Baby deaths increase at Tembisa Hospital

Despite a lower number of deliveries, baby deaths have increased in the last three years at the Tembisa Hospital, with 280 deaths in 2022, up from 271 deaths in 2021, and 237 deaths in 2020.

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

A total of 50 661 babies were born at the hospital in this period (17 122 in 2020, 17 054 in 2021, and 16 485 in 2022).

The causes given for the 788 baby deaths are due to infections, immaturity related, hypoxia (lack of oxygen) and congenital anomalies.

I am concerned that the percentage of deaths from infections has risen to 37%, which is much higher than the 25.1% infection deaths in 2020. Hypoxia deaths are also up to 15.2%, compared to 11% last year and 14.8% the year before. This is a disturbing upward trend in deaths from causes that could probably have been avoided with better care.

There are currently 32 vacant posts in the neo-natal and maternity wards, and alarming equipment shortages that include the following:

• 1 x EEG machine
• 2 x therapeutic cooling machines
• 1 x MRI scan
• 2 x iStat machines for urgent ABG +Electrolytes
• 1 x Ultrasound machine with Cranial and Cardiac Probes
• 15 x infant weighing scales

There is also a shortage of consumables for all critical care equipment e.g. oscillator/ventilator circuits.

The Department claims “there is no definitive cases of negligence established”, but admits to “an issue of resource constraints due to issue of overwhelming number of patients.”

As in the case of baby deaths at the Chris Hani Baragwanath Hospital, they seem to be in denial that many babies could have been saved if there were adequate staff and equipment.

Tembisa Hospital has been rocked by scandal due to massive irregular and wasted spending amounting to R1 billion over the last three years according to a SIU report.

This shows that it is not a shortage of money, but a shortage of competent and honest management that dooms many babies to death from avoidable causes.

I will continue to campaign for full accountability for the management disaster at Tembisa Hospital, which needs to prioritise patients, not greedy thieves and incapable people.

Top legal posts vacant as Gauteng Health faces a barrage of negligence claims

The Gauteng Health Department has hundreds of medical negligence cases but 6 out of 26 positions in its Legal Services Unit are vacant, and its lawyers are burdened with about 240 cases each.

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

I am concerned that three critical Director posts are vacant:

Director: Litigation
Director: Mediation
Director: Contracts

A medical doctor post is also vacant, as well as two clerical positions.

Nkomo-Ralehoko says “the ability of this unit to handle legal matters, particularly medical negligence, will be improved once the vacant posts have been filled.”

This Department gets about 150 new medical negligence claims each year, and total claims are more than R16 billion.

Another weakness is poor service contracts that often don’t have penalty clauses for non-performance.

Massive losses are suffered because negligence claims are handled incorrectly, and service delivery suffers when there are defective contracts.

The Department’s Legal unit should be fully staffed with top class people to ensure legal matters are dealt with professionally. This will save money and improve patient care in our hospitals.


Human rights of ostomates violated by Gauteng hospitals

Moves are afoot to refer the Gauteng Health Department to the Human Rights Commission for the poor treatment of ostomates. These are people who have had surgery to create an ostomy, which is an opening for waste to be directed outside the body.

According to a reply by Gauteng Health MEC Nomantu Nkomo-Ralehoko, there are 4224 ostomate patients in Gauteng hospitals, with varying practices concerning how many ostomy bags are given to them.

While most hospitals say they give 10 to 30 bags every month to ostomates, one hospital gives only two bags and patients complain about the poor quality of the bags.

The General Manager of the South African Society of Ostomates (SASO), Faizel Jacobs, has accused the Gauteng Health Department of gross human rights violations, citing cases where patients are unable to go to work or leave their homes due to their condition.

He says bag shortages are common and people experience terrible discomfort with poorly fitted bags which often leak.

In the case of one patient at Helen Joseph Hospital, Jacobs writes: “He asks, how do I go to work? I have no bags – I can’t event take a taxi because I have shit running down my side – I stink! I have not been to work for 3 weeks now!

Ostomates can live fulfilling lives with proper treatment, but too often they face leaking faeces and urine which curses their lives.

Jacobs points out that there are too few trained ostomate nurses, but Groote Schuur Hospital in Cape Town is a model for how ostomates can receive dignified care.

I support his intention to report the Gauteng Health Department to the SA Human Rights Commission if they do not speedily improve treatment for ostomates.

Gauteng Health won’t blacklist non-compliant companies

The Gauteng Health Department will not blacklist the 12 non-compliant companies that got R381 million in contracts from Gauteng hospitals in the last three years.

I asked Gauteng Health MEC Nomantu Nkomo-Ralehoko whether her department would blacklist these companies, and she responded in a written reply:

“A company can only be prevented from doing business with the Department if the
the matter has been investigated and if the investigation report recommends that the
the company must be prevented from doing business with the Department.

The 12 companies are linked to Mr Hangwani Morgan Maumela, a nephew by marriage to President Cyril Ramaphosa. In her previous reply, Nkomo-Ralehoko said “none of the listed companies has SA Health Products Regulatory Authority (SAHPRA) approval for the sale of medical products”, and she blamed “inadequate processes and oversight.”

The companies got R36 million from Tembisa Hospital last year, amongst many payments that murdered Babita Deokaran identified as “possibly fraudulent”.

Maumela has been identified as a central figure in the Tembisa Hospital purchases that Babita flagged. He is reported to have ties with Bejani Chauke, President Cyril Ramaphosa’s chief political advisor.

My view is we don’t need to wait for the conclusion of a lengthy investigation as it is already admitted that the companies were not compliant in various ways and should not have got the contracts.

Quick scrutiny shows outrageous overcharging e.g. Tembisa Hospital paid R456 960 for 50 stainless steel kidney dishes. This amounts to more than R9000 a dish!

Another example is 50 flat-bottomed round bowls bought for R496 555.

This price gouging should surely disqualify companies from any further contracts.

Hospital patients suffer most when huge amounts of money are wasted on fishy companies that grossly inflate the prices of goods.

I will continue to press for a freeze on all new contracts with non-compliant companies that charge ripoff prices

Gauteng is short of 2700 ICU Nurses but no training since three years ago

Gauteng hospitals should have 3340 Intensive Care Unit (ICU) nurses, but only 659 ICU nurses are working, and no new ICU nurses have been trained since 2019.

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

According to Nkomo-Ralehoko, there should be 3340 ICU nurses based on the number of ICU and high care beds and the nurse: patient ratio of 1:1 for the ICU and 1:2 for the High Care Unit.

She says there are 317 specialised nurses posts that are vacant because of the shortage of ICU nurses.

But the training of ICU nurses was discontinued in 2020 because “the old programme of a post basic has been discontinued as the new programmes that are aligned with Higher Education Qualification Sub Framework are to be implemented.”

Approval for the training of Critical
Care Nurses is awaited from the Council for Higher Education, and the programme needs to be registered with the SA Qualifications Authority. But only 85 critical care students will be trained annually in the enrolment plan approved by the SA Nursing Council (SANC).

It is unbelievable that nurse training is halted by red tape and incompetence. Many patients die because they don’t get proper care in understaffed ICUs.

And the waiting lists for operations get longer because ICU care is required after major surgery.

Meanwhile, the private health sector can train many more nurses but they are limited by the SANC.

The DA is pushing in parliament for the lifting of irrational restrictions on nurse training, and the expedited approval of training programmes.

Rapid expansion of nurse training in both private and public sectors is needed to counter the massive shortage of specialised nurses.

Charlotte Maxeke Hospital short of more than 1000 parking spaces

The Charlotte Maxeke Johannesburg Hospital has made slow progress in providing parking to replace what was destroyed in the fire 18 months ago, with a shortage of more than 1000 parking spaces.

According to a written reply by Gauteng Health MEC Nomantu Nkomo-Ralehoko to my questions in the Gauteng Legislature, the hospital used to have 1700 on-site parking bays, but now has only 229 bays in the hospital and 400 nearby.

This means there are 1071 fewer parking bays than previously.

Alternative parking is provided at the Nelson Mandela Children’s Hospital (140 bays), 120 at the Johannesburg College, 80 at the hospital residence, and 60 at the Wits Web Help Building.

I have proposed that the hospital use the parking at the province-owned Emoyeni Conference Centre which is opposite the hospital. Nkomo-Ralehoko says that the hospital requested parking at Emoyeni from the Department of Infrastructure Development (DID) in October 2021, but was informed
that the parking bays are not accessible as it was privately leased.

Confusingly, she says that her department “will approach the Department of Land Affairs through National Department of Health to negotiate the use of parking at Emoyeni.”

An extra 300 rebuilt parking bays are supposed to be available on 6 November this year, and the hospital has approached Wits University and KPMG for more off-site parking using shuttle services.

Meanwhile, hundreds of staff and patients are frustrated every day as they hunt for parking and walk long distances to get to the hospital.

It shows the poor leadership of CMJH CEO Gladys Bogoshi who should have pushed far earlier for solutions to alleviate this parking crisis.

For instance, why are they only now approaching the Department of Land Affairs in order to use the Emoyeni parking?

The DA proposes that hospital CEOs be appointed using rigorous criteria to ensure that only tiptop people are chosen who get things done, instead of weak CEOs chosen for political reasons.

Patients suffer as aircon failure cancels ops at Steve Biko hospital

Patients at the Steve Biko Hospital are suffering as all non-urgent operations have been cancelled after air-conditioning at the theatres broke down on Wednesday last week.

With the hot weather experienced lately, the risk of infection is too high to do surgery without air-conditioning as this can lead to infection.

I have received complaints about patients who have been in the hospital for more than month who are waiting for their surgery.

It is yet another maintenance failure by the Department of Infrastructure Development (DID), which keeps appointing incompetent contractors who can’t do the job.

In this case, the first contractor couldn’t fix the chillers, and a new contractor had to be appointed yesterday. The hospital hopes that the chillers can be fixed by Friday this week.

This hospital has also suffered from broken lifts which disrupted surgery as patients could not be transported between floors.

The DA has long proposed that maintenance be devolved to major hospitals like Steve Biko which can do a better job than the dysfunctional and corrupt DID.

Meanwhile, surgeons stand idle and the surgery waiting lists get longer, while patients suffer in wards instead of being discharged after their surgery.

Gauteng Health employee paid R4.7m to stay at home

The Gauteng Health Department has paid its top legal head R4.7 million to stay at home since July 2019.

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

According to Mokgethi, Advocate Lebeloane Mpelegeng is Chief Director: Legal Services, but was told to stay at home following a Public Service Commission report on her appointment that found irregularities in her transfer from the Department of Water and Sanitation.

The PSC recommended that the department apply to the Labour Court “without delay” to set aside her transfer to the Department.

The Department made the application to the Labour Court on 18 November 2020, but Mpelegeng opposed it.

Mokgethi says that the Court Registrar has indicated that a date for this matter will only be set in 2023, and “The Department wants to see the matter concluded as speedily as possible, however, remains constrained by the Court’s processes which are outside the Department’s control.”

Meanwhile, there is an acting person in her job, and she has been paid R4 681 700 for the period 1 July 2019 to 30 September 2022.

This is an enormous sum of money to pay for a botched appointment.

It could have paid for 10 senior nurses for a year at our understaffed hospitals.

Lebeloane has a chequered history with the Department – she was former Health MEC Gwen Ramokhopa’s personal assistant when she was fired in January 2006 for misusing state property, but was later absolved on appeal. When Ramokgopa returned as Health MEC in February 2017, she recruited Lebeloane to get her buddy back into the department.

The PSC investigated Lebeloane after complaints about her high-handed management style.

I am appalled that the department’s mismanagement has wasted so much money that should be used to provide better care for hospital patients.

I will continue to expose the appointments of buddies in this department and the protection of cadres like the suspended Tembisa Hospital CEO Ashley Mthunzi.

The DA’s policy of a merit-based public service is needed to fix this ailing department.


Year-long postponement in Hlongwa corruption case highlights failure to all-or-nothing approach

The Democratic Alliance notes the year-long postponement of the corruption case against former Gauteng Health MEC Brian Hlongwa, his wife Jolene and five others, who are facing 258 charges that include fraud, corruption, money laundering and racketeering.

This postponement was granted yesterday at the request of the State as they were applying for the extradition of one of the accused – businessman Richard Payne – from an undisclosed country, and also because one of the accused is appealing a racketeering certificate.

It is very disappointing that this case continues to drag out for events that occurred 14 years ago, including 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.

There is strong evidence that Hlongwa received kickbacks from other tenders issued when he was the Health MEC.

The Gauteng Health Department has never recovered from this early example of state capture which diverted money that should have been used to treat patients in our hospitals.

It is said that justice delayed is justice denied. Hlongwa received political protection against corruption charges for years, and state incapacity could drag it out for many more years as well.

What hope is there that recent cases like the PPE corruption and the R850 million fishy Tembisa Hospital payments will ever get to court in good time?

It does not look like there will be justice anytime soon for the 144 mental patients who died in the Life Esidimeni scandal six years ago.

The state simply does not have the resources to speedily prosecute and convict corruption cases. There are all the Zondo commission cases, and more corruption in government departments is revealed all the time.

My view is that success is far more likely by selecting the easiest-to-prove charges in complicated corruption cases, so that implicated people get convicted for at least something.

My fear is that the all-or-nothing approach can end up with nothing.

There are lots of lesser charges that Hlongwa and his colleagues could have faced in court long ago, without the potential for endless stalling tactics.

The cancer of corruption will only be stopped when crooked people are speedily charged and convicted.

DA refers appointment of Tembisa hospital CEO to the Public Protector

Following the Gauteng Health Department’s bizarre about-turn on whether the Tembisa Hospital CEO Ashley Mthunzi was facing disciplinary charges when he was appointed last year, I have referred this matter to the Public Protector for investigation.

The Department accuses me of “sensational allegations” and “deliberate distortion of facts” after I stated that Dr Mthunzi was appointed even though he was facing a disciplinary charge which should have disqualified him.

I based my statement on an official reply by Gauteng Health MEC Nomathemba Mokgethi (see here) in which she says as follows:

“On 15 September 2021, the acting Head of Department, Dr Sibongile Zungu approved recommendations that Dr A Mthunzi should be disciplined for contravening the Recruitment and Selection Policy. The Labour Relations Directorate was supposed to implement the said recommendations.”

When I asked who provided the false information that he had not been found guilty on any misconduct charge, the reply was that it was the former Acting DDG: Hospital Services Mr Freddy Kgongwana.

According to Mokgethi: “The Selection Committee did not have knowledge or information on Dr Mthunzi’s pending disciplinary hearing whilst at Pholosong Hospital”, and the reason is that “The Selection Committee was not aware as the information was not in his personal [file] nor in the register of pending disciplinary cases.”

It is clear from the above that Mthunzi was indeed facing a disciplinary hearing when he was at Pholosong Hospital, and that it was wrong that this information was not given to the Selection Committee.

Why is the department now contradicting an official reply by the Health MEC?

While they concede that the former Acting Head of Department signed a report recommending that Mthunzi be given a final written warning, which confirms that he was facing a disciplinary charge, they now claim it was invalid as they did not provide Mthunzi the opportunity to respond.

I do not believe this is true. It’s a cover-up by Mthunzi’s buddies in the department who are trying to shield him as they are themselves implicated in irregular activities.

It confirms my suspicion that there was a plot to get Mthunzi appointed at Tembisa Hospital, which was followed by a surge of payments to suspicious companies that murdered whistleblower Babita Deokaran says were “possibly corrupt”. She requested a forensic audit but it was never done.

The Public Protector is already investigating the alleged irregular appointment of the Department’s CFO Lerato Madyo after a whistleblower referred it to them and also a referral by myself to the PSC which passed it on to them.

We need to expose the sinister network at the Department that colluded in massive theft while patients suffer in under-staffed and poorly equipped hospitals.