1954 deaths due to negligence in Gauteng hospitals

Gauteng public hospitals recorded 1954 deaths last year due to Severe Adverse Events (SAEs), which are defined as unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient.

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

According to Mokgethi, these deaths gave rise to only 28 disciplinary cases. How can there be so few disciplinary cases in this matter?

These SAEs have so far resulted in 13 litigation cases, and 31 referrals for mediation.

The worst hospital by far was Kalafong hospital which had an astounding 1015 SAEs last year.

This compares to the similar-size Helen Joseph and Tembisa hospitals which had 587 and 626 SAEs respectively, which are also unacceptably high.

The four large academic hospitals had the following number of SAEs:

• Chris Hani Baragwanath Hospital – 854 SAEs
• George Mukhari Hospital – 453 SAEs
• Steve Biko Hospital – 330 SAEs
• Charlotte Maxeke Johannesburg Hospital- 212 SAEs

Other hospitals with disturbingly high SAEs in relation to their patient numbers include the following:

• Leratong Hospital – 395 SAEs
• Weskoppies Psychiatric Hospital – 367 SAEs
• Pholosong Hospital – 239 SAEs
• Sebokeng Hospital – 206 SAEs
• Mamelodi Hospital – 194 SAEs
• Edenvale Hospital – 157 SAEs
• Bertha Gxowa Hospital – 134 SAEs
• Jubilee Hospital – 122 SAEs
• Bheki Mlangeni Hospital – 118 SAEs

It is horrifying that there have been so many deaths and injuries to patients because of avoidable negligence.

This is why medical negligence claims continue to rocket, with courts awarding massive payouts.

Hospitals should be only about healing rather than places where patients are harmed.

The Gauteng Health Department needs to drastically improve hospital management, and ensure there are adequate and well-trained staff with proper equipment.

 

Seven hundred and eighty -five ops cancelled at Charlotte Maxeke hospital as 2677 patients wait for surgery

Over 780 operations were cancelled at the Charlotte Maxeke Johannesburg Hospital last year, worsening the long waiting lists for surgery which has grown to 2677 patients.

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

Paediatric surgery was the most affected, with 610 cancelled operations. The other cancellations were as follows:

• 80 Cardiothoracic ops cancelled
• 40 Gastrointestinal ops cancelled
• 25 Breast clinic, Endocrine and Soft Tissue ops cancelled
• 20 Neurosurgery ops cancelled
• 10 Ear, Nose and Throat (ENT) ops cancelled

The largest waiting list is for Orthopaedics, with 833 patients who could wait up to two years for surgery.

Paediatric surgery has 453 child patients who will wait between 6 months and two years.

There are 200 cataract patients who will wait between 6 and 8 months for surgery, 137 neurosurgery patients will wait for six months, and 109 urology patients will wait between 4 and 6 months.

I think these figures underestimate the true situation as it does not include the long waiting periods for many patients to be diagnosed by a specialist before they are placed on the waiting lists for surgery.

Insufficient theatre time and the shortage of ICU beds are the major reasons for the cancellation of operations.

Disruption from Covid-19 and the partial closure of the hospital due to the fire in April last year are other factors.

It’s particularly upsetting that many children suffer from the surgery delays.

This highlights the need to fully re-open the hospital as soon as possible, and to expand the operating theatre and ICU capacity in order to drastically cut the surgery waiting lists.

Injured child turned away from Alexandra Clinic as generator was broken

A family in Alexandra township is mourning the death of their 4-year-old child who was injured on Wednesday this week in a car accident, but they were turned away from the Alexandra Health Centre at 5 pm after security guards told them the clinic had no electricity as the generator was not working.

According to the family, the child died from his injuries when they tried to take him to a hospital.

I have taken up this tragic case with Health MEC Nomathemba Mokgethi, and it has been confirmed that the generator is broken because it exploded during the frequent load-shedding.

While the investigation into this matter is continuing, it is inexcusable that a generator at a large clinic has been out of action for two weeks.

This highlights once again the incompetence of the Gauteng Infrastructure Development Department which is responsible for the maintenance and repair of all generators at healthcare facilities.

Other health facilities in Gauteng that have suffered from failed generators include the Badirile and Thusong clinics on the West Rand, and the Far East Rand Hospital ran out of fuel for one of its generators two weeks ago.

Broken generators should never be a reason for turning people away from a health facility.

More delay in release of Bank of Lisbon fire reports

Three firefighters died in the Bank of Lisbon fire which burnt the entire building on 5 September 2018, but there is more delay in releasing the findings of four investigations into this fire.

According to a written reply by Premier David Makhura to my questions in the Gauteng Legislature:

“… various investigations are required to

be undertaken by different State

Institutions into the fire at the Bank

of Lisbon Building … The Office of the Premier is coordinating with all agencies to

ensure that all investigations are

completed. To date, two reports have

been received and two are still

outstanding. The South African

Police Service has indicated that their

case/file was handed in at the

Johannesburg Magisterial Court on

the 25th of January 2022 and is still

awaiting the decision of the

Magistrate of the Inquest Court. The

Department of Labour has requested

to submit the report in the month of

July 2022.”

Last year, however, Makhura said in a written reply to my questions that the findings would be made public in October 2021.

Why is there endless stalling and shifting of dates as to when we will know the truth about the fire which started suspiciously at the head office of the Gauteng Health Department?

I suspect the delay is because the findings implicate senior ANC politicians and officials who failed to take legally required preventive measures. They could even face criminal charges.

Immediately after the fire I laid criminal charges of culpable homicide against then Health MEC Gwen Ramokgopa and Infrastructure Development MEC Jacob Mamabolo for negligence in not setting up a functioning Occupational Health and Safety Committee for the building, and for ignoring multiple warnings from unions and staff about the fire hazard.

The four investigations are by the South African Police Service (SAPS), the City of Johannesburg, the Provincial Government, and the Department of Labour.

Makura says that “as soon as all the reports are

received, the Office of the Premier

will provide them to the Gauteng

Provincial Legislature.”

But why not make public the two reports that have already been completed?

After nearly four years, all these investigations should have been completed, but endless investigations allow politicians to evade accountability.

It’s either gross incompetence or a deliberate cover-up.

The same problem afflicts the investigation into the devastating fire at the Charlotte Maxeke Johannesburg Hospital in April last year.

Meanwhile, the families of the firefighters who died still do not have closure for the loss of their loved ones.

I will continue to press for all fire reports to be made public so that there is no cover-up and those at fault are held accountable.

Devastating effect of load-shedding on Gauteng hospitals

I am most concerned by the devastating impact of load shedding on Gauteng’s public hospitals and clinics, including some serious incidents of generators not working.

Even though the Far East Rand Hospital has been exempted by the local municipality from loadshedding, the hospital generators had to kick in on Saturday after a fault at the local power station. On Sunday, however, one of the hospital’s two generators ran out of diesel at 9am and new diesel was only available two hours later.

At the Charlotte Maxeke Johannesburg Hospital, the head of internal medicine Professor Adam Mohammed has described the situation when power goes off as “playing Russian roulette with our patients.”

Rahima Moosa Mother and Child hospital has also been badly affected by the power cuts, as detailed by Dr Tim de Maayer in his anguished open letter in May this year.

In Kagiso on the West Rand, the Thusong clinic has been without power since Wednesday last week, with no diesel to work the generator. Nurses do their best to see patients in the dark or outside, but their equipment does not work without electricity.

There is no excuse for running out of diesel, and proper management is needed to ensure it is always available.

But the sad reality is that batteries and generators were not designed to cope with frequent load shedding, so the lives of patients are endangered when this occurs.

Hospitals cannot operate fully even when generators work as their power is only enough for emergency surgery.

It’s not just Eskom power cuts – Chris Hani Baragwanath Hospital has sometimes cancelled surgery because of power loss from cable theft.

This is all terribly stressful for hospital staff and patients.

Hospitals should be exempted from Eskom power cuts wherever possible, and generators should always be in working order to mitigate the effects of unreliable power supply.

 

 

861 urology patients at Bara Hospital wait up to three years for surgery

861 urology patients are on the waiting list for surgery at the Chris Hani Baragwanath Hospital (CHBH), some of whom will have to wait as long as three years.

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

There are 10 patients who will wait between two and six weeks for surgery for cancer of the testes, kidney, or bladder, but the worst wait is for 250 patients with benign prostate cancer and 120 patients with urethral stricture (narrowing) who will wait between two and three years.

Other waiting times are as follows:

  • 6 months for 60 malignant prostate cancer patients
  • 2 years for 171 adult patients with undescended testes
  • 1 to 2 years for 150 patients with hydrocele (swelling in the testicle)
  • 6 to 12 months for 100 patients with incontinence

These are very long times to wait for painful conditions, and lives are at risk in the case of cancer delays.

According to Mokgethi, reasons for the long waiting times include the following:

  • many referrals from clinics are un-booked and walk-ins are common.
  • only one of the two urology operating theatres is currently used as the other one is dedicated to Covid-19 cases.
  • cable theft and electricity disruptions/water disruptions/linen shortages all continue to slow services.
  • extra patients from the Charlotte Maxeke Johannesburg Hospital

This very busy urology department sees more than 200 patients a day and needs two more nurses to provide a proper service to them.

It would help if extra capacity was built up at other hospitals to treat urology patients at an earlier stage and only refer the serious cases to CHBH.

Reliable electricity supply and clean linen would also cut down on the serious problem of cancelled operations.

 

 

Patients suffer and R4.8 million is lost as computers break down at George Mukhari Hospital

Patient care has been badly affected at the George Mukhari Hospital in north-west Gauteng due to the breakdown of their computer system, which has also resulted in a revenue loss of R4.8 million.

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

According to Mokgethi, the Medicom system at the hospital has not been functional since 23 January this year. The infrastructure equipment for Medicom was acquired between 2011 and 2012, but it was no longer under warranty or supported by the original manufacturer.

Mokgethi says that “as a result of continuous exposure to occasional power outages and the age of the equipment, the equipment was compromised and failed.”

The result for patients is “a huge negative impact on service delivery” as old patient files cannot be retrieved and new paper files have to be opened. Furthermore, there is “inability to retrieve files for medico-legal cases, Road Accident Fund claims, follow-up of information for SA National Blood Services, follow-up of complaints lodged.”

Manual registers are being used instead, which require “intense monitoring” as they have drawbacks that include:

  1. High risk of fraud
  2. It can be stolen or misplaced
  3. There is no backup

The estimated revenue loss because patients cannot be properly billed and debts followed up is estimated at R4.8 million.

The Department concedes that this outdated system cannot be fixed and says that the hospital has been prioritised for the new health information system which they envisage will start on 11 July 2022.

The reason that patients are still suffering from an outdated system is because of massive corruption under former Health MEC Brian Hlongwa who is currently on bail facing charges of fraud, corruption, money laundering and racketeering along with former senior Gauteng Health officials.

One of the charges is the award of a R1.2 billion tender to the Baoki consortium in 2008 to set up a health information system and electronic health record. They were paid more than R400 million before their contract was cancelled a year later with no system installed.

I have long advocated a new health information system and I hope they finally get this right as it is crucial to improve efficiency and to cut queues for patients.

 

Abandoned Kempton Park Hospital used for alleged criminal activities

The abandoned Kempton Park Hospital is now allegedly being used for criminal activities instead of being refurbished and re-opened to help to ease pressure at Tembisa and Edenvale Hospital, which are currently overcrowded and unable to render adequate healthcare services.

 

Residents of Kempton Park cannot continue to travel long distances to Tembisa and Edenvale Hospital to receive healthcare services, while their nearest hospital has been abandoned.

 

The DA conducted an oversight inspection at the abandoned Kempton Park Hospital following numerous complaints from the residents about the alleged criminal activities happening in the building. We were disappointed to discover that there were learners in school uniforms from the neighbouring schools inside the abandoned hospital during school hours. These learners have found a new ‘chilling’ spot where they are prone to indulging in alleged criminal activities.

 

The DA will continue to put pressure on both the Gauteng Department of Health and the Department of Infrastructure Development to ensure that this hospital is revamped and re-opened as people in this area are in dire need of this facility. We will be tabling follow-up questions in the Gauteng Provincial Legislature (GPL) to ascertain when the renovations of this hospital will begin and when the hospital will be re-opened.

Heart patients suffer as 4 out of 10 beds out of action at Charlotte Maxeke Hospital

The lives of critically ill heart patients are at risk at the Charlotte Maxeke Johannesburg Hospital (CMJH) as four out of ten acute beds cannot be used as they are in the fire-damaged section.

According to Gauteng Health MEC Nomathemba Mokgethi in a written reply to my questions in the Gauteng Legislature, there are at least two or three acute patients waiting for beds at any one time.

These patients may wait between 24 and 48 hours to get a bed. Mokgethi says that the effect of long waiting times is that:

“some patients may not be treated timeously in a cardiac Intensive Care Unit (ICU) setting but instead cared for in a general ward or at the referring facility. Some patients may deteriorate while waiting to be transferred to tertiary care.”

There are only four cardiology departments in public hospitals in Gauteng, and CMJH takes patients directly from casualty or from 14 referring hospitals.

The CMJH cardiac unit current has 36 nursing staff, but needs a minimum of 48 nursing staff.

New ICU beds are needed at CMJH as the current ones are at the end of their working lives, and they also need 6 new cardiac monitors and 2 new mobile suction units.

It is tragic that the delay in fixing the hospital has led to many severely ill heart patients not getting the best care to save their lives.

Doctors feel hopeless when they lose patients who could have been saved if there was proper staff and equipment.

The DA will continue to press for the urgent upgrade of facilities to provide quality care to all heart patients.

 

 

Over 30 thousand duplicate invoices in one year shows the Gauteng Department of Health is vulnerable to fraud and corruption

The Gauteng Department of Health for the last financial year has received 34 856 duplicate invoices, clearing indicating that measures to prevent this are failing.

This information was revealed to me in a written reply to my questions tabled in the Gauteng Provincial Legislature (GPL) to the MEC for Health, Nomathemba Mokgethi regarding duplicate invoices received from suppliers. The total rand value of the duplicate invoices amounted to R24 256 537 105,09, for the period 1 April 2021 to 31 March 2022.

According to the MEC, the duplication of invoices arises when a Supplier/Service Provider uploads the same invoice more than once on the EIS (Electronic Invoice Submission (EIS) — a system developed by the Gauteng Provincial Government to facilitate the paperless submission of invoices from suppliers. Whilst the suppliers use an Electronic Invoice Submission (EIS) system, a 3-way financial check is done once the invoice has been submitted, however, with the high number of duplicates it would appear as if this system is not being strictly adhered to.

It is deeply concerning that the MEC puts all the blame for duplicate invoices on the suppliers which highlights the inadequate training given to suppliers about the uploading of invoices. There is also a need to refine the system as a matter of urgency to prevent invoices from being uploaded more than once, and the possibility of suppliers using this loophole in the system to defraud the state of taxpayers’ money.

The department in collaboration with the Gauteng Provincial Treasury needs to put in place proper checks and balances to stop the uploading of duplicate invoices as it can potentially result in serious financial losses for the department.

Other departments like Social Development and Education, which has responded to similar questions, have indicated that they did not receive any duplicate invoices from suppliers who use the same system to upload their invoices to the departments for payment.

The DA is demanding that the Department of Health must learn from its counterparts in terms of best practices, so that duplicate invoices can be avoided in future. If this is not done, it might mean that this system is open to fraud and possible corruption.