3 Tshwane hospitals found lacking in Busisiwe Mkhwebane’s report on Covid-19 state of readiness

At least three hospitals in the City of Tshwane have been found wanting by Public Protector Busisiwe Mkhwebane in her report about the state of readiness of public health facilities in dealing with Covid-19.

Mkhwebane’s investigation looked at the administration, management, and responsiveness of certain hospitals to the Covid-19 pandemic in August last year.

The report followed claims last year that Gauteng hospitals had been hardest hit by the pandemic due to a backlog of tests, lack of field hospitals constructed and bed shortages.

Deputy Public Protector Kholeka Gcaleka said the aim of the investigations was to assess how the facilities coped with the demand for services and get a sense of whether sufficient safety measures were implemented to cushion both workers and the public from the devastation brought about by the Covid-19 pandemic.

Gcaleka said the team also looked into the general conditions at the facilities, including infrastructure, the availability of equipment and medical supplies as well as matters pertaining to human resources.

Random interviews were conducted with medical and nursing staff organised labour and patients as part of the probe.

Gcaleka said the investigations confirmed that the administrative deficiencies at the Gauteng Department of Health had led to systemic challenges in the delivery of primary healthcare services at all the hospitals visited.

In respect to Jubilee District Hospital in Hammanskraal, the investigation found there were challenges with the centralisation of the procurement of personal protective equipment, resulting in delays in supply and delivery.

The hospital was also found to have also struggled with delays in the testing turnaround time. However, that improved over time.

Jubilee Hospital was also found to have allegedly failed to provide evidence that it had complied with the directive for staff members who contracted Covid-19 to be granted special leave upon application as claimed by the organised labour.

According to the report, the situation at Dr George Mukhari Academic Hospital was no better as there were systemic deficiencies such as the failure to remunerate contracted Covid-19 healthcare workers and the late creation of positions, which was acknowledged by the hospital chief executive Dr Richard Lebethe.

The hospital also experienced gross delays in the procurement of medical equipment for the hospital, which was requested more than three years ago.

However, the report highlighted that this fault was not squarely of its doing; in fact, it was due to the limited delegation given to the hospital chief executive as well as centralisation of procurement and ineffective supply chain management unit within the provincial Health Department.

A lack of contract management in respect of waste disposal at George Mukhari Hospital also resulted in the service provider benefiting for four years without a competitive bidding process being undertaken.

Gcaleka explained that the failure to convene regular risk management meetings had hampered the hospital in preparing for and mitigating emerging risks during the pandemic.

The Steve Biko Academic Hospital, much like Dr George Mukhari Academic Hospital, was found to have failed to convene risk management meetings for the current term, with the risk management committee not comprised of both management and external members or the nomination of an external chairperson of the risk committee as recommended by the Public Sector Management Framework Act.

The report also pointed towards the ineffective communication of the risk strategy to all officials employed by the hospital.

Following on this, the public protector recommended that the provincial Department of Health, in consultation with the Department of Infrastructure Development, ensured that Steve Biko conducted a full conditional assessment of the hospital’s roof repairs in order to develop a cost-based strategy for planning and budget allocation.

Secondly, the hospital had to convene regular risk management meetings with a committee comprising of all the necessary members.

In respect to Jubilee Hospital, the acting head of the provincial Department of Health, Dr Sibongile Zungu, was instructed to ensure that steps were taken to ensure there was compliance with testing turnaround times of specimens and for the hospital to be provided with additional fleet vehicles from the department in instances where it was allocated high volumes of goods.

Working alongside the Infrastructure Development Department and the Gauteng Provincial Treasury, it was recommended that a full conditional assessment of hospital buildings at Jubilee hospital be conducted in order to develop a cost-based strategy for planning and budget allocation for the refurbishment of the facility, within the 2021/22 medium-term expenditure framework.

This work had to be completed within 30 working days of the report release on Friday.

As part of the recommendations for Dr George Mukhari Academic Hospital, the head of the provincial department is to address its waste management woes as well as to conduct an assessment of the hospitals’ buildings, while at the same ensuring that disciplinary steps were taken against those officials responsible for the late payment of contract health workers as well as the appointment of staff before positions were created.

The public protector also instructed the head of the Infrastructure Development Department to submit a report to her office regarding the maintenance plan of the hospitals, and how they were maintained or repaired within 60 working days of the report’s release.