Public Protector Busisiwe Mkhwebane on Friday released a number of investigative reports focusing on service delivery at Gauteng’s six public hospitals.
The investigation focused on Jubilee District Hospital in Hammanskraal, Dr George Mukhari Academic Hospital near Ga-Rankuwa, Steve Biko Academic Hospital in Pretoria as well as Soweto’s Chris Hani Baragwanath Academic Hospital and Lilian Ngoyi Community Health Centre, including Charlotte Maxeke Johannesburg Academic Hospital.
The investigation commenced in August last year and entailed inspections and interviews with medical and nursing staff, unions and patients.
This is a summary of the public protector’s findings:
1. Dr George Mukhari Academic Hospital
The public protector found that there were systemic deficiencies at the facility such as the failure to remunerate contracted Covid-19 healthcare workers and the late creation of positions.
There were also delays in the procurement of medical equipment for the hospital, which was requested more than three years ago.
It was established that systemic deficiencies such as the failure by the hospital to secure and dispose of medical waste in terms of the applicable provisions of the National Health Act was substantiated.
“There was a lack of contract management in respect of waste disposal, which likely resulted in the service provider benefiting for four years without a competitive bidding process being undertaken.”
2. Steve Biko Academic Hospital
Evidence in the public protector’s possession confirmed that the facility’s roof leaks, but that the Department of Infrastructure Development does conduct routine maintenance.
While the public protector found that the hospital could improve its communication lines with officials, there was no evidence indicating the provision of personal protective equipment (PPE) was inappropriate.
“The reuse and redistribution of cleaned and sanitised PPE is in compliance with version two of the Covid-19 disease: infection, prevention and control guidelines. Therefore my office could not find any wrongdoing with the reuse of the PPE by the hospital.”
The hospital also complied with the registration and declarations of donations in the donations register.
3. Chris Hani Baragwanath Academic Hospital
The office of the public protector found that systemic deficiencies at the facility such as broken taps in the kitchen and the ablution facilities in ward 59 which was also broken, but they had since been repaired.
There was also an undue delay to fill vacant positions as a result of the late creation of positions.
Due to the hospital’s human resources capacity constraint challenges, porters were unavailable at their workstations in the facility to assist with the movement of patients to various wards.
It was established that there were challenges with the centralisation of the procurement of PPE as shown by the delays in the supply and delivery of PPE.
“There was no dedicated ward or specialised ward to house Covid-19 psychiatric patients, which meant that in the event that any psychiatric patient tested positive, there would be no ward to accommodate them.”
4. Lilian Ngoyi Community Health Centre
Evidence obtained by the public protector revealed systemic deficiencies at the facility, such as the lack of hot water in the labour ward.
“Broken geysers and heaters were observed at the facility however new geysers and heaters have since been installed at the facility after the intervention by the public protector in August 2020 as shown by evidence.”
The facility also had challenges with its ICT infrastructure such as telephone lines not working, but this has since been remedied on 17 August 2020 when the telephone lines were installed.
There were systemic deficiencies related to the undue delay to fill various posts. The institution’s management also conceded that there was dirty linen on the beds, but a supervisor had since been assigned to oversee and manage linen.
Among other findings, patients were found to wait for over three hours to be attended to by doctors, and there was a lack of nutritional food available for patients who stay overnight at Lillian Ngoyi.
5. Charlotte Maxeke Johannesburg Academic Hospital
Like other hospitals, Charlotte Maxeke hospital struggled with delays in the creation of positions and filling of positions.
There were delays in the distribution of PPE and some of the PPE was of poor quality, which had to be returned to the depot. This has since been corrected and although some of the PPE was of inferior quality, not all PPE procured was sub-standard.
There was a lack of medical soap or scrub and the staff had to use green soap. There were also delays in the procurement and maintenance of medical equipment despite requests being made to the Gauteng health department.
There were delays in the storage, collection and disposal of medical waste at the hospital as a result of poor performance by the service provider.
The linen was not checked for sharp objects before being sent to the laundry room and this had the potential to cause harm to the staff in the laundry room.
6. Jubilee District Hospital
The allegation that the hospital’s kitchen is small and not conducive to curb the spread of Covid-19 was substantiated even though this was found to be a structural issue.
The office of the public protector also found that there were systemic deficiencies such as delays in the distribution of personal protective equipment (PPE) to the hospital, shortage of certain items of PPE such as N95 masks and delays in the testing turnaround time.
The evidence at the public protector’s disposal indicated that the hospital did not declare all donations received with National Treasury.
Based on the evidence in the public protector’s possession and the submissions made by management at all six hospitals, Mkhwebane found that the Gauteng department of health experienced systemic challenges which impacted the health care services.
She made several remedial actions and recommendations to the provincial department to urgently fix the challenges at the hospitals.
Compiled by Thapelo Lekabe