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Shocking treatment of psychiatric patients at Charlotte Maxeke Hospital

The Democratic Alliance is appalled by the report today that 30 psychiatric patients are kept in poor conditions in an emergency ward at the Charlotte Maxeke Johannesburg Hospital.

According to a quoted source, these patients “are being kept like animals.” They do not have privacy or direct access to toilets, relieving themselves on the floor or in a bottle as security escort them to toilets only once or twice a day.

Safety is an issue as a patient has attacked a nurse in this ward.

It is utterly shameful that this is happening at our flagship hospital in our province.

I will be pressing the Gauteng Health Department to take urgent measures to provide decent facilities and treatment for these patients.

 

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Child dies after bed and ambulance failure

The Democratic Alliance is most distressed by the death of 6-year-old Oreratile Chabalala as no ambulance was available to transfer him speedily from Odi hospital to a specialist hospital to save his life.

Oreratile had breathing problems on 2 October and was admitted to Odi Hospital in north Gauteng. He needed to be transferred to George Mukhari hospital, but they said they had a bed shortage. When a bed became available there was no ambulance available to transport him, and he died last Saturday.

His devastated family blame the bed and ambulance shortage for delaying treatment that could have saved his life.

This tragic case highlights the hospital and ambulance crisis in Gauteng due to gross mismanagement and corruption.

According to the latest Gauteng Health Department Quarterly Report, only 42% of Priority 1 calls in urban areas were attended to within 30 minutes instead of the 85% target. In rural areas, ambulances reached 83% of P1 calls within 60 minutes instead of the 100% target.

The scandalous thing is that rural ambulances from Bronkhorstspruit have to be used to attend to calls from the George Mukhari, Steve Biko, Mamelodi and Odi hospitals. It is unbelievable that an ambulance is sent to pick up a patient 90 kilometres away!

I will be asking the Gauteng Health Department to urgently investigate Oreratile‘s death as well as the broader service delivery failures that lead to lost lives.

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DA challenges Gauteng Premier on slow action against Tembisa Hospital corruption

Tomorrow (Tuesday 8 August), the Democratic Alliance (DA) will challenge Gauteng Premier Panyaza Lesufi on why 10 staff members at the Tembisa Hospital are still working despite the SIU recommending they be disciplined over irregular contracts to fraudulent companies.

The slow progress on this matter has been outrageous, as whistleblower Babita Deokaran was murdered shortly after requesting that “possible corrupt” payments be halted at this hospital.

I will be asking Lesufi during the Premier’s Question Time why the Acting Head of the Gauteng Health Department did not act swiftly to put the implicated officials on precautionary suspension, as happened with the Department’s Chief Financial Officer and the Tembisa Hospital CEO.

Furthermore, why was the Gauteng Treasury given the task of initiating discipline in this matter instead of the Gauteng Health Department, and why was the Premier’s Office not involved in speeding this up?

The nine officials still at Tembisa Hospital include the Deputy Director: Supply Chain, two Financial clerks, an Admin clerk, a Food Service Manager, Assistant Manager Nursing, Chief Physiotherapist and Physiotherapist, and a Medical Officer.

There should have been no delays in disciplining them as the evidence is readily available in the SIU report which the Premier released in December last year.

I hope Lesufi gives a clear undertaking that all the SIU recommendations are speedily implemented, otherwise it looks like foot-dragging to protect certain ANC politicians who benefit from the massive corruption at Tembisa Hospital.

Note: the sitting on Tuesday starts at 10am and the Premier’s Question Period is the first item after announcements and notices without notice. Proceedings can be watched on YouTube or at the Legislature.

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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.

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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.

 

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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.

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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

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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.

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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.

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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.