Bara Hospital Without A CEO For More Than A Year

The Chris Hani Baragwanath Hospital has operated without a permanent Chief Executive Office (CEO) since January last year, but an appointment process is in place for a new CEO.

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

According to Ramokgopa: “The vacant position of Chief Executive Officer was advertised in the national media with a closing date of 15 December 2016. The department received four applications in this regard and the appointment process is in place.”

She added “no appointment has been finalised.”

It is highly regrettable that this large hospital has suffered without a permanent CEO for so long.

Former Health MEC Qedani Mahlangu is to blame as she removed the previous CEO Dr Sandile Mfenyana without any explanation and dithered in finding a replacement.

I hope that Ramokgopa moves speedily to finalise the appointment of a dynamic and competent CEO to lead this major hospital which treats many thousands of patients.



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

Gauteng Health Department Ignored Report That Could Have Saved Esidimeni Patients

Health Advance Institute Report

A report commissioned by the Gauteng Health Department in May 2015 found that the service provided by Life Esidimeni (LE) for psychiatric patients was “good value for money” and made recommendations that were ignored concerning the monitoring of patients transferred to NGOs.

According to a written reply by Gauteng Health MEC Gwen Ramokgopa to my questions in the Gauteng Legislature, the report was done by the Health Advance Institute (HAI) which was asked to evaluate the cost of LE’s services and to evaluate the appropriate daily tariff per patient.

The report cost R410 500 and was sent to the department on 22 May 2015.

HAI found that the profit over all LE’s facilities in 2014/15 was R29.85 million (13.8%) on a turnover of R215.74 million, which was considerably lower than the 28% average profit by health companies on the JSE at that time.

Instead of a predicted average cost of R320 per patient per day in the five LE facilities for 2260 patients, the actual cost was R262 per patient, which was 22.6% lower than expected.

The report says that “LE low costing is probably due to a combination of low infrastructure costs, large number of patients per unit, patients treated in groups rather than individually, below expected staffing levels and efficient management.”

According to HAI “there is generally substantial compliance with the terms of the Service Level Agreement (SLA) within the following areas: patient cleanliness, nourishment of patients, good relation between patient and staff, treatment and care.”

They did note, however, some areas for review, including:

– a dischargeable status within one year was not met that was a requirement of the SLA and may not be achievable
– no record of milestone observed in the patients file
– limited explanations on the management of treatment to the patients and family
– upholding the responsibility to try to find alternative accommodation for all the patients
– setting up an appropriate M & E system

The report concludes as follows:

“In general the service provided by LE is good value for money. HAI believes that sufficient and relevant information has been obtained to enable the Gauteng Department of Health to make sound and evidence-based decisions with regards to the future financial planning and management of this SLA.”

Former Gauteng Health MEC Qedani Mahlangu

Suggestions were also made, including the following:

– establish task team to define the minimum standards required … in selection of the new places or alternative accommodation
– urgent inspections and reporting on each of the facilities to which patients were distributed after termination of the LE contract in relation to the norms and standards as defined by the task team
– to withdraw and re-accommodate any patients who are in sub-optimal conditions
– establish regular monitoring inspections at all facilities where patients are to be managed.

On the basis of the report, the department granted a tariff increase as requested by LE.

This report undermines the claim by former Gauteng Health MEC Qedani Mahlangu that LE was overcharging and that the contract was terminated because of high cost.

Furthermore, the recommendations concerning monitoring of patients sent to other facilities were ignored, which led to the tragedy of more than 100 deaths as found by the Health Ombudsman.

It is further evidence of gross negligence by Mahlangu and senior officials that should lead to a conviction of culpable homicide in a court of law.





Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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No Spectacles At South Rand Hospital

Department’s Ineptitude Causes Suffering to Patients

Patients with sight problems at the South Rand Hospital in south Johannesburg have been unable to get spectacles since January last year because there is no agreement between the hospital and the service provider.

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

There is an optometrist at the hospital who did 166 eye tests on patients last year, but none of them got spectacles.

Ramokgopa says that “Problems experienced with manufacturing spectacles are due to the non-existence of a service level agreement between the hospital and the service provider.”

This is a poor excuse that shows bad management and an uncaring attitude to patients.

Ramokgopa says that additional funds from the 2017/18 budget will be allocated to improve service delivery in this area, but it will probably still be some months before patients can get spectacles at this hospital.

It’s one more example of the department’s ineptitude that causes suffering to patients.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Fewer Psychiatric Patients But Long Waiting Times At South Rand Hospital

Custom-designed Psychiatric Ward

South Rand Hospital has fewer psychiatric patients than before but the two wards set aside for them need to be relocated to a custom-designed psychiatric ward on the ground floor.

This was the observation of a DA delegation that visited the hospital yesterday (27 February) after receiving complaints from patients. DA Gauteng Shadow Health MEC Jack Bloom, DA Joburg South Constituency Head Manny de Freitas MP and DA councillors Michael Crichton, Rashieda Landis and Faeeza Chame inspected various parts of the hospital and met with hospital CEO Dr Nobantu Maleka.

We were pleased to find that psychiatric patients were no longer mixed with other patients in ordinary wards and that the numbers were down dramatically because of the recent opening of the psychiatric ward at the Bheki Mlangeni Hospital in Soweto.

There were only three psychiatric patients in the 27-bed female psychiatric ward and 11 patients in the 34-bed male psychiatric ward on the fourth floor.

Psychiatric patients are seen for an observation period of 72 hours and then discharged or sent to a more specialist and long-term facility.

One Security Guard at the Psychiatric Ward

The two psychiatric wards are not ideal as they have been converted from ordinary wards. A request has been made for the refurbishment of a former crèche on the ground floor into a proper psychiatric ward where staff can interact with the patients and they can also recuperate in a secure garden.

Staff expressed concern that there was only one security guard at the psychiatric ward and that the glass windows could be shattered and shards used as a weapon or to commit suicide. There are burglar bars to prevent a patient jumping to their death, as happened in May last year.

Long waiting periods are a continuing problem at this hospital.

Official figures for July to September last year show that patients wait between two-and-a-half hours to three hours at both the Outpatients department and at Casualty, which is unacceptable.

Moratorium on Hiring more Admin Staff

On a positive note, however, the hospital is looking very clean and pharmacy waiting times have decreased.

Hospital CEO Dr Nobantu Maleka said there was a moratorium on hiring more administrative staff which has led to long waiting times; there was also a shortage of 16 nurses.

The hospital’s staff compliment needs to be increased to cope with the large increase in patient numbers.

Maleka said that there are plans to renovate the Outpatient ward towards the end of the year.

The DA will monitor the promised improvements and push for more staff and for electronic files to replace the paper files that often get lost and add to patients’ frustration and waiting time.




Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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NGO Threatens Brother Of Deceased Patient

Shammah House NGO

I am appalled that the Shammah House NGO has threatened the brother of a deceased mental health patient who was sent there from Life Esidimeni last year.

Mr Mike Thlolwe (60) died at Shammah House in Cullinan on 12 February this year shortly before an ambulance was to take him to hospital.

Last week on Thursday the NGO sent a letter from a law firm to his brother Ike Thlolwe threatening him with legal action if he did not retract public statements blaming them for poor treatment of his brother.

Health Ombudsman’s Recommendation

According to the legal letter “Our instructions are that our client attended to your brother’s health and welfare according to best practice and followed every relevant protocol … Our client reserves its rights to take any legal action should they become aware of any untrue, unfounded or defamatory statements or insinuations in respect of their conduct.”
Shammah is acting in a very inappropriate and insensitive manner.

I have reported this to Gauteng Health MEC Gwen Ramokgopa and requested her to intervene to resolve this matter.

I am also concerned that Shammah has reportedly been offered a contract by the Gauteng Health Department to continue to accommodate 44 mental health patients.

This is despite the Health Ombudsman’s recommendation that former Esidimeni patients be moved from the unlicensed NGOs.

We need to know that all mental health patients are in suitable facilities that are regularly monitored by health officials.



Media Enquiries
Jack Bloom MPL
DA Gauteng Shadow MEC for Health
082 333 4222
Image source

R1.6 Billion Overspend Projected For Gauteng Health

Gauteng Legislature’s Health Committee

The Gauteng Health Department is projected to overspend by R1.6 billion by the end of the 31 March financial year.

This was revealed in a presentation by the department at a meeting of the Gauteng Legislature’s Health Committee earlier this week.

According to the presentation, the biggest overspend will be R1.162 billion by the four academic hospitals (Chris Hani Baragwanath, Charlotte Maxeke Johannesburg, Steve Biko and George Mukhari).

Provincial hospitals will also overspend by R199 million and district health services by R50 million.

Court-ordered payments for medical negligence are a major reason for the overspend.

Health Science and Training Programme

Other reasons include the improvement of conditions of service funding gap on the Occupational Specific Dispensation (OSD), and the payment of accruals on medicine, medical supplies and agency and support services.

The Health Science and Training Programme is projected to overspend by R137 million mainly because of the cost of training students to become doctors in Cuba.

The department’s funding crisis is leading to delayed payments of suppliers, pushing many small companies into financial ruin.

The funding deficit is also likely to rise because of the extra costs in relocating psychiatric patients from unsuitable NGOs where they were placed after the closure of Life Healthcare Esidimeni.

New Health MEC Gwen Ramokgopa faces a daunting task in fully funding services for patients.

I suspect that the provincial government will have to bail out the health department, diverting money from other departments as has happened previously.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Esidimeni Death Toll Rises

I have been informed of another death of a patient transferred from Life Esidimeni to the Shammah NGO based in Cullinan.

According tohis brother, he died this week and was in an emaciated condition.

This gives urgency to the need to close down the dodgy NGOs and transfer the patients to decent facilities as recommended by the Health Ombudsman in his report on 94 previously identified deaths.

Delays in transferring patients should not add to the immense tragedy of avoidable deaths in this whole sorry saga.

The final death count is likely to be well over a hundred as Health Minister Aaron Motsoaledi noted yesterday that there were 19 unidentified bodies in mortuaries from NGOs where Esidimeni patients were transferred.

I welcome Motsoaledi’s announcement that 22 of the 27 NGOs will be closed based on the assessments of the expert team that he has assembled in this matter.

He also said that seven facilities had already been closed down, including the two Rebafenyi facilities associated with Police Major-General Sandra Malebe-Themba and Tshwane ANC councillor Nosipho Makeke-Tyobeka.

I think it is good that the private health sector will also be used for the patients, including the re-opening of Life Esidimeni facilities in a phased manner. This is necessary because existing state facilities are already over-crowded.

Another positive is the Minister’s commitment to involve the families in approving the appointment of a prominent person to lead the Alternative Dispute Resolution Process as recommended by the Health Ombudsman for healing and redress.

The DA will monitor the implementation of the Ombud’s recommendations which need to be completed within the 45 day deadline.

It is important that the public is kept informed of all steps taken in this tragic matter, including criminal charges that should be laid against all those implicated.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

ANC Councillor And Police General Implicated In Unlicensed Premises For Psychiatric Patients

Police Major-General Sandra Malebe-Themba

I have established that a ANC councillor and a police general are involved in a NGO which looked after more than 100 psychiatric patients transferred from Life Healthcare Esidimeni at two unlicensed premises in Tshwane.

Police Major-General Sandra Malebe-Themba is the Executive Chairperson of the Re-Bafenyi Victim Empowerment Centre (RVEC) which is a NGO based in Atteridgeville that was established in 2011. Its primary purpose is to provide a safety net to all victims of domestic violence and abuse.

But Rebafenyi Mental Health is a recent programme added by RVEC which says in a presentation had two 24-hour operational centers:

– At Hennops River with 59 beneficiaries
– At Phelindaba (Schuverberg) with 60 beneficiaries

Tshwane ANC councillor Nosipho Makeke-Tyobeka

Tshwane ANC councillor Nosipho Makeke-Tyobeka is listed as a committee member of Rebafenyi Mental Health. At the time she was the MMC for Sports, Recreation and Arts
and Culture and states in her profile that she is a member of the ANC Women’s League.

Last year in November I pointed out that the Rebafenyi facility in Hennops River was blatantly contravening municipal by-laws. This was according to a report by the Tshwane Health and Social Development Department which investigated the NGO after complaints received by DA Councillor Kingsley Wakelin that people living there were jumping the fences and disturbing the neighborhood.

The Health Ombudsman found that neither of the two Rebafenyi facilities were operating with legal licenses and the patients have since been transferred elsewhere.

Christopher Mogwarane

Christopher Mogwarane (56) was one of the patients transferred to Rebafenyi in Hennops River from Esidimeni and died there. According to his brother Lucas, he was not happy there and he did not appear to be getting proper nutrition and medication.

There were fortunately no deaths at the Phelindaba facility, but the patients were unexpectedly placed there in June last year by Rebafenyi and the owners placed signs saying they were not legally liable for anything that happened to them.

I suspect that money was the motivation for certain NGOs taking psychiatric patients that they could not care for properly.

Refanyeni was paid R2700 per patient per month, so it got about R270 000 a month for patients.

Investigation into Money Flow

It is shocking that a senior ANC Councillor and a police general are involved in a dodgy NGO with unlicensed premises in which one patient died, possibly from neglect.

General Malebe-Themba resigned from the police in 2013 after a misconduct probe but was re-employed after acting commissioner Kgomotso Phahlane took office in 2015. She is currently facing a complaint of racism.

There should be an investigation into the money flows and who personally benefited at all the NGOs where Esidimeni patients were placed.

Criminal charges should be pursued in cases where money was diverted into private pockets while patients were neglected and their lives placed at risk.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

DA Welcomes Resignation Of Gauteng Health MEC

Health Ombudsman’s Report

I welcome the resignation of Gauteng Health MEC Qedani Mahlangu in the wake of the highly critical findings of the Health Ombudsman concerning the deaths of at least 94 mental health patients.

Premier David Makhura bears part of the blame for this disaster as he should have acted earlier to fire her and taken action to protect the patients, many of whom are still suffering in unsuitable NGOs.

Dr Gwen RamokgopaDr Gwen Ramokgopa

It took 141 days for Mahlangu to resign following the first disclosure of deaths in reply to my question in the Gauteng Legislature on 13 September last year.

I am not impressed with the return of Dr Gwen Ramokgopa as MEC of the Gauteng Health Department. She was mediocre in this position previously and does not have the drive to fix this deeply dysfunctional department.

Premier Makhura has failed badly in this matter and needs to keep his promises to ensure that action is taken against all those implicated, including criminal charges.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Premier Must Take Stern Action Over 94 Patient Deaths

Health Ombudsman’s Report

I am shocked to the core by the revelation today by the Health Ombudsman that 94 psychiatric patients died (and possibly more) after their transfer last year from Life Healthcare Esidimeni.

Health MEC Qedani Mahlangu lied to me in the Gauteng Legislature on 13 September last year when she said that 36 patients had died in the NGOs in which they were placed. Health Ombudsman Malegapuru Makgoba said that on that date 77 patients had already died.

Premier Makhura has to fire Mahlangu and ensure that disciplinary action is taken against the 11 senior health department officials identified in the report.

Criminal Charges

Criminal charges should also be laid against all implicated parties including those in the five NGOs where 80% of the patients died.

Premier Makhura must also ensure that immediate steps are taken to ensure the safety and well-being of all the patients who are still with the NGOs.

Makura’s image has taken a severe blow because of his failure to fire Mahlangu earlier and to replace her with a competent and caring Health MEC.

This is a crisis for the ANC in Gauteng and all those who failed to act earlier against Mahlangu.

I will study the full report and monitor the actions based on its findings.



Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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