Auditor General slams Gauteng Health Department

The Auditor General has again given a damning report on the Gauteng Health Department, which had R2.26 billion irregular expenditure in the 2022/2023 financial year, R15 million fruitless and wasteful expenditure, and failed to spend R2.7 billion of its budget.

This is revealed in the Gauteng Health Department’s Annual Report for 2022/2023 which was tabled in the Gauteng Legislature last week. This covers the period 1 April 2022 to 31 March this year.

According to the AG, R3.1 billion of patients’ debt was written off, and there were 26 293 invoices for R2.5 billion that were undisputed but still not paid after 30 days or the agreed period. Only 53 850 invoices (35%) out of 154 076 were paid within the legally required 30 days.

The Department says these non-payments are “due to cash shortages because of medico-legal payments and settlement of old accruals, over-commitment on goods and services procured as well as delays in clearing of web-cycle transactions.”

The AG says effective and appropriate steps were not taken to prevent irregular expenditure, most of which was due to failure to invite competitive bids. Disciplinary steps were also not taken again the officials responsible.

One of the reasons for fruitless and wasteful expenditure is the failure to pay court orders within 30 days, so interest has to be paid on the outstanding amount.

Another concern is that the Department has unreliable information about meeting targets, in some cases claiming falsely to have achieved them. The AG notes that 75% of the budget for Health Facilities Management was spent, but 0% of targets were achieved!

The AG’s report shows little progress has been made in fixing the appalling financial mismanagement which allows criminal syndicates to flourish. This includes the R1 billion irregular expenditure the SIU has identified at the Tembisa Hospital alone following the murder of whistleblower Babita Deokaran.

How can it be that officials are still not disciplined for financial misconduct and competitive bids are not always done?

Last week Premier Panyaza Lesufi claimed departments were getting better audit reports, but failed to acknowledge the glaring deficiencies in the Gauteng Health Department.

He should strive for real achievement instead of claiming false victories.

Gauteng Health Department has an Eskom level of corruption

Note to Editors: This speech was delivered by Jack Bloom MPL during the budget vote on the Gauteng Department of Health in the Gauteng Provincial Legislature today.

Madam Speaker, this is the 30th health budget that I am speaking on.

In 1994, when I was first elected to this Legislature, the population of Gauteng was about seven million people.

It has grown to more than 16 million today, but Gauteng’s health budget has also grown impressively.

It was less than R6 billion in 2000, compared to R60 billion this year. This is a threefold increase when adjusted for inflation.

So, the big question is why there are so many deficiencies in the health care provided today when the budget has grown significantly more than our population.

Why does this department get terrible reports from the Auditor-General year after year?

The Gauteng Health Department should be on par with the Western Cape Health Department, which has got four clean audits in a row.

It should have a functioning health information system which was first promised by the first Health MEC Amos Masondo. That’s how far back this goes, with many failed attempts including R1.2 billion on a corrupt contract under Brian Hlongwa.

We now have yet another suspect company awarded the contract for a health information system which it won’t deliver.

There is one sense in which the Gauteng Health Department is not inefficient at all. It is in fact very efficient at benefiting the crooks who get paid for contracts that charge outrageous prices or don’t deliver at all.

Babita Deokaran uncovered the tip of a vast iceberg of corrupt syndicates siphoning off money needed to treat patients.

The SIU found that more than R1 billion was misspent on corrupt contracts over three years at the Tembisa Hospital. Just think how that money could have been spent providing hospital services instead of buying skinny jeans and R5000 armchairs.

The corruption machine in this department is very efficient indeed. It’s quite likely that at least 20% of the R20 billion goods and services budget is lost due to corruption. That’s about R4 billion in total every year.

It’s an Eskom level of corruption that is literally killing people because ambulances don’t arrive on time, machines aren’t working, or there are too few ICU beds.

Madam MEC, you are surrounded by snakes and you won’t make any progress until they are identified and dismissed.

I am sure the lifestyle audits you mentioned this week will be a revelation.

I am reminded of what Kgalema Motlanthe said in 2007 when he was ANC Secretary-General:

“This rot is across the board … Almost every project is conceived because it offers opportunities for certain people to make money.”

The Honourable MEC rightly praised the Gift of the Givers for raising R60 million to build a state-of-the-art stores facility in record time at the Charlotte Maxeke Johannesburg Hospital.

This is very worthy, but we have to ask why the department is incapable of doing this itself, or even simple things like drilling a borehole for water.

I would guess that if the Gauteng Infrastructure Development Department was involved it would cost R200 million and take three years because the first contractor won’t be able to do it, and another contractor would have to finish the job.

Now just imagine if the Gift of the Givers ran the Gauteng Health Department.

What would they do with a R60 billion budget?

This is really the standard that we should be aiming at.

We need more private/public partnerships like the new project that involves Section 27, the Cancer Alliance and private hospitals to cut the backlog of cancer treatment.

But we don’t need a state pharmacy which is likely to be just another sinkhole of waste and inefficiency, with money diverted to politically connected people.

I don’t want to paint all doom and gloom with this department because there are some amazing people who do their best to innovate and selflessly dedicate themselves to their patients.

It’s really wonderful that Sebokeng Hospital can now do brain surgery.

There is vast expertise in our university medical schools that should also be brought on board.

There is really so much opportunity, but it’s currently drowned by bureaucracy and the crooks and incompetents that proliferate in this department.

For the record, the DA is voting against this budget because of the continuing failure to spend effectively and efficiently to meet the health needs in our province.

These failures include the following:

1. late payments of suppliers and staff
2. poor emergency ambulance response times
3. unsafe hospital buildings
4. the high number of acting personnel in senior positions
5. massive irregular spending on security and other contracts
6. lack of progress in implementing a health information system
7. worrying numbers of infant deaths and maternal mortality
8. non-achievement of vaccination targets
9. huge waiting lists for surgery

I could add to this, but you get the picture. The reality is that budget objectives will only be met when the Auditor General’s recommendations are fully implemented, and he can issue a clean report.

119 abandoned babies at Gauteng hospitals last year

The tragedy of abandoned babies continues in Gauteng with 119 babies left without parents at hospitals last year.

This compares with 145 abandoned babies in 2020, and 56 babies abandoned in Gauteng hospital from January to August this year.

These figures are disclosed by the Gauteng Health Department in a written reply to my questions in the Gauteng Legislature.

Thelle Mogoerane Hospital was the worst affected, with 15 abandoned babies last year.

Other hospitals with significant numbers include the following:

Tembisa Hospital – 13
Chris Hani Baragwanath Hospital – 12
Charlotte Maxeke Johannesburg Hospital – 12
Leratong Hospital – 11
George Mukhari Hospital – 10
Far East Rand Hospital – 7
Sebokeng – 7
Edenvale Hospital – 6
Mamelodi Hospital – 5

The hospitals all identify the poor socio-economic background of mothers as a major reason for babies abandoned in their wards.

Other reasons include the following:

• babies born from broken relationships.
• deliberate furnishing of wrong identifying details by migrant mothers due to fear of deportation.
• babies born disabled, so mothers abandon them.
• unplanned pregnancies.
• poor support system, fear of rejection by partner or family.
• teenagers conceal their pregnancies to avoid social stigmatisation.
• sex workers with repeat deliveries.
• admitted substance abuse mothers give birth then abandon babies because they need a quick fix.

Missing or wrong contact details for mothers is frequently mentioned by hospitals.

Some babies are brought to hospital after they are dumped in the veld, streets or dustbins.

The Covid pandemic worsened the socio-economic circumstances that lead to abandoned babies.

It is clear that this is a tragic and multi-faceted issue which needs a variety of preventive measures.

These measures should include family preservation, and better provision of contraceptive services, especially to teenagers

One example given is a doctor at Pholosong hospital who goes to schools to educate teenagers not to fall pregnant.

There are worthy NGOs who do good work in this area as well.

The support options for new mothers at risk should be strengthened and communicated widely so that no mother ever feels forced to leave her child forever.

R1.6 billion new claims for medical negligence in Gauteng hospitals

The Gauteng Health Department has received 157 new summonses in the last year which claim R1.6 billion for medical negligence.

This information is disclosed in a presentation by the department at a meeting of the Gauteng Legislature’s Health Committee.

According to the department, medical-legal litigation continues to increase and “extraordinary measures must be taken to prevent a possible collapse of the health care system.”

The department also identifies the legal attachment of funds as “a huge challenge to the financial sustainability of the department” as they “diminish the ability of the department to render health services to patients as it is obliged to do in terms of section 27 of the Constitution.”

The department has been refused extra funding to pay for adverse judgements which is why its own funds are attached by creditors.

The department acknowledges that “the root cause of all medico-legal litigation is negligence which occurs in the hospitals and clinics.”

It is distressing that every year hundreds of patients suffer horribly because of avoidable medical negligence in Gauteng public hospitals.

I am alarmed that negligence claims are increasing rather than decreasing, which highlights the continuing failure to fix the deep-rooted problems in this department.

Our hospitals urgently need better management, the filling of staff vacancies, and proper equipment, especially in maternity units where most of the court cases arise because of babies injured at birth.

Porters carry patients and dead bodies on stairs as lifts are broken at South Rand Hospital

The three lifts at the South Rand Hospital in south Johannesburg have been broken for more than three weeks, forcing porters to carry patients and even dead bodies on the stairs.

These lifts have not been fixed since breaking in mid-January because the Gauteng Department of Infrastructure Development has not paid the lift maintenance contract.

Meanwhile, patients must be carried up and down stairs to have surgery, and dead bodies are carried down to the basement mortuary of this 7-storey building.

Food for patients is carried up the stairs, causing great stress for staff. A cleaner fell while hauling up a large pot of porridge but was fortunately not injured.

Lifts have also failed at other Gauteng public hospitals, including the Charlotte Maxeke Johannesburg Hospital and the Steve Biko Hospital.

It is disgraceful that something as simple as keeping lifts in good order is not achieved in our hospitals which suffer from years of neglect in maintenance of facilities.

This is aggravated by the failure to pay contractors because of bad financial management.

I have alerted Gauteng Health MEC Nomathemba Mokgethi to this dire situation which needs her urgent attention.

Gauteng Health fails to pay 78% of suppliers within the required 30 days

Despite promises to improve financial management, the Gauteng Health Department only pays 22% of suppliers within 30 days as required by law.

This is revealed in the recently released Third Quarterly Report of the Gauteng Health Department which covers the period from October to December last year.

According to the report, the failure to pay suppliers on time is “because of payment of Accruals and PPEs including the impact of staff rotation arrangements during Covid which also impacted on processing of payments.”

This is a poor excuse which reflects continuing poor financial management.

Late payments are particularly harsh for township businesses and small businesses which the department is supposed to be encouraging.

Some companies refuse to do business with the department because of slow and irregular payments that can stretch into years of delay.

Speedy payments are the best way to assist small business that supply goods to the department.

Gauteng should follow the example of the Western Cape provincial government which makes most of its payments within 15 days.


145 abandoned babies at Gauteng hospitals last year

Last year was a bad year for abandoned babies in Gauteng, with 145 babies left without their mothers at Gauteng public hospitals.

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

Thelle Moegerane Hospital in Vosloorus in 2020 had 51 abandoned babies in 2020, and other hospitals with large numbers of abandoned babies were as follows:

Leratong Hospital – 14 babies

Charlotte Maxeke Johannesburg Hospital – 13 babies

Chris Hani Baragwanath Hospital – 12 babies

Tembisa Hospital – 10 babies

Tambo Memorial – 5 babies

According to Mokgethi, the reasons for abandoned babies include the following:

  • The baby is disabled
  • The mother is a teenager
  • Unwanted pregnancies/unplanned pregnancies
  • Lack of support (emotional/financial) from the father of the baby
  • Socio economic issues
  • Undocumented and foreign mothers
  • Mental illness
  • Substance abuse
  • Relationship problems

Mokgethi says that hospital social workers assist nurses to identify new mothers at risk for abandonment, and they try to get accurate contact numbers for the mothers. They can also provide a donation of basic pack of clothes and toiletries for the newborn and a dignity pack and basic items for the mother.

It is immensely distressing that there are so many abandoned babies due to deep-rooted problems in our society. There are also babies who are abandoned outside hospitals who do not survive.

There are worthy NGOs who do good work in this area. The support options for new mothers at risk should be strengthened and communicated widely so that no mother ever feels forced to leave her child for social reasons.


Death of whistle-blower in PPE tender scandal an indictment on the Gauteng government

The failure of the South African Police Service (SAPS) to protect key whistle-blower, Babita Deokaran in the Personal Protection Equipment (PPE) scandal is a clear indictment on the Gauteng government.

Babita, who was the Gauteng Department of Health’s Chief Director of Financial Accounting officer was brave and courageous enough to come forward with information on corruption in the PPE tenders, instead, she was rewarded with a hail of bullets.

This week I have written to the Ahmed Kathrada Foundation to assure them that we will continue to put pressure on the provincial government to release the Special Investigating Unit’s (SIU) reports on the various investigations they have undertaken in the province including that of the procurement of PPE in the province.

This is worrying and is a huge setback in the fight against corruption in government and the public sector.

It is clear that our country is being held hostage by an ingrained culture of corruption and criminality which has now reached the point of no return.

The rot in our government needs to be exposed and now is the time for all parts of society, civic organisations and political parties to unite against the scourge of corruption.

Babita’s death cannot be in vain, and the DA will continue to expose the rampant looting of our government departments and entities.

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Gauteng Health spends R17.6 million on corruption investigations but no money recovered as hospital services suffer

The Gauteng Health Department has spent R17.6 million on 12 corruption investigations since January 2018, but has recovered no money that is desperately needed to provide hospital services for sick patients.

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

According to Mokgethi, only 4 of the investigations have concluded and they concerned the following: 

• Fraudulent deposits at Tambo Memorial Hospital 

• Fraudulent activities regarding Motor Vehicle Accidents (MVAs) at Thelle Mogoerane Hospital

• Procurement irregularities at Emergency Medical Services (EMS)

• R500 million wasted on the V-Block data storage contract

Nobody was fired as a result of these investigations although disciplinary warnings were given and 6 officials involved with the V-Block matter resigned.

I am astounded that no criminal charges were laid as a result of the investigations, and not a single cent of funds recovered. In the case of the R500 million V-Block scandal, this should surely have resulted in criminal charges against the implicated officials. And why was money not recovered in this case?

Eight other investigations are still ongoing into various fraud and corruption cases.

The most expensive investigation is costing R3.4 million, and is looking at human resource and supply chain irregularities at the Bheki Mlangeni Hospital in Soweto.

I suspect that the department is being ripped off by expensive legal firms who conduct these investigations.

In many cases the investigation costs more than what is alleged to have been stolen!

The department needs to have effective measures to prevent theft and fraud in the first place. But if it occurs, the investigations should be cost-effective and speedy, with stolen money recovered and the culprits charged in court.

The DA calls for the department to review the exorbitant cost of investigations by legal firms, and to ensure that criminal charges are always laid where indicated. The in-house capacity for investigations should also be expanded.

These measures will enable more money to be spent on the department’s prime purpose to provide quality health services to sick people.

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R32.5 million wasted on Cuban doctors

The Gauteng Health Department took R32.5 million out of its HIV/AIDS grant to pay 28 Cuban doctors for a year’s service on Covid-19 related activities even though no local need for them had been identified.

This wasteful and misdirected spending was disclosed by Gauteng Health MEC Nomathemba Mokgethi in a written reply to my questions in the Gauteng Legislature.

According to Mokgethi, the Cuban Brigade doctors were employed from 15 May 2020 to 30 May 2021. Their work “ranged from advisory, health data specialists, Public Health specialist care, consulting with patients and total health care delivery.”

Their one-year salaries ranged from R858 000 for a Biostatistician to R1.58 million for a specialised Medical Doctor.

Mokgethi says that their employment “was as a result of a Government to Government agreement entered into by South Africa and Cuba to fight the Covid-19 pandemic.”

The budget for them was taken from Covid components of the HIV/AIDS grant, which is surely irregular. It appears that Gauteng was forced to fit in with the nationally imposed decision to use Cuban doctors even though no local need was identified.

I doubt whether these doctors did anything that local doctors could not have done more cost-effectively.

It’s yet another example of the ANC’s Cuba obsession that diverts money that should be used to save lives of patients in our crumbling hospitals.

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