DA calls for inter-ministerial task team to address backlogs at forensic labs
5 February 2015
Note to Editors: The following remarks were delivered by DA Shadow Minister of Health Dr Wilmot James MP, DA Shadow Minister of Police Dianne Kohler Barnard MP, and DA Shadow Deputy Minister of Health Dr Heinrich Volmink MP, at a press conference in Parliament today.
Over the last few weeks the DA has travelled the country to investigate the entities tasked with processing blood-alcohol samples, the Department of Health's Forensic Chemistry Laboratories (FCLs). The findings are alarming and in contradiction to Minister Motsoaledi's reassurances that "all was in order" (see full text below).
The country-wide backlog of samples stands at an astonishing 62 261 (November 2014) and has no doubt increased over the festive period to date.
We are not calling for the Department of Health to solely focus on FCLs, even though the set up for FCLs is relatively simple compared to the complexities of primary, secondary and tertiary healthcare. If Minister Motsoaledi cannot get the basics right, it is no wonder his department is struggling to excel in life or death healthcare.
It only takes 15 minutes to prepare and four minutes to process a blood alcohol sample. However, given the major skills deficit and an inadequate staff compliment of just over 90 chemical analysts, 19 minutes for each of the 62 261 backlogged samples is a daunting task.
Furthermore, the physical state of these laboratories (i.e. collapsing and dilapidated infrastructure) was found to be in contravention of the Occupational Health and Safety Act of 1993 by the Auditor General in a 2009 report on the performance of the FCLs in the country.
The AG further found:
Low staff morale at the laboratories as they are situated in unsuitable buildings;
Inadequate storage space for blood samples;
High turnover and vacancy rate;
No back-up power supply to ensure that samples or specimens are not spoilt; and
Inadequate information systems.
Management systems and effective leadership are lacking and no system has been devised to encourage speedy turnaround times for processing of blood-alcohol samples.
According to the Director of Pathology Services at the Department of Health, FCLs are equipped with generators, however when load-shedding occurs for longer periods of time, generators run out of diesel and given the tedious procurement process, FCLs are left in complete darkness. Testing blood that has not been stored at the correct temperature nullifies the sample, which then cannot be used as evidence in a court.
Unlike the Cape Town laboratory, the Johannesburg and Pretoria FCLs are not accredited with the South African National Accreditation System which certifies that a lab is competent to perform its tasks in line with international criteria.
Indeed, it is clear from these reports and our findings that FCLs are in a state of crisis.
The failure to provide timely analysis of blood samples results in delays in the investigation and prosecution of crimes. Court cases depending on forensic evidence can be delayed, lost or dropped. Consequently drunken drivers continue to cause havoc on our roads.
We call for the establishment of an inter-ministerial task team consisting of the ministries for Health, Police and Public Works, together with forensic and legal experts, to investigate and explore ways in which to address the crisis preventing swift delivery by our FCLs.
We must do everything we can to ensure drunk drivers are prosecuted and not let off easily due to the failure of FCLs to process blood-alcohol samples in good time.
It is time for Minister Motsoaledi to tackle forensic labs with a sense of urgency, as we can no longer afford would-be killers to escape the reach of the law.
A brief on the current state of Forensic Chemistry Laboratories in South Africa and how to fix it
05 February 2014
Introduction
The battle against drunk driving will only be won if there is successful, swift and severe justice taken against offenders.
Delays in blood-alcohol sample processing have a severe impact on our criminal justice system and on victims of crime.
Timely forensic analysis results are critical to decreasing crime in our country. It will also provide relief to families and friends who will be provided with information about the cause of death of their loved ones.
But justice can be neither swift nor successful when it takes an inordinate time to process blood samples at our national Forensic Chemistry Laboratories (FCLs).
It must be understood that there are two kinds of national state-financed forensic laboratories: those falling under the police that involve the disciplines associated with crime-scene investigation such as ballistics and explosives; and those, three in all - in Pretoria, Johannesburg and Cape Town - that involve chemical compound analysis falling under Dr Aaron Motsoaledi's Health Department. These laboratories deal with blood alcohol chemical (ethanol) analysis. They must co-operate with the police's laboratories, which poses problems of its own.
As University of Cape Town chemical pathologist Professor Dave Marais points out, the test for blood alcohol can be done in any decent laboratory. But the laboratory management must with fidelity take full "custody of the sample" from "cradle to grave" to avoid mistaken identity or the corruption of the samples. Only the Health Department laboratories have the legal responsibility for "sample custody".
However, the current system clogs up, with the result that blood alcohol samples accumulate and do not get expeditiously processed. In an answer to a parliamentary question put in November last year, the Health Department recorded that it took 13.5 months for the laboratories of Johannesburg, 12.4 months for those of Cape Town, and 7.6 for the Pretoria laboratories to "process all currently unprocessed samples at the current output rate", whilst new samples keep coming in.
It is imperative that FCLs function optimally to produce legally indisputable results. It is simply not acceptable that blood sample testing, a routine and simple procedure, cannot be carried out effectively at our labs.
Problems at FCLs
FCLs have been facing major problems since it's migration from the National Health Laboratory Services.
Auditor-General's Report:
The auditor-general (AG) conducted a performance audit of the Health Department's laboratories in September 2009 in response to media reports and internal pressure from the managers of the non-communicable diseases programme.
The AG established the key problems - in 2009 - to be:
Low staff morale as the laboratories are situated in unsuitable buildings.
Inadequate storage space for samples.
High vacancy rate.
No back-up power supply to ensure that samples or specimens are not spoilt.
Total disregard for the Occupational Health and Safety Act No. 85 of 1993.
Inadequate information systems.
This list of items is a savage indictment of the late former Minister of Health, Dr Manto Tshabalala-Msimang's mismanagement.
Motsoaledi undertook on September 14, 2009, to take the following actions:
To resolve the long-standing issue of the non-accreditation of the Forensic Chemistry Laboratories with the South African National Accreditation System.
Implement his strategy to reward the staff of the Forensic Chemistry Laboratories adequately.
Give due attention to the matters that arose in the auditor-general's report.
Please find the AG's report here.
However, progress in executing his commitment is frustrated by the slow and dolorous march of the health bureaucracy.
Five years after Motsoaledi's commitment, The Star reported (on February 26 2014) that three laboratories "at the front line of the war against drunk driving" where "all blood tests from arrested motorists are sent for testing" have been "mired in controversy over their inability to do the tests, as the backlog across the country heads towards 60 000 since the beginning of the year alone".
Health Department spokesman Joe Maila responded to "acknowledge that the backlog is serious in our labs. We need to build capacity to deal with the backlog". In a November 2013 reply to a DA parliamentary question, Motsoaledi himself admitted (IOL News February, 26, 2014) that 52 748 post-mortem, toxicology and drunk-driving samples waited processing.
A reply to a DA parliamentary question revealed that during the 2012/2013 period, a total of 44 526 cases of drunken-driving were withdrawn from the courts. This is an increase of 15 961 or 36%, when compared to the 2010/2011 period. During the 2011/2013 period, the figure stood at 36 180.
This large rise in drunken-driving cases being withdrawn from the courts is deeply concerning and is an indictment of both the Departments of Health and Police.
In January 2014 a reply to a DA parliamentary question revealed that as at 31 October 2013, across all three national Department of Health Forensic Chemistry Laboratories there are:
17 017 unprocessed toxicology samples;
34 185 unprocessed blood alcohol drunken driving samples; and
1 546 blood alcohol unprocessed post-mortem samples.
These severe backlogs are highly problematic and have adverse consequences on our criminal justice system because without the timeous processing of these blood alcohol samples, cases of drunken-driving cannot be properly investigated.
This means that drunken-drivers cannot be prosecuted. The perpetrators stay on our roads and continue to cause a serious risk to both other drivers and pedestrians.
FCL Legal Mandate
In terms of legislation for blood alcohol samples and drunken driving the Criminal Procedures Act 51 of 1977; section 212 4 (a) and 8(a) and the National Road Traffic Act of 1991, section 65 apply.
Custody of a blood alcohol sample is regulated by a SAPS/Health Protocol and not by law or regulation and it applies only to the SAPS.
DA's efforts dismissed
On the 21 December 2014 - the DA requested the Minister of Health to grant emergency funding to the Forensic Laboratories in Pretoria, Johannesburg and Cape Town - not excluding the construction of the Durban FCL.
This fell on deaf ears.
The Health Department's 2013/2014 Annual Report committed R30 million for capital goods for the three laboratories. This is a drop in the ocean. If we want to take the war against drunk driving seriously (the recent Lancet UK medical journal, all-cause and cause-specific 2014 mortality study, confirmed that road accidents, half of the deaths for which are caused by drunk drivers or involve drunk pedestrians, is the fifth most serious cause of death in South Africa) he must:
Ramp up his technology;
Management; and
Staffing commitments.
Compared to other middle-income countries, we have a very high alcohol abstention rate, 59,4% of South Africans over 15 years of age abstained from having alcohol between 2013-2014 as reported in the World Health Organisation 2014 Global Status Report on Alcohol and Health.
The DA's requests to enter these facilities to conduct oversight have been rejected repeatedly. This in contravention of section 55 (2) of the Constitution which allows for Parliament to ensure that all executive organs of state in the national sphere of government are accountable to it and to maintain oversight of the exercise of national executive authority.
Click here to access images.
Personnel problems
Strong anecdotal evidence suggests that there are a myriad of breakdown points in staffing and recruitment policies. There are also a considerable amount of vacancies at the three laboratories. The information on this can be sourced via the Department of Health. The DA is awaiting a response from the Ministry.
We could however establish the following staff compliment make-up:
KwaZulu Natal - 16 chemical analysts, 8 gas chromatographers
Cape Town - 25 chemical analysts, 5 gas chromatographers
Johannesburg - unknown.
Pretoria - 30 chemical analysts, 8 gas chromatographers
Work environment
The morale is very low at all of the scientific establishments. These laboratories have for the longest time been plagued with very little funding and priority shown to it by the Ministry for Health.
Management systems have not been worked into turnaround times for processing of blood-alcohol systems.
According to the Director for Pathology Services at the Department of Health, FCLs are equipped with Generators, however when load-shedding occurs for longer periods of time, generators run out of diesel and the procurement process is time consuming - leaving the FCLs in a state of desperation.
Accreditation
The Johannesburg and Pretoria FCLs are not fully accredited with the South African National Accreditation System (SANAS) which ensures formal recognition that a laboratory is competent to perform its tasks in line with international criteria. The AG has also quite rightly pointed out that this could have an impact on the acceptance of forensic chemistry results in court.
Accreditation by SANAS in terms of the Accreditation for Conformity Assessment, Calibration and Good Laboratory Practice Act of 2006, serves to ensure formal recognition that a lab is competent to perform tasks in accordance with international criteria.
Minister Motsoaledi is on record (Report of the Auditor-General on a performance audit of the Forensic Chemistry Laboratories, November 2009) to 'resolve the long outstanding issue of the non-accreditation of the Forensic Chemistry Laboratories'.
Minister Motsoaledi made this promise 6 years ago, without acting on it. Accreditation has not been resolved at the Johannesburg and Pretoria labs.
Only the Cape Town FCL is accredited and it is worrying whether or not the new Durban FCL will be granted accreditation by SANAS.
The DA would ensure that there is an integrated facility in every province equipped for the analysis of all case exhibits. The DA would also reconsider the role of laboratories managed by the Department of Health in dealing with forensic evidence (blood samples). These facilities are not currently providing effective support to the criminal justice system.
Therefore the DA will be pursuing the following action to fix FCLs in our country:
Request the Minister of Health to set up an inter-ministerial task team, consisting of specialists in the Departments of Health, Police and Public Works.
Request the Auditor-General, Kimi Makwethu, to again conduct a performance audit of the three FCLs.
Request the Portfolio Committee on Health to conduct oversight at the three + one unfinished FCLs.
Request for ease of the current backlog faced, that universities assist the FCLs in processing blood alcohol samples.
Request that the Minister's budget speech include measures to increase funding to improve the buildings of the three existing laboratories and provide for new equipment.
Statement issued by Dr Wilmot James MP, DA Shadow Minister of Health, February 5 2015
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