Patients will suffer as Gauteng cuts doctors’ overtime

Patients will suffer as the Gauteng Health Department is clamping down on overtime for doctors.

According to a circular issued by Mr Lesiba Malotana on 15 February:

“The Department is currently facing a number of challenges on the approval and management of Commuted Overtime. Therefore, it has become necessary to withdraw the delegation to approve overtime applications for the upcoming 2024/25 financial year.

The Corporate Services team is diligently reviewing the policy and procedures governing the approval process. Once this review is finalised, the revised guidelines will promptly be communicated to all Accounting Officers.”

This means that doctors’ overtime will be cut drastically from 1 April, which is the start of the new financial year. It will cause short-staffing at night, on weekends, and on public holidays.

It’s a blow for many doctors who rely on the extra overtime money.

It is unclear why the approval of overtime has become problematic – is it poor administration, or is the Department trying to save money at the expense of doctors and patients?

The DA calls on the Department to reconsider this move and find a way for overtime to continue in a properly approved way.

No lifestyle audits for Gauteng Health Department

No lifestyle audits have been done on any Gauteng Health Department official as the Premier’s Office has been slow to initiate them.

Gauteng Health and Wellness MEC Nomantu Nkomo-Ralehoko disclosed this in a written response to my questions in the Gauteng Legislature.

According to the MEC:

“The department has requested the Office of the Premier to assist with the lifestyle audit for 2021/2022 for the officials as potential candidates for lifestyle audit based on incongruency between their wealth. asset accumulation and remuneration. The department also identified some officials through investigation request from one
of the district offices in 2023.”

The Premier’s Office has all the forensic services but has yet to initiate the requested lifestyle audits.

This shows yet again that Premier Panyaza Lesufi is all bark and no bite. He has promised lifestyle audits but won’t do them because they could implicate ANC cadres.

Compare this to the DA-run Western Cape government where lifestyle audits are taken seriously and expedited.

Lifestyle audits are a vital tool in fighting corruption.

There should be no delay in implementing lifestyle audits to root out the pervasive corruption that leads to poor treatment of patients in crumbling hospitals.

 

Gauteng Premier’s anti-corruption unit is grossly understaffed

Gauteng Premier Panyaza Lesufi’s anti-corruption unit is grossly understaffed, with 20 out of 43 posts vacant, including the head position.

This is revealed by Lesufi in a written reply to my questions in the Gauteng Legislature.

According to Lesufi, the Provincial Forensic Unit does not have a Chief Director, and is short of 4 investigators as well as vacancies in the following positions:

Trainee Level 2 – 9 vacancies
Assistant Director – 3 vacancies
Deputy Director – 1 vacancy
Personal Assistant – 1 vacancy
Administration Clerk – 1 vacancy

Since January this year there have been 10 resignations. Lesufi says the high turnover rate is because of “the high demand of these skills in the market, higher income jobs and career growth.” He says they are head-hunting for a capable and skilled head for the unit.

Last year, there were 76 investigation requests, but 47 (62%) of these are still not concluded. One investigation took more than 8 years to be concluded!

This pathetic unit shows the ANC isn’t serious about rooting out corruption, probably because so many of their buddies are implicated.

The Gauteng provincial government needs a fully staffed and professional internal investigation unit to speedily root out rampant corruption that deprives residents of vital services.

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.

Babita’s assassins must reveal who gave orders

The Democratic Alliance is most concerned that the six men who have admitted guilt in the murder of whistleblower Babita Deokaran should reveal who gave them the orders to kill her.

I hope their plea deal includes as much information as possible about those who wanted to stop Babita uncovering massive corruption at the Tembisa Hospital and elsewhere.

Anything less will be a travesty of justice and a blow to Babita’s family who are commemorating the second anniversary of her murder tomorrow.

Delayed angiogram machine risks lives of heart patients at Charlotte Maxeke Hospital

The Democratic Alliance is concerned that heart patients at the Charlotte Maxeke Johannesburg Hospital are at risk because of the hasty decommissioning of the angiogram machine before the new one arrives in three months time.

This expensive machinery is critical in imaging blocked arteries for vascular surgery to save lives and the limbs of patients with vascular disease.

The old angio suite was supposed to be replaced in 2018, but medical staff were told in early August that it was being decommissioned within a week. They had to inform patients they have to wait for the two new replacement machines to be installed.

It is inexplicable why the old machine is not being used pending the arrival of the new machines which cost about R44.5 million. The delay may be more than three months as rooms need to be renovated to house the new machines.

I will be asking questions in the Gauteng Legislature about this poor planning that risks the lives of heart patients. I will also probe whether corruption is involved in the abrupt sale of the old machine, apparently for scrap.

Lives at risk due to Adrenaline shortage in Gauteng hospitals

The Democratic Alliance is most concerned by the shortage of Adrenaline in Gauteng public hospitals.

Adrenaline injections are used to resuscitate heart attack victims and in other life-threatening medical emergencies.

Doctors at the Chris Hani Baragwanath Hospital have tried to warn of the looming shortage for months, as the contracted company Pharma-Q has fallen short in supplying enough Adrenaline.

Pharma-Q has blamed load-shedding for its failure to supply Adrenaline, but other suppliers are available and should have been approached to supply what is needed.

Yet again, patients suffer because unreliable companies are chosen for essential medical products.

We need a speedy solution to the Adrenaline shortage, but the real problem that needs to be fixed is poor procurement practices, often tainted by corruption.

7143 Adverse events in Gauteng Hospitals

Gauteng public hospitals had 7143 Serious Adverse Events (SAEs) last year, up from 6910 SAEs in 2021 and 4701 SAEs in 2020.

This is revealed by Gauteng Health and Wellness MEC Nomantu Nkomo-Ralehoko in a written reply to my questions in the Gauteng Legislature.

A SAE is defined as an event that results in an unintended harm to the patient by an act of commission or omission rather than the underlying disease or condition of the patient.

Chris Hani Baragwanath Hospital had the highest number of SAEs (1191), followed by Steve Biko Hospital with 528 SEAs, George Mukhari Hospital with 499 SAEs, Leratong Hospital with 480 SAEs, and the Helen Joseph and Kalafong hospitals with 477 SEAs each.

Other hospitals with high SAEs include the following:

  • Charlotte Maxeke Johannesburg Hospital – 409 SAEs
  • Tembisa Hospital – 408 SAEs
  • Weskoppies Hospital – 374 SAEs
  • Pholosong Hospital – 294 SAEs
  • Thelle Mogoerane Hospital- 262 SAEs
  • Rahima Moosa Hospital – 206 SAEs
  • Bheki Mlangeni Hospital – 113 SAEs

While hospitals with more patients can be expected to have more SAEs, certain hospitals seem to have disproportionately high SAEs – this includes the Chris Hani Baragwanath, Leratong and Weskoppies hospitals.

According to the MEC, the circumstances of the injury or death are classified as follows:

• Clinical administration

• Clinical process/procedure

• Healthcare associated infections

• Medication/intravenous fluids

• Blood or blood products

• Medical device/equipment

• Behaviour

• Patient accident

• Pressure ulcers acquired during or after

• Clinical structure/building and fixtures

• Laboratory pathology, and

• Others

Furthermore:

“All serious adverse event cases identified in all facilities are reported within 24 hours of occurrence, immediately investigated, presented to the facility patient safety Incident committee and mortality and morbidity meeting or subjected to clinical review depending on the severity, develop a Quality Improvement to address the gaps identified.”

It is distressing that SAEs continue to increase, leading to injury or death to many patients, as well as soaring claims for medical negligence.

Our hospitals need better management, adequate staff and equipment, proper training, and consequences for non-performance.

DA welcomes suspension of Tembisa Hospital staff implicated in corrupt payments

The Democratic Alliance (DA) welcomes the suspension of the nine officials at the Tembisa Hospital who were recently still working despite the SIU recommending in December last year that they be disciplined over irregular contracts to fraudulent companies.

This was revealed today by Gauteng Premier Panyaza Lesufi in an oral reply to my questions at today’s sitting of the Gauteng Legislature.

According to Lesufi, they have been put on precautionary suspension but he could not give me the date on which they were suspended.

I suspect action was only taken because I previously raised the issue with Health and Wellness MEC Nomantu Nkomo-Ralehoko, and now the Premier was pushed to act because of my questions to him on this matter.

Lesufi says an external service provider was appointed to do the disciplinary process, and he is committed to implementing all the SIU recommendations concerning corruption at the Tembisa Hospital.

He also claimed he was “personally monitoring” it, and that witnesses were being protected. Furthermore, the Justice Department was being continually reminded to process the Presidential Proclamation to extend the SIU investigation at the hospital.

The DA will continue to pressure the provincial government to speedily bring to justice all those involved in the corrupt activities that whistleblower Babita Deokaran wanted to stop before she was murdered.

Her family are suffering from all the delays, including slow progress in convicting her murderers and finding those who hired them.

Lesufi needs to dispel suspicions that the foot-dragging is to protect certain ANC politicians who benefit from the massive corruption at Tembisa Hospital.

 

Why is the new Johannesburg mortuary still not completed

Delays in releasing bodies from the Hillbrow mortuary have caused great distress recently, but the real scandal is why this decrepit facility is still operating when a new mortuary was supposed to have been completed four years ago.

There have been endless delays in building the new mortuary at the Helen Joseph Hospital grounds which was started in November 2016 and was supposed to be completed in November 2019.

According to a written reply to my questions last year, the new building was 71% complete and was supposed to open in January this year.

Despite a budget of R588 million, unpaid contractors were refusing to work on the building.

Delays have also been blamed on poor service by the professional team and change in designs during the construction stage, which has led to additional work and cost increases.

Meanwhile, the old Hillbrow mortuary is plagued by rats, has poor ventilation and a terrible smell as the ozone generator has not worked for eight years.

This has led to poor staff morale and distress for families who visit to see the bodies of their loved ones.

Gauteng Health and Wellness MEC Nomantu Nkomo-Ralehoko needs to account for the unacceptable delay in moving to a modern expanded facility that should have been completed years ago.