Medical waste: Auditor-General needs to investigate misuse of R259 million dispensation
26 January 2016
Today, I will write yet another letter to the Auditor-General (A-G), Thembekile Makwetu, to request that, in his scrutiny of the financial affairs of the medical waste disposal industry, he probes the allegation coming from private and public industry insiders that up to a half of the medical waste collected from hospitals, clinics and laboratories nationwide is in fact general waste. This pattern has the phenomenal implication that R259.5 million was wastefully paid in the last financial year to medical waste removal companies to pick up ordinary garbage, meaning that these companies were extremely overpaid for a job that didn’t need their specialised expertise.
It is perhaps inevitable that even with the most rigorous medical waste separation and segregation management, some ordinary garbage finds its way into hazardous waste. Best practise in some countries like Sweden results in a mix of 90% hazardous waste to 10% ordinary garbage, while the global norm is about 80 to 20. In South Africa, for reasons to do with the poor and careless management practises, industry insiders from both the public and private healthcare sectors say it is about 50 to 50. It is clearly unacceptable and dangerous that segregation management outcomes of medical waste be reduced to the same probability as a randomised coin-toss.
The beneficiaries of this state of affairs are the medical waste removal companies. To collect and dispose of hazardous waste costs on average R9 per kg whereas general garbage costs R1.36 per kg (anatomical waste costs R11.93, pharmaceutical waste R20.51, infectious and sharps R6.98 and cytotoxic i.e. cancer related R20.51. As the bulk of waste collected is anatomical, infectious and sharps, the average cost is about R9). For unscrupulous medical waste companies, removing and disposing of ordinary garbage as medical waste is easy money.
This may well explain why it is that, even taking into account the longer distances trucks travel, some provinces with small populations and limited health-care infrastructure have annual tender budgets for medical waste removal that are inexplicably high. For example, the Northern Cape’s budget was R45.6 million for 2014/2015 despite the fact that the lowest tender submitted came in from a credible company at R6 million, which is about right. Mpumalanga - R36.2m budget and R12.4m lowest bid - is similarly questionable.
It may well be that the medical waste removal companies are taking advantage of poor management practises at some healthcare facilities. But it may equally be that there is collusion between the tender committees and removal companies in provinces such as the Northern Cape and Mpumalanga. It is therefore of the greatest importance for the Auditor-General to get to the bottom of this, as over R200m of taxpayers’ money is being wastefully, possibly even corruptly, misspent in this bloody business.
The DA will continue to pursue the issue until public confidence in the biosafety of our health-care institutions is secured.
Issued by Wilmot James, DA Shadow Minister of Health, 26 January 2016
