code of conduct in the public service”.

I commend the PSC for taking up my complaint and compelling the Department to enforce the important principle that public servants should not promote any political party in the course of their duties.
 
Media Enquiries
 
Jack Bloom MPL
DA Gauteng Shadow Health MEC
082 333 4222

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100 Gauteng psychiatric patients still in NGOs

I am concerned at the report today that about 100 psychiatric patients in Gauteng are still at NGOs that are not equipped to care for them.

All the mental health patients that were transferred last year from Life Esidimeni were supposed to have been transferred to licensed facilities by the end of April according to an agreement by the Gauteng Health Department with the Health Ombudsman who had originally specified a 45 day deadline when he tabled his report on 1 February this year.

My information is that there are enough beds for the patients at the Selby Park Hospital and at the Esidimeni Waverley facility in Germiston which has been reopened.

The Gauteng Health Department should give a full report as to why it has not met the extended deadline for the transfer of patients, including the numbers of patients at the various NGOs and why they are still there.

I am also concerned by the slow progress into holding accountable the perpetrators of the more than 100 patients who died and also the failure to appoint a credible prominent person to lead the recommended Alternative Dispute Resolution procedure for redress and compensation to relatives.

Every effort should be made to comply with the Ombudsman’s recommendations following the terrible harm caused by the callous transfer of patients from Esidimeni to unsuitable NGOs.
 
Media Enquiries

Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222

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Gauteng Premier tightens controls to avoid another Esidimeni debacle

Gauteng Premier David Makhura has tightened controls in a number of areas in order to avoid a repeat of the oversight failure that led to the deaths of more than 100 mental health patients who were sent to unsuitable NGOs after the cancellation of the Health Department’s contract with Life Esidimeni.

In a written reply to my questions on this matter in the Gauteng Legislature, Makhura says that there was “no monitoring of the decision to transfer mental health patients to NGOs because such a decision was not approved or reported to the Premier or the Executive Council.”

He says that the transfer of the patients to NGOs was brought to his attention only when the former Health MEC was responding to questions in the Legislature.

Makhura has taken the following measures to improve internal controls and enhance risk management:

1) The Service Delivery War Room and the Performance Monitoring and Evaluation (PME) Unit in his office will now be directly involved in the implementation of all major decisions of the Executive Council and Departments.
2) No Department will implement any major decision or policy without seeking the approval of the Executive Council – this is because “the current decision-making system of the Executive Council inherited from the previous administration allows for too much discretionary action on the part of Departments.”
3) All MECs have to ensure that every legal action instituted by Departments has the explicit approval of the Director-General and where the Premier is cited as an applicant or respondent, the Premier should also give explicit approval – “this is born out of the realization that for many years Departments have cited the Office of the Premier in litigation matters without seeking approval.”

These are sensible changes that enhance the role of the Premier’s Office in keeping track of bad developments that need to be terminated before further damage is done.

But the real reason for the Esidimeni tragedy was the Premier’s head-in-the-sand attitude as he ignored a torrent of adverse media reports on the rushed transfer of patients to NGOs.

Extra controls cannot substitute for good judgement by the Premier who is ultimately accountable for the successes and failures of his administration.
 
 
Media Enquiries:
 
Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222