Mixed progress in implementing Health Ombud’s report on Rahima Moosa Hospital

There is mixed progress by the Gauteng Health Department in implementing the recommendations of the Health Ombud’s report on Rahima Moosa hospital which was released on 14 March this year.

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

A key recommendation was that a new hospital CEO be appointed within three months. According to the MEC, the post was advertised with a closing date of 5 May, and a selection process is underway.

Another recommendation is that the hospital is prioritised for refurbishment within six months. The MEC says the hospital has been included in the priority hospital programme, and a schedule of maintenance works has been identified, with initial funds to start immediately.

A “Smart Fridge” was supposed to be installed within one month, and this has been done.

Although a 24-hour Laboratory and Blood Bank Services was supposed to be done within two months, the department says this requires “multiple stakeholder engagement and is still work in progress.”

A Discharge Lounge was supposed to be functioning within one month, and this has been done.

Disciplinary action has been taken against a nurse who used her own concoction for infection control, but the former CEO Dr Nozuko Mkabayi has not yet been disciplined for her failings.

The biggest disappointment is the failure to appoint an independent forensic and audit firm within two months – the Office of the Premier is still busy “with the process of appointing an independent forensic and audit firm.”

It’s good news that application has been made to convert the hospital into a tertiary institution, as this will allow access to National Tertiary Service Grants.

A draft Human Resources Plan has been developed which needs further work in relation to the reclassification of the hospital as a tertiary institution.

The key to further progress is whether a top notch CEO is chosen soon and is given the resources to fundamentally improve this hospital to provide a decent service to mothers and children.

I will continue to monitor the progress implementing the Health Ombud’s recommendations, and will hold the MEC to account for any backsliding.

It’s not just Rahima Moosa, other Gauteng hospital CEOs should be replaced

The Democratic Alliance welcomes the Health Ombud’s report on the Rahima Moosa Mother and Child Hospital which lays bare the severe management deficiencies that have led to poor care, including pregnant women sleeping on the floor.

He finds irregularities in the appointment of the hospital CEO Dr Nozuko Mkabayi, and observes that the Gauteng Health Department’s “CEO appointment systems are weak to non-existent”. Furthermore, the criteria used “is far below the required standard for such senior positions”

The reality is that cadre deployments are rife in senior posts throughout the department.

This is why we have so many incompetent people who fail to take action against corruption networks as we have seen at the Tembisa Hospital.

All hospital CEOs need a review to assess their competency and strict criteria used in new appointments.

The DA will closely monitor whether the Department carries out the Health Ombud’s recommendations at Rahima Moosa Hospital and other hospitals.

DA condemns continued discipline of Rahima Moosa whistleblower doctor

The Democratic Alliance condemns the continuing disciplinary action against Dr Tim de Maayer despite the lifting of his suspension last week for his open letter about poor conditions at the Rahima Moosa Mother and Child Hospital.

It is extremely disappointing that Dr de Maayer has now been informed that he will be served with a warning letter which colleagues fear may lead to his dismissal.

According to the Progressive Health Forum, he has allegedly been forced to apologise to the hospital CEO Dr Nozuko Mkabayi because he reportedly sent a short message thanking his colleagues for their support rather than being completely mute about his case.

I have heard disturbing reports that staff at the hospital are unhappy that Dr Mkabayi does not address their concerns and spends too much time working from home instead of being full-time at the hospital.

Staff appointments are allegedly delayed because documents have to be taken to her house for sign-off.

She has also been slow to fix the CT scanner at the hospital, and patients have to be sent to other hospitals for scans.

The DA calls for an urgent investigation into the conduct of Dr Mkabayi in the case of Dr de Maayer as well as her poor management of the hospital.

Conditions at this hospital need to be improved drastically so that mothers and children get decent care.

DA condemns suspension of doctor who exposed conditions at Rahima Moosa Hospital

The Democratic Alliance condemns the suspension of Dr Tim De Maayer who wrote an open letter last month exposing the terrible conditions of patients at the Rahima Moosa Mother and Child Hospital.

He has been accused of serious misconduct and is not allowed on hospital property because he may “endanger patients” or “interfere with witnesses” or “reoffend”.

It is utterly appalling that this dedicated doctor is victimised for standing up for the children who die needlessly because of shortage of staff and equipment.

The person who should be suspended is the hospital’s CEO Dr Nozuko Mkabayi, who has spent many days working from home instead of fixing the crisis at the hospital where pregnant women were recently found sleeping on the floor.

Gauteng Health MEC Nomathemba Mokgethi needs to intervene urgently to reinstate Dr De Maayer who deserves praise rather than punishment.

I have signed this petition to withdraw his suspension at https://chng.it/ycwynN4p and I urge everyone else to sign it as well.

Gauteng Health should admit there is a crises

The Gauteng Health Department has given a weak response to the heartfelt plea by Dr Tim De Maayer who wrote an open letter this week about the crisis at the Rahima Moosa Mother and Child Hospital (RMMCH).

Dr De Maayer describes how “things are falling apart”, and children are dying because of basic services not being available.

I challenged Gauteng Health MEC Nomathemba Mokgethi in the health budget debate yesterday in the Gauteng Legislature to admit that there is a full-scale crisis, rather than “pressures” as she has said in a recent interview.

But her response was only more of the same that we have heard before, that the department is responding and issues are being addressed.

A case in point is the 16-year-old CT Scanner that has been broken for more than three months at the RMMCH.

According to the department, the breakdown was due to normal wear and tear, and a part was ordered from the Netherlands. After it was installed it was discovered that yet another part was faulty which was ordered from Phillips SA, but it turned out that there was yet another fault that caused the newly installed part to blow out.

Technicians are now looking to salvage parts from a condemned CT Scanner at the Charlotte Maxeke Johannesburg Hospital which may or may not ensure that the RMMCH Scanner returns to working order.

When I asked MEC Mokgethi yesterday as to when the CT Scanner would be fixed she could not give me a firm date.

Meanwhile, Dr De Maayer describes how a child needed an urgent brain scan but had to wait 48 hours before it could be done at the Nelson Mandela Childrens Hospital.

The key issue is why there wasn’t a continuous maintenance contract for the scanner and a plan to replace it when it predictably broke down after being used for a normal lifespan.

This is a problem at other public hospitals in Gauteng where vital machinery breaks down all the time and patients’ lives are put at risk.

The first step in addressing a crisis is to admit that there is a crisis. Dr De Maayer is correct to say that “things are falling apart”.

I noted in my budget speech yesterday that there are still too many incompetent and corrupt officials in key positions. This is why a very large budget of R59.4 billion is spent so inefficiently and ineffectively.

It’s like pouring water into a leaking bucket.

This is why we saw the feeding frenzy over the PPE money, and other scandals like the R500 million spent on the Anglo Ashanti ghost hospital in the far west rand.

It’s also why Charlotte Maxeke Johannesburg Hospital has not been speedily repaired, causing terrible suffering to thousands of patients.

We need determined political will from the very top to take the hard decisions to fix the deep rot in the Gauteng Health Department, otherwise the life-destroying scandals will continue to happen.

 

DA welcomes Human Rights Commission visit to Rahima Moosa Hospital

by Jack Bloom MPL – DA Gauteng Shadow Health MEC

I commend the visit last week by the SA Human Rights Commission (SAHRC) to investigate the deaths of 9 babies from Necrotising Enterocolitis (NEC) at the Rahima Moosa Hospital in west Johannesburg.

According to the SAHRC regional manager Buang Jones, the hospital management conceded that it has violated patients’ rights to quality healthcare.

I am concerned that the origin of the NEC outbreak has not yet been established, and it is likely that shortages of staff, equipment and beds contributed to the deaths.

This hospital needs to be upgraded to cope with 13 000 births every year despite not having an intensive care unit, a laboratory service or 24-hour blood bank on site.

The appointment of a permanent Hospital CEO should be speeded up as the previous CEO retired in June this year, and staff and equipment shortages should also be rectified.

It is unacceptable that mothers give birth in an environment of risk rather than top quality care.

I hope that real solutions emerge when the SAHRC subpoenas Gauteng Health MEC Gwen Ramokgopa and Head of Department Professor Mkhululi Lukhele to account for the conditions at this hospital.

Rahima Moosa Hospital suffers as nursing agency owed R6.2 million

A nursing agency that has stopped providing nurses to the Rahima Moosa Mother and Child Hospital in west Johannesburg is owed R6 173 045, putting extreme strain on the hospital as it tries to cope with fewer nurses.

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

According to Ramokgopa, three nursing agencies were being used by the hospital at the beginning of this year, but they stopped services in September because they had not been paid.

Two of the agencies were paid in full on 31 October, but The Nursing Services of SA agency was paid R4.9 million on this date, and is still owed R6 173 045.

Ramokgopa says that “amounts are loaded for payment but due to cash allocation constraints such are outstanding. Discussions are underway at the level of the Executive Council Subcommittee on Health Finances.”

The withdrawal of agency nurses has led to staff burnout at the hospital. Two wards have been closed and three operating theaters have been cut down to one.

This is a sad effect of the Department’s ongoing financial crisis which increases the risk of medical negligence for the 14 000 births at this hospital every year.

It is essential that extra money is found soon to pay the Department’s many debts, otherwise more companies will halt services with terrible consequences.

Rahima Moosa Hospital struggles without agency nurses

The Rahima Moosa Maternity Hospital in west Johannesburg is struggling as nurses have been withdrawn by a nursing agency that has not been paid.

This is yet another ill-effect of the Gauteng Health Department’s financial mismanagement.

Last week was grueling for staff trying to cope without the agency nurses in an extremely busy hospital which delivers about 14 000 babies a year.

There are two emergency operating theatres but only one is being used because of the nursing shortage.

This could put lives at risk if there is a surge in the need for emergency caesarean operations.

The financial woes of the Department has led to telephone cuts, machines not repaired and now a hospital trying to ensure safe births without enough nurses.

We need to know urgently what is being done to rectify the finances of the department so that it can pay all its suppliers on time.

Gauteng’s Most Dangerous Hospitals

Serious Adverse Events

The Chris Hani Baragwanath Hospital has the highest number of Serious Adverse Events (SAEs) affecting patients in Gauteng, with 62 SAEs reported in 2015.

This is according to information I have obtained from the Gauteng Health Department after submitting a request using the Promotion of Access to Information Act (PAIA).

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 by the underlying disease or condition of the patient. This can involve negligence, staff incompetence and system failure.

Most Dangerous Hospital

Chris Hani Baragwanath Hospital compares poorly with the other academic hospitals which had the following much lower SAEs in 2015:

Charlotte Maxeke Johannesburg Hospital – 10 SAEs

George Mukhari Hospital – 9 SAEs

Steve Biko Hospital – 3 SAEs

Jubilee Hospital is the most dangerous hospital in Gauteng as it recorded 51 SAEs despite being much smaller than Baragwanath Hospital.

Other dangerous hospitals include the following:

Pholosong – 46 SAEs

Leratong – 30 SAEs

Kopanong and Odi – 28 SAEs

Pretoria West – 23 SAEs

Sebokeng – 22 SAEs

Far East Rand – 21 SAEs

Safest Hospitals

The safest hospitals with the lowest SAEs are as follows:

Heidelberg – 1 SAE

Edenvale – 2 SAEs

Tambo Memorial – 3 SAEs

Rahima Moosa – 4 SAEs

Medical Mistakes

The most improved hospital is Tembisa, which had 17 SAEs in 2015, down from 71 SAEs recorded from January 2012 to September 2013.

There was a total of 503 serious adverse events (SAEs) in Gauteng state hospitals in 2015.

More steps are needed to cut down medical mistakes and ensure that patients are healed  rather than injured in our state hospitals.

 

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

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Workmen’s Comp Owes R38m To Gauteng Hospitals

Gauteng public hospitals are owed R38.2 million by the Workmen’s Compensation Fund, with some claims dating back to 2001.

This shock information is revealed by Gauteng Health MEC Qedani Mahlangu in a written reply to my questions in the Gauteng Legislature.

In the last three years, 9061 claims were lodged by the Gauteng Health Department for a total value of R17.4 million, but only R3.34 million was paid out by the Fund.

Workers whose employers are registered with the Fund can claim if they are involved in an accident at work or develop an illness caused by working conditions.

According to Mahlangu, the under-recovery is due to insufficient information provided by the patient with regard to employers’ details, and employers not completing the relevant Employers report (WCL 2).

There is also a lack of response by the Fund to the claims submitted.

The largest amount (R7.5 million) is owed to the Steve Biko Hospital.

Other hospitals with more than R1 million outstanding include the following:

  • Charlotte Maxeke Johannesburg – R4.9 million;
  • Tembisa – R4.416 million;
  • George Mukhari – R4.399 million;
  • Thelle Mogoerane (Natalspruit) – R2.47 million;
  • Helen Joseph – R2.19 million;
  • Kalafong – R1.95 million;
  • Chris Hani Baragwanath – R1.78 million; and
  • Leratong – R1.37 million.

The hospital with least owing to it is Rahima Moosa Hospital, where only R5186 is outstanding.

The department appointed a service provider in November last year to assist in recovery of outstanding claims from the Fund, but this measure has clearly failed

It is outrageous that so much is owed from the Fund, as the money is desperately needed to improve treatment in our hospitals.

Effective measures should be taken to ensure that outstanding money is recovered as soon as possible.

 

Media enquiries:

Jack Bloom MPL

DA Gauteng Shadow MEC for Health

082 333 4222

[Image source]