Public Protector concerned about apparent problems at Chris Hani Baragwanath hospital

6 Aug 2013

Public Protector Adv Thuli Madonsela has expressed concern about the conditions she found at the Chris Hani Baragwanath Academic Hospital, in Soweto, Johannesburg, during a surprise visit to the facility on Monday afternoon. This was part of her office's ongoing National Stakeholder Dialogue.

The visit also served as an inspection-in-loco for the systemic investigation the Public Protector is conducting following a complaint from a group of doctors at the hospital. The complaint primarily relates to irregularities and inefficiencies in the procurement of hospital medicines and equipment leading to interruptions of essential services.

At the beginning of the investigation earlier this year, the Public Protector briefed Minister Aaron Motsoaledi about it. The Minister welcomed the investigation, stating that he hoped it would help his department verify allegations of fraud and corruption involving massive amounts of money. He further advised that action was already being taken by his department to verify such allegations.

During their tour of the hospital's different departments on Monday, the Public Protector and her Deputy, Adv Kevin Malunga, heard from staff members, who shared their frustrations including what they described as a "dire" shortage of medical personnel, medication and critical medical equipment.

Equipment affected by shortages experienced in the medical admission wards, which house high blood pressure, heart attack and diabetes patients, included blood pressure meters and scales. In addition, cardiac monitors needed servicing.

Paediatric wards were experiencing shortages beds, incubators and ventilators.
Overcrowded medical admission, paediatric and casualty wards bore testimony to the fact that the limited staff was struggling to cope with the ever increasing patient numbers.

Some wards were in a state of dilapidation, with open electric plugs and hanging live wires. Paint was peeling off the walls in some of the wards while stains of leaking roofs could be seen in others. In the medical admission wards, paint was peeling off an asbestos ceiling - something, which, according to doctors, posed a risk at patients.

Cleanliness also appeared to be a problem at the facility, which ranks amongst the largest hospitals in the world, with around 3 200 beds, over 6 700 staff, and an area surface occupying over 170 acres of land.

Consistent with the complaint about inadequate staff that was not balanced with an increasing workload, patients generally complained about long waiting periods before they could get their files retrieved, medical attention and receive medication.

Allegations of a lack of synergy between the top management and the various departments within the hospital were made. The issue of budgeting for the various departments also emerged as a challenge. Doctors said they had raised their challenges with management and the provincial Department of Health, in vain.

Hospital Chief Executive Officer (CEO), Dr Sandile Mfenyana, was not present to respond to some of the issues raised and those observed by the Public Protector during her walk-about. A follow up meeting with Dr Mfenyana will be convened in this regard.

Earlier, the Public Protector embarked on a similar expedition at Leratong Hospital in Kagiso township, near Krugersdorp. She also held a meeting with community members at the Krugersdorp City Hall.

At Leratong Hospital, the Public Protector and her deputy heard of challenges similar to those at Chris Hani Baragwanath, particularly staff and equipment shortages, and the incapacity of the facility to cope with patients who walk through its doors every day.

CEO Joseph Dube said about 1500 patients were admitted at the hospital on a daily basis, with the figure working out to 26 000 patients a month. He said anaesthetic, x-ray and ventilation equipment needed replacement.

Although the vacancy rate stood at 11%, the majority of it being support staff, Mr Dube said there was a need to create additional posts in order to deal with the increasing workload.

Among the posts that needed to be created were those of clerks to bring down the waiting periods. The average waiting time for file retrieval was three hours; patients had to wait another hour to see a doctor; and a further three hours to get medication.

Some patients said they arrived as early as 5h30 and only left in the late afternoon. Others were often required to bring their own linen as the hospital was experiencing a shortage.

On a positive note, some private sector establishments donated equipment to the value of R10 million, lifting the burden off the overstretched state resources. This was the case with some of the equipment and facilities at Chris Hani Baragwanath.

During the meeting with the local community, various issues of service delivery were reported to the Public Protector. These included clinics that closed at 13:00 after reaching their daily intake limit, long waiting periods at the clinic and ineffective ambulance services.

Other complaints related to alleged irregular allocation of RDP houses, lack of a school for the disabled, one high school inadequately servicing a highly populated area, unemployment and low wages for EPWP beneficiaries and home-based health care givers.

More complaints relating to allegations of nepotism at Mogale City, and the alleged disappearance of and lack of accountability for funds to the tune of R21 million ahead of the 2010 FIFA World Cup at Mogale City were made.

"Government representatives present have made an undertaking to look into some of the matters that they concede to be problematic. From our side, we will take all your complaints and put them in our [voices and views] report and follow up with the municipality on others," the Public Protector told the community.

The dialogue, which is coupled with a public hearing to boost the systemic investigations that the Public Protector is conducting, focuses on strengthening government's ability to deliver on Millennium Development Goals, with a particular emphasis on improving healthcare services and eradicating poverty.

On Tuesday, the Public Protector was interacting with formal stakeholders, including CEOs of several hospitals and NGOs. She will engage with the provincial legislature on Wednesday, before proceeding to Orange Farm, where she will dialogue with locals.

Issued by the Public Protector South Africa, August 6 2013

Click here to sign up to receive our free daily headline email newsletter