Tag: Gauteng

Categories : Ethics and LawTags :

Probe Clears Most Gauteng Care Organisations

On By ModernMedia

Handful of organisations remain under investigation

Photo by Scott Graham on Unsplash

By Daniel Steyn, Joseph Bracken and Raymond Joseph

Most of the non-profit organisations that were flagged in a forensic audit by the Gauteng Department of Social Development have been cleared of all findings and have started to receive subsidies from the department again.

The forensic audit, announced by Gauteng Premier Panyaza Lesufi during his 2023 State of the Province Address, was a key intervention by former social development MEC Mbali Hlophe and aimed to uncover fraud and corruption in the non-profit sector. The department pays about R1.9-billion in subsidies to more than 700 non-profit organisations every year.

In a list circulated to affected organisations on Wednesday by the department, which GroundUp has seen, 34 of the more than 50 organisations that had audit findings against them, have been cleared after they rejected the findings. The organisations, which include drug rehabs and women’s shelters, have had to endure three months without any funding since the start of the new financial year on 1 April.

Read the list

According to the list, six organisations are yet to receive the final outcome of their submissions. These include the training academies Daracorp and Beauty Hub, which collectively received R114-million in funding in 2022 and 2023. There are still unanswered questions about why these two organisations received so much in subsidies while budgets were cut for other organisations that care for people with HIV and older persons.

Social work organisation Kitso Lesedi Community Development, which has rejected the findings against them, is also still awaiting the final outcome of their submission.

The department has decided to “uphold” the decision not to fund two organisations, according to the list. These are Life Healthcare’s non-profit drug rehab in Randfontein and Tembisa Society for the Care and Welfare of the Aged. GroundUp understands that Tembisa is taking steps to appeal the decision.

Also, eight organisations are part of a Hawks investigation, according to the list. These include several foodbanks and Godisang Development, which has historically played a key role in the department’s Welfare to Work programme.

The department has not responded to GroundUp’s questions on the Hawks’ investigation, and the Hawks told us that it will be difficult to answer questions without a case number.

According to the department, 14 officials have been suspended since the forensic audit was launched, but their identities, the allegations against them, and the status of their disciplinary processes remain unknown.

Total Organisations on List51
Organisations cleared34
Hawks Investigation8
Organisations yet to receive outcome6
Organisations that did not make submissions
(But one of these organisations, Carroll Shaw,
claims it made a submission)		2
Organisations that remain unfunded due to
investigation (decision upheld after submissions)		2

The forensic audit caused catastrophic delays in this year’s funding adjudication process, forcing hundreds of organisations to survive the first two months of the 2024/25 financial year without any funding. Some organisations retrenched staff, scaled down services or even shut down.

The department decided to centralise the process of allocating funds and appointed external adjudication panels. The department claimed this was because of findings by the Auditor-General, but the Auditor-General told GroundUp no such findings or recommendations were made.

The centralisation delayed the allocation of funds and the whole process ultimately collapsed, with the department deciding to simply extend contracts with organisations already signed in 2023.

The department did not respond to GroundUp’s questions.

Organisations vindicated

Organisations that have been cleared and have received findings told GroundUp that they feel vindicated and relieved.

Derick Matthews, CEO of Freedom Recovery Centre, which provides in-patient drug rehabilitation, told GroundUp that they have started admitting patients again and ordering supplies.

“Crazy days, but super excited,” Matthews said.

Mpule Lenyehelo, director of A Re Ageng, which runs women’s shelters and gender-based violence care centers, says it will take time to repair the relationship with the department.

“I am very angry and disappointed with the department,” Lenyehlo said. “Their allegations were unfounded and could not be substantiated as we have always received positive feedback from their monitoring and evaluation team. What the department seems to conveniently forget is that the organisation is providing essential services to the most vulnerable people in the community as well as 114 staff members in terms of job creation.”

One organisation caught in the cross fire was MES. The organisation never appeared on the list of organisations under investigation but nevertheless received a letter saying that there was a finding against them and that they would not be receiving funding. The finding was that they had not spent their full subsidies.

Leona Pienaar, CEO of MES, said she was confused because there was no money left over. She wrote to the department asking for clarity but received no reply. She then wrote to FSG Africa, the forensic auditing firm that was appointed to conduct the probe. FSG Africa told Pienaar that they made no findings against MES. After meeting with the department, MES finally had their funding for 2024/25 reinstated.

Lisa Vetten, chair of the Gauteng Care Crisis Committee, which has led litigation against the department and organised pro-bono legal assistance for affected organisations, says that she appreciates recent efforts by the new MEC Faith Mazibuko and some officials in the department to resolve the issues faced by the nonprofit sector.

“Corruption deprives people of services and has no place in the social care sector. But serious questions should be asked about the value of this audit, which not only came at great cost to organisations and their beneficiaries, but also, up to this point, hasn’t yielded much of substance,” said Vetten.

Categories : Healthcare Politics and RegulationsTags :

Nomantu Nkomo-Ralehoko’s Comeback as Gauteng MEC for Health Sparks Mixed Reactions

On By ModernMedia
Nomantu Nkomo-Ralehoko is sworn in by Judge Lebogang Modiba as the new MEC for Health. (Photo: Gauteng Provincial Government)

By Ufrieda Ho

ANC support in Gauteng dipped below 40% in the recent provincial elections and an ANC-led minority government is now at the helm. Among those in Premier Panyaza Lesufi’s new Cabinet is Nomantu Nkomo-Ralehoko who’s been reappointed as MEC for Health and Wellness.

Nomantu Nkomo-Ralehoko was first appointed Gauteng’s MEC for Health and Wellness in October 2022. A long-time ANC member, she previously served as MEC for Finance and e-Government and has been a member of the provincial legislature since 1999.

She returns to the critical role at a time when the province’s health department, based on extensive reporting by Spotlight and other publications,  remains mired in a chronic cycle of administrative and service delivery dysfunction.

At just under R65 billion for the current financial year, the department gets a massive slice of the Gauteng budget. While the National Department of Health leads on health policy, the day-to-day running of public healthcare services is managed by provincial departments of health.

The Gauteng health department has a high number of vacancies. On the administrative side this includes the critical position of a chief financial officer (CFO). The previous CFO, Lerato Madyo, was suspended in August 2022. Her case is still to be concluded. Research conducted last year by community healthcare monitoring group Ritshidze found that the majority of healthcare facility staff and public healthcare users that they surveyed felt that healthcare facilities were understaffed.

Madyo’s case is connected to ongoing investigations into corruption at Tembisa Hospital undertaken by the Special Investigating Unit. This was also the issue that whistle-blower Babita Deokaran was investigating before she was assassinated in August 2021. Deokaran was acting chief finance director before she was killed. Since her death it’s been confirmed that there was corrupt spending to the tune of R1bn at Tembisa Hospital.

When Nkomo-Ralehoko answered 10 questions from Spotlight shortly after her appointment in 2022, she said: “One of my immediate focus areas is to ensure that the department’s systems across delivery areas such as Finance, Human Resources, Monitoring and Evaluation, Risk Management, etc. are strengthened so that processes are not dependent on human vulnerability but there are clear checks and balances. An environment that has no consequence management breeds ill-discipline and a culture of ignoring processes and procedures as prescribed in our legislative framework.”

Gauteng also faces mounting surgery and oncology treatment backlogs. Its clunky supply chains and procurement systems have often left suppliers unpaid and facilities struggling without basic medical consumables as well as not being able to procure large pieces of equipment when it’s been needed. Some hospitals have had periods when patients have had to go without food.

There remains questions about governance capacity in the department. Notable examples from Nkomo-Ralehoko’s tenure so far include inaction over utilising a March 2023 Gauteng Treasury allocation of R784 million for outsourcing radiation oncology services. These ring-fenced funds were secured following sustained pressure and protests by activists and civil society. To date, this money has still not been spent.

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The department is also still to implement a June 2022 memorandum of agreement with the University of Witwatersrand. The agreement sets a framework for the department and the university to mutually address many of the health sector challenges in the province, while ensuring the academic training of the next generation of doctors takes place.

Another key challenge for Nkomo-Ralehoko will be how to navigate a changed Gauteng Provincial Legislature in this seventh administration. There is no outright majority and there is no unity government deal that includes the largest opposition party, the Democratic Alliance (DA). This will represent distinct hurdles for passing budgets or garnering enough votes for approvals in the house.

Despite these challenges, the reappointment of 58-year-old Nkomo-Ralehoko is being welcomed by some. They say that she brings stability to a portfolio that has been plagued by shaky, short-lived tenures in the top role. They say she has a flexible leadership style, and that she is open to working with many different stakeholders. But her critics charge that she cannot deliver the overhaul that the department needs and that she has not been tough enough on corruption.

‘More of the same’

Jack Bloom is the DA shadow minister for health in Gauteng. He says: “I don’t think the present MEC deserves to be reappointed, but that’s for the ruling party to determine. What we will get going forward is more of the same. The Gauteng Department of Health needs wholesale change but it’s not going to happen under the present situation.”

Bloom says Nkomo-Ralehoko’s comeback is “cadre deployment and political protection” and he adds: “I’m afraid that the corruption is across the board and the looting is going to continue.”

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He says the MEC slow-walked disciplinary action on many suspended senior staffers and has also failed to tighten up on the likes of pre-employment checks on would-be employees, resulting, he says, in weak candidates being appointed.

The EFF is the third largest party in the Gauteng legislature. Nkululeko Dunga was contacted to weigh in on Nkomo-Ralehoko’s reappointment but he declined to take our calls and didn’t respond to written questions.

‘Delays that cost lives’

Speaking briefly to news channel eNCA after she signed her oath of office on 3 July, Nkomo-Ralehoko mentioned oncology and radiation services as one of her priority areas. She referred specifically to the building of bunker-like facilities in order to house specialist cancer treatment equipment procured for Chris Hani Baragwanath Hospital and George Mukhari Hospital.

However, for Salome Meyer of the Cancer Alliance, the fact that equipment has been procured but is sitting in storage amounts to delays that cost lives. She says there are currently 3 000 patients in the province on waiting lists for cancer treatment.

“Our facilities are operational but they aren’t operating at full capacity because the  equipment is not in use or we don’t have  staff to operate the equipment,” Meyer says.

“What we’re seeing is resignation after resignation of radiation therapists because they aren’t on the correct pay grade. So even when we do get equipment there is not enough people to operate the equipment.

“The MEC has to start looking after her own people – the people who work in our clinics and hospitals,” she says.

‘Ensuring stability’

For the Democratic Nursing Organisation of South Africa (Denosa) in Gauteng though, Nkomo-Ralehoko has used her 20 months in the MEC role so far to start making the right turnarounds for the health department.

Bongani Mazibuko of the nursing association says: “We believe that this welcome appointment of the MEC will go a long way in ensuring that there’s stability in the department and it’s something that Denosa has long been calling for”.

Lack of stability has been a feature of Gauteng health over the last decade or so. When Nkomo-Ralehoko was appointed in 2022, she replaced Nomathemba Mokgethi, who had been in the job for less than two years. Prior to Mokgethi, Bandile Masuku was also in the position for less than two years. Gwen Ramokgopa filled in for a bit more than two years, and before her, Qedani Mahlangu was forced to resign after the Life Esidemeni tragedy.

Denosa in Gauteng also call for the finalisation of CEO appointments and for senior management posts to be filled. They also say fixing of infrastructure is critical “so that the department can be more functional”.

Mazibuko adds: “We need to ensure that appointment of nurses is prioritised as they are the backbone of the system. But we have faith that we can continue working together to ensure that the people of Gauteng get the health that they deserve.”

Right direction, but needs to act on corruption

Treatment Action Campaign Gauteng chairperson Monwabisi Mbasa also supports Nkomo-Ralehoko’s reappointment. He says compared to her predecessors, Nkomo-Ralehoko has so far been someone they feel they can work with.

“We have seen that in the past nearly two years the MEC has been trying to address some issues plaguing public healthcare at provincial, district and clinic level. She is hands-on and flexible, so we have confidence in her still,” Mbasa says.

But Mbasa says she must be held to account on not taking “drastic action against corruption”. He says 26 of Gauteng’s 37 public hospitals have in recent times run out of food but Nkomo-Ralehoko’s intervention included using suppliers and service providers who were not properly registered. He says it is a red flag and they will continue to hold the MEC to account.

Mbasa says to move forward now for health in the province will require alignment of the health department with the departments of infrastructure and development and of finance.

“Infrastructure of our health facilities is an emergency. We are also calling for the improvement of supply chain management and procurement of goods and services and we need to improve human resources.

“There are challenges and weakness in the Cabinet but it’s good that we are not working with completely new people in these portfolios. This is the time to accelerate and to ensure that we use the seventh administration to improve the delivery of public health,” Mbasa says.

After long and tense talks, negotiations with the DA to form part of the provincial executive deadlocked. This resulted in Premier Panyaza Lesufi naming a Cabinet with seven MEC positions for the ANC and one each to the PA, IFP and Rise Mzansi.

Republished from Spotlight under a Creative Commons licence.

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Categories : Healthcare Politics and RegulationsTags :

Gauteng Non-profit Organisations Reject Findings of Province’s Forensic Probe

On By ModernMedia

Six out of 13 drug rehabs previously funded by the Gauteng Social Development Department are now “under investigation”

Photo by Scott Graham on Unsplash

By Daniel Steyn and Masego Mafata

Non-profit organisations whose funding by the Gauteng Department of Social Development has been withdrawn say they are being unfairly punished for “frivolous” and “flimsy” findings made by forensic auditors.

Among the organisations concerned are women’s shelters, drug rehabilitation centres and organisations that provide meals and social work services to homeless people. Many say they have no choice but to scale down their services and even close their doors.

Only seven in-patient drug rehabilitation centres, out of 13 that received funding last year, will be receiving funds for the first two quarters of this financial year, the department confirmed to GroundUp on Wednesday. Six rehabs are under investigation, the department said. 

A manager at a children’s home told GroundUp earlier this week that they had to send a teenager struggling with substance use disorder back to their family because there were no state-funded in-patient drug rehabilitation centres available in the West Rand.

Forensic auditors were appointed by the department in 2023 to probe allegations of maladministration and fraud in the non-profit sector. The department’s budget for non-profit organisations is R1.9-billion for 2024/25, but Gauteng premier Panyaza Lesufi has promised it will be increased to R2.4-billion. Fourteen department officials have been suspended based on findings of forensic audits, the department has said.

The forensic audits were supported by outgoing MEC Mbali Hlophe. Hlophe has claimed several times that non-profit organisations in the province were “stealing from the poor” and that there has been extensive corruption in the sector.

A report provided by the department to the Gauteng Care Crisis Committee last week, on the orders of the Gauteng High Court, contains a list of 53 organisations that are under investigation, out of several hundred funded by the department.

Among the organisations on the list are Daracorp and Beauty Hub which received millions of rands in subsidies for training, while others have had their budgets cut.

But while organisations such as these have received large amounts of funding under questionable circumstances, the department has not provided evidence that this applies to all organisations on the list.

In May, almost two months into the new financial year, organisations flagged in the investigations started receiving letters informing them that they would not receive funding due to the findings made by the auditors. Some only received the letters in June.

When they requested clarity from the department, some received details in writing. But others were only given reasons for the suspension of their funding during a meeting with the department’s lawyers on Wednesday.

GroundUp spoke to representatives of five organisations who attended Wednesday’s meeting. They said the findings they were presented with on Wednesday were minor issues that should have been picked up by the department’s own monitoring and evaluation teams and would have been quickly resolved. They said they did not understand why a forensic audit was necessary.

The organisations have not received any funding from the department since the end of the financial year in March, and are battling to keep going.

“Flimsy and frivolous”

Derick Matthews, CEO of the Freedom Recovery Centre, which until March was funded for 52 beds for in-patient drug rehabilitation, told GroundUp that the allegations against the centre are “flimsy” and “frivolous”.

Matthews was told at Wednesday’s meeting that Freedom Recovery Centre had not submitted audited financial statements for 2022. GroundUp has seen evidence that he submitted the audited financial statements.

Matthews said the department had never before raised concerns about the organisation’s compliance with legislation. He said every quarter the department’s monitoring and evaluation officials would check the centre’s financial statements and that no concerns had ever been raised.

The auditors also found a “high turnover of security personnel” at Freedom Recovery Centre which was causing “instability in the organisation”. Matthews explained that this was because the security staff are employed from the centre’s skills development programme, through which a person who has been sober for a year works for three to six months at the centre.

“They are paid salaries from DSD funding. Our security is not working directly with the residents so they cannot impact the stability of the centre,” Matthews said.

The third finding against Freedom Recovery Centre was that staff members were being given “loans”. Matthews explained that sometimes when the department paid subsidies late, the centre would pay part of staff salaries from the tuck shop’s funds, which would later be deducted from their salaries.

Matthews says that they are in the process of discharging their last state-funded patients. “Both government-funded centres that we have been told to send people to during this crisis are full, they can’t help us. In the last week, I’ve received about 12 phone calls of people that needed urgent help and we can’t even help or intervene,” he said.

Representatives of other organisations GroundUp spoke to had similar concerns about the findings against them but did not want to be named for fear of victimisation.

They also raised concerns that their meeting on Wednesday was with only one department official and the department’s lawyers, while the organisations themselves did not have lawyers present.

They were told they have until Monday to provide evidence to dispute the allegations against them.

At the meeting on Saturday convened by Gauteng Premier Panyaza Lesufi, it was agreed that the organisations would receive an interim service-level agreement from the department by Monday, which would be finalised once the organisations were cleared. But not one organisation GroundUp spoke to has received an interim service-level agreement. Then on Wednesday they were told they will receive the agreements next week.

One organisation under investigation, Child Welfare Tshwane, was finally paid by the department last week after Gauteng High Court Judge Ingrid Opperman issued a directive that the organisation be paid to prevent harm to the beneficiaries.

GroundUp sent detailed questions to the Gauteng Department of Social Development, but we were told that the department will not be responding to media queries relating to the non-profit sector until further notice.

Republished

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Categories : Healthcare Politics and Regulations Substance UseTags :

Almost Half of State-funded Drug Rehab Beds in Gauteng Under Threat

On By ModernMedia

Organisations are “under investigation” but have not been told why

Photo by Colin Davis on Unsplash

By Daniel Steyn, Masego Mafata and Raymond Joseph

The Gauteng Department of Social Development has decided to defund more than half of its existing capacity for inpatient drug rehabilitation in the province.

The department funded 571 beds in 13 non-profit organisations in the 2023/24 financial year, but at least five organisations, with 246 of these beds, will not be funded in the 2024/25 financial year.

The five organisations to be defunded – Westview Clinic Empilweni Treatment Centre, Golden Harvest Treatment Centre, Freedom Recovery Centre and Jamela Rehabilitation Centre – have been providing inpatient treatment for several years, but they have not received subsidies since the end of the last financial year.

Organisations GroundUp spoke to said they received letters from the department in the past few weeks informing them that they would not receive funding due to ongoing investigations. But they had not been told why they are under investigation, they said.

Representatives of FSG Africa, a forensic auditing firm appointed by the department, briefly visited some of the centres earlier this year, but the centres received no feedback on the progress or outcome of these investigations.

The auditors spent less than two hours at most of the facilities, asking only a few questions before leaving, the organisations said.

The organisations said they are yet to receive a report on the findings of the investigations. Queries they sent to the department have gone unanswered.

In previous years, the funding process was managed at a regional level, but this financial year it was centralised, cutting out the regional officials who would usually be in direct contact with the organisations. This has caused catastrophic delays.

Several of the organisations have been operating without departmental funding since March, depleting their savings and taking on debt, and having to short-pay staff salaries.

The department’s spokesperson Themba Gadebe confirmed to GroundUp that the organisations are under investigation, but did not provide details on the allegations.

In October 2022, Premier Panyaza Lesufi said treatment for substance abuse disorder was a priority. Yet the department has decided to defund beds in treatment centres without a clear plan to replace the lost capacity.

Gadebe said the department’s state-owned facility in Cullinan, near Pretoria, which has 288 beds, is undergoing renovation to increase its capacity. But he did not provide further details or timelines for completion.

Sedibeng’s only inpatient centres face closure

The only two drug rehabilitation centres with an inpatient programme in the Sedibeng region of Gauteng, with 116 funded beds between them, will be defunded this financial year.

One of these, Freedom Recovery Centre, was funded last year for 52 of its 94 beds (the remainder are for private patients). CEO Derick Matthews says when they received the department’s letter on 23 May “our world came crashing down”. What shocked him most was that there had been no warning that funding would stop.

Freedom Recovery Centre received a visit from the forensic auditors in March, who spent just two hours at the centre. They asked to see vehicles that the centre had supposedly received from the department.

“I was shocked by this request because we have never received vehicles from the department. But the auditor said that, according to their list, we had received vehicles from the department,” said Matthews.

“We are being punished for something. But we don’t even know what our transgression is,” he said.

On Monday, Freedom Recovery Centre began the process of discharging patients who were nearing the end of their treatment plans, as they can no longer afford to care for or feed them.

“We’ve had to take out loans for the past few months because of the delays in finalising service-level agreements and paying subsidies,” said Matthews. The centre has racked up more than R2-million in debt.

“Our staff are entering the third month of working without pay. Eskom is going to cut our electricity some time this week, because we are in arrears, and then we won’t even have water, because we rely on electricity to pump our boreholes. There are no funds left to keep the centre going,” said Matthews.

He said the centre will have no choice but to close completely in the coming weeks.

The other inpatient programme in the Sedibeng region, Jamela Recovery Centre, funded for 64 beds in 2023/24, faces a similar fate. CEO George Sibanda said they were relying on food donations from community members to feed their patients.

“We have been fully funded by the department since 2018 and our services are offered at no cost,” Sibanda said.

“We always had a backlog of patients. Our waiting list is sitting at 60 people so we were relieved when the department informed us that we would be getting additional beds in March this year. But what we don’t understand is how we must now provide a service to those patients if the department is not funding us this year?” said Sibanda.

Jamela also received a visit from the forensic auditors in March.

Despite not receiving any subsidies this financial year, Sibanda said the centre has been operating at full capacity.

“The department continued to refer people to us and we couldn’t turn them away,” he said.

Social workers at the centre have had to use their own money to pay for petrol for the centre’s car, which they use for outreach programmes.

Department spokesperson Themba Gadebe said that the closure of both centres in Sedibeng was not a concern as “the department prefers the placement of individuals within inpatient facilities far from where they reside, to limit the risk of them checking out or being contacted by those within their substance use networks.”

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Categories : CancerTags :

Activists and Patients March on Gauteng Health Department Demanding Radiation Treatment

On By ModernMedia

Nearly R800-million set aside for radiation treatment outsourcing has not been spent

Activists and patients marched on Tuesday in Johannesburg demanding radiation treatment for cancer. Photo: Silver Sibiya

By Silver Sibiya for GroundUp

Activists and cancer patients marched to the offices of the Gauteng department of health on Tuesday demanding that millions of rands allocated for radiation treatment for cancer patients be used.

SECTION27, Cancer Alliance and Treatment Action Campaign (TAC) called for the department to use R784-million set aside by the provincial treasury in March 2023 to outsource radiation treatment. They say not a single patient has received treatment through this intervention a year later.

In an open letter to health MEC Nomantu Nkomo-Ralehoko last week, Khanyisa Mapipa from SECTION27, Salomé Meyer from the Cancer Alliance and Ngqabutho Mpofu from TAC said that in March 2022, Cancer Alliance had compiled a detailed list of approximately 3000 patients who were awaiting radiation oncology treatment.

They said there were shortages of staff in the two radiation oncology centres in Gauteng, Steve Biko Academic Hospital and Charlotte Maxeke Johannesburg Academic Hospital. Charlotte Maxeke Hospital had only two operational machines compared to seven in 2020. Tenders for new equipment had been delayed and the backlog of patients was increasing, they said.

As a result, SECTION27 and Cancer Alliance had asked the provincial treasury to set aside R784-million to outsource radiation treatment. The money had been allocated in March 2023, but a year later, no service provider had been appointed.

“It has actually been four years since the matter was brought to the Department of Health,” said Mapipa on Tuesday. She said cancer patients were not getting the treatment they needed.

“We as Cancer Alliance and SECTION27 ran to Gauteng Treasury to ask them to allocate these funds. Gauteng Treasury responded and they gave this money, but this money is still sitting.”

Thato Moncho, who was diagnosed with breast cancer in September 2020, is one of the patients on the waiting list. She said she had faced many delays in her treatment. “I’ve had three recurrences of cancer and I need to have radiation six weeks after my surgery, which they failed to give me. I have pleaded with the MEC of Health and the Chief Executive Officer at Charlotte Maxeke to speed up the process so I can get my radiation but they failed.”

“I’m pleading: help us so we can get radiation to live a normal life with our family.”

Gauteng Department of Health spokesperson Motalatale Modiba said the department had received the memorandum and would respond to it. He acknowledged that there had been delays which he said were caused by tender processes.

“It is in our interest to ensure that we get to address the backlog of those that require treatment, and the department will formally respond to the concerns that have been raised.” He said a tender had been awarded.

“In May the process to treat patients will start in both hospitals.”

“The respective heads of oncology in Charlotte Maxeke and Steve Biko hospitals are busy with that process of onboarding.”

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Source: GroundUp

Categories : General Interest Obstetrics & GynaecologyTags :

Gauteng Health Rings in the New Year with 112 Births

On By ModernMedia
Photo by Christian Bowen on Unsplash

New Year’s Day saw the Gauteng Department of Health welcoming 112 babies into the world, the lion’s share of more than 400 births in total for the country. According to data released by Gauteng Health on X/Twitter, in the province’s public healthcare facilities, there were a total of 59 boys and 53 girls. Thelle Mogoerane Regional Hospital topped the table with 10 babies, followed by Chris Hani Baragwanath Academic Hospital (CHBAH) with 9 babies. But all of this was relatively quiet compared to Christmas Day, which saw more than three times the New Years’ Day number.

MEC Nkomo Nomantu together with MMC for Health Rina Marx joined the postpartum mothers at Dr George Mukhari Academic Hospital on the morning of New Year’s Day in welcoming their new arrivals. Gauteng’s academic hospitals recorded 19 births, while there were 10 births at the tertiary hospitals. Regional and district hospitals had 69 births and community healthcare centres had 14.

Christmas Day saw 387 babies born, 201 of them girls and 186 boys. CHBAH welcomed the most, with 46 births, followed by Tembisa Hospital with 38.

Categories : HospitalsTags :

Mixed Responses to Gauteng Health’s Latest Security Plans

On By ModernMedia
Photo by Maxim Hopman on Unsplash

By Thabo Molelekwa for Spotlight

Following reports of healthcare workers who have been bitten, punched, hit in the face, robbed, assaulted, or even killed in healthcare facilities in Gauteng, the province’s health department announced that healthcare workers will now be trained in handling patients who become violent.

The initiative was recently announced by Motalatale Modiba, spokesperson for the Gauteng Department of Health, on social media.

A lack of security at public healthcare facilities is not a new problem. A previous series of Spotlight articles highlighted security challenges in public health facilities in several provinces – including Gauteng – and reports of robberies and assaults at some facilities. Last year, there was a fatal shooting of a nurse at Tembisa Hospital which sparked an outcry among health worker unions over the safety of their members.

The departments’ announcement prompted questions by organised labour and an opposition politician about whether the authorities have lost trust in the multi-million rand security measures already in place in health facilities to protect both workers and patients, with some arguing that security guards, rather than healthcare workers, should be responsible for safety.

However, according to Modiba, the training of staff has nothing to do with the security contracts of security companies.

“Security personnel are non-medical personnel, therefore, their presence in facilities does not substitute the need to ensure that our staff is empowered with techniques to know how to handle difficult patients,” he told Spotlight.

‘Just a tick-box exercise’

The training plans, however, have inspired little confidence among healthcare workers.

According to the nurses’ union Denosa’s Gauteng Provincial Secretary, Bongani Mazibuko, the training does not address the safety concerns that exist in the facilities. “It’s just a tick-box exercise to say the employer is trying to do something. The root cause of these attacks is the influx of mental health patients and the mixing of mental health patients with medical patients,” he told Spotlight.

The department in a statement in April said many of the incidents were reported at Weskoppies Psychiatric Hospital with 21 cases since January last year. At Carletonville Hospital there were nine safety incidents, nine incidents at the Far East Rand Hospital, seven at Chris Hani Baragwanath Academic Hospital, four at Thelle Mogoerane Hospital, and three at Kopanong Hospital. There were also reports of some isolated incidents at other facilities.

Mazibuko said that from the reports they received from their members working in Gauteng public health facilities, the training has also not yet taken place. “We would like the department to tell us which institutions they have provided the training to so that we can confirm with our members if they received the training or not.”

Modiba, however, did not respond to Spotlight’s questions about where training had taken place so far, how many healthcare workers have been trained, or the impact this is having.

Explaining aspects of the plan, however, Modiba said that the department training staff to know how to protect themselves is a practical step that shows that they are conscious of the environment they operate in. According to him, training on how to manage a violent mental healthcare user is generic to the training of doctors and psychiatric nurses as regulated by the Health Professions Council of South Africa, which is a statutory body established in terms of the Health Professions Act. “A special course on management of violent mental healthcare users is planned to be rolled out from the second quarter of the 2023-2024 financial year. It is based on a similar course attended by one of the healthcare workers in the UK. He will be working in one of our Specialist Psychiatric hospitals, Sterkfontein Hospital. He will be the main facilitator and will be working with other employees from the Regional Training Centres, the Office of Health Standards Compliance (OHSC), and Wellness Practitioners,” said Modiba. He said the department is also working with the police.

But Mazibuko said Denosa has had many talks with the department on healthcare workers’ safety concerns and the need to create a safe working environment. “This was part of our demands when we marched last year. Even on International Nurses Day, we were vocal about our concerns about the safety of our members at the workplace.”

He said the union had previously presented its safety campaign to the department.

SAMA ‘deeply concerned’

Meanwhile, following a scoping review study, the South African Medical Association (SAMA) recently published a report outlining the nature and extent of violence against healthcare workers between 2012 and 2022. The study found an increase in violent acts targeting healthcare workers, with the most affected being doctors, nurses, and paramedics. The study found that female healthcare workers were disproportionately affected compared to their male counterparts and most of the incidents were reported in Gauteng.

In an interview with Spotlight, SAMA Chairperson Dr Mvuyisi Mzukwa said they are “deeply concerned” about the safety of healthcare professionals. He said they appreciate efforts that can realistically improve the safety of healthcare workers in the workplace.

“SAMA has shared an interim report [based on the study findings] on violence targeting healthcare workers with DENOSA and the media. This report was designed to sensitise all stakeholders about crime targeting healthcare workers and to prime the stakeholders, including the National Department of Health, to initiate intersectoral solutions to limit and prevent safety threats in the workplace against all healthcare workers in the country,” Mzukwa said.

SAMA’s report found eight murders of healthcare workers reported in the media, “with six of the deaths (or 75%) occurring among doctors”. One nurse and one paramedic were also murdered in the set period the report found. “Of all the 45 media reports examined, only 17 arrests (38%) were reported, with only two resulting in successful prosecution.”

According to Mzukwa, SAMA had recommended that a multi-sectorial strategy for the security of healthcare workers to protect them from targeted crime be developed and implemented.

“Without this intervention, healthcare in itself continues being further jeopardised and more doctors will feel threatened and seek safer refuge in foreign countries, taking with them critical skills and expertise that are in dire need locally. Law enforcement agencies should also act swiftly in dealing with crime and to ensure the safety of both patients and healthcare providers,” Mzukwa said.

61 safety incidents

Speaking in the Gauteng Legislature in April, MEC for Health and Wellness, Nomantu Nkomo-Ralehoko said there were 61 incidents reported in health facilities between January 2022 and April 2023. She told MPLs that most of these incidents were attributed to mental healthcare users, while others relate to patients’ anger towards staff for various reasons, such as refusal to buy them items or patients trying to escape, as well as angry relatives and patients linked to criminal activities.

Nkomo-Ralehoko said that staff training in responding to aggression and violence in the affected institutions is one element of their intervention. She said the department will be installing CCTV cameras at strategic locations for monitoring purposes.

“Our goal is to minimise – if not eradicate – such incidents in our facilities. We have to work with healthcare workers and other stakeholders such as hospital boards, clinic committees, and the patients themselves to curb incidents of attacks inside our facilities,” she said.

But security concerns in Gauteng’s public health facilities are also fuelled by systemic and contract management issues – something the MEC vowed to address. In March, responding to concerns over these multi-million rand security contracts that are rolled over year on year without a proper tender, Nkomo-Ralehoko acknowledged that the situation is unacceptable. The department is spending over R59 million on month-to-month security contracts at its facilities.

“The security contracts are rolled over irregularly as there is currently no contract in place; only service level agreements are used to manage the contracts,” she said.

Responding to a question from Spotlight on the progress with the new security tender, Modiba said that the tender was advertised and has since closed. “The evaluation committee has been appointed and will now go through the evaluation process to assess the various bids that have been received. We are still on course to complete the process within this financial year,” Modiba said.

But according to Denosa’s Mazibuko, in-sourcing security services, separating mental health patients from other patients, and ensuring that mental health patients are only admitted to where the institutions can commit them, will help the department and the healthcare workers work in a safe space.

He said that the fact that there have been years of year-on-year security contracts, shows that the department is not in touch with the challenges on the ground. “In-sourcing of security will help as well since it will address the issue of security withholding their services as they have not been paid and security being given proper gear for work,” he said.

According to Jack Bloom, the Democratic Alliance’s health spokesperson in Gauteng, the department is failing in its basic responsibility to provide a safe working environment for staff and patients in public hospitals.

“A huge amount of money is spent on security companies that don’t do their job, and it is high time that new security contracts are awarded to competent providers,” he said.

Bloom said that healthcare providers should not have to defend themselves against attacks because that is what security guards are supposed to do. “There needs to be a complete overhaul of security arrangements at our hospitals, with a professional assessment of what should be provided at a reasonable cost,” he said.

Republished from Spotlight under a Creative Commons Licence.

Source: Spotlight

Categories : Healthcare Politics and RegulationsTags : 1 Comment

In the Hot Seat: New Gauteng Health MEC Responds to 10 Questions from Spotlight

On By ModernMedia
Nomantu Nkomo-Ralehoko, MEC for Health in Gauteng. Photo: GP Health and Wellness/Twitter

By Spotlight Editors

On 7 October, Gauteng Premier Panyaza Lesufi appointed Nomantu Nkomo-Ralehoko to the position of MEC for Health in the province. Nkomo-Ralehoko replaced Nomathemba Mokgethi, who had been in the job for less than two years.

The position of MEC for Health in Gauteng is one of the most important, and probably one of the toughest public sector health jobs in South Africa. Spotlight sent Nkomo-Ralehoko ten questions about her plans and on the chronic problems plaguing health in Gauteng. We received the below responses via Tshepo Shawa, the MEC’s spokesperson.

1. After the murder of Babita Deokaran, the Gauteng Health Department was very slow to follow up on the alleged corruption that Deokaran had exposed at Tembisa Hospital. What steps will you take as MEC to ensure that the alleged corruption at Tembisa Hospital is fully investigated and that justice is done?

Nkomo-Ralehoko: The Gauteng Provincial Government has already, through the Office of the Premier, taken action to ensure that the Special Investigating Unit (SIU) conducts a forensic investigation into the transactions at Tembisa Hospital. I am also aware that the Hawks are probing the matter.

I have made a commitment that as soon as the SIU concludes the forensic investigation, we will definitely not hesitate to act on the recommendations.

Sometimes, justice might seem delayed, but it is important that we allow law enforcement agencies to complete their work so that firm action can be taken where there is wrongdoing.

2. From PPE-related corruption to alleged corruption at Tembisa Hospital, the Gauteng Department of Health appears to have a chronic and systemic problem with corruption. What steps will you take as MEC to:

i) root out corruption in the department at a systemic level;

ii) and ensure there are consequences for those implicated?

Nkomo-Ralehoko: One of my immediate focus areas is to ensure that the department’s systems across delivery areas such as Finance, Human Resources, Monitoring and Evaluation, Risk Management, etc. are strengthened so that processes are not dependent on human vulnerability but there are clear checks and balances.

An environment that has no consequence management breeds ill-discipline and a culture of ignoring processes and procedures as prescribed in our legislative framework. Our environment is highly regulated through various prescripts and it is important for oversight purposes and for good governance that the distinctive roles in terms of the role of Executive Authority and the role of Accounting Officer are appreciated.

I have already made an undertaking to work with stakeholders internally and externally to ensure that there is accountability and consequence management. Equally so, it will be important to also recognise people that go beyond the call of duty. We need to encourage an environment where we get back to the Batho Pele principles by ensuring that our work is geared towards improving patient experience of care and improving our service offering. We also need to make sure that employees work in an environment that appreciates the service they are rendering to communities and allows them to thrive.

3. The work of restoring Charlotte Maxeke Johannesburg Academic Hospital was handed over to the National Department of Health after the Gauteng government botched the job. What steps will you take as MEC to ensure that Charlotte Maxeke is fully functional again as soon as possible?

(Here, the MEC referred us to a response provided to the provincial legislature regarding the rebuilding of Charlotte Maxeke)

4. There have in recent years been chronic management-level vacancies in the Gauteng Department of Health. What steps will you take as MEC to ensure that all vacancies in the department are filled with suitably qualified people?

Nkomo-Ralehoko: Part of the intervention programme for the remainder of the 6th Administration term of office will be to review the age-old organisational structure which was last updated in 2006 to ensure that it is relevant and fit-for-purpose and takes into consideration the size of the Gauteng healthcare system and the kind of skills that are needed to provide adequate and effective care to the over 16 million people of the province, majority of whom rely on the public healthcare system.

We have put in place an ambitious plan called Turning The Tide: Reclaiming the Jewel of Public Health in Gauteng, which looks at a number of intervention areas. Key amongst these is the Human Resource component.

This is to ensure that we have a structure that responds adequately to clinical, administrative, social, and economic challenges faced by the province. This will enable the department to be able to deliver on the workforce that positively impacts its strategy execution efforts and acceptable levels of organisational performance.

5. Are you in favour of cadre deployment in the provincial health department?

Nkomo-Ralehoko: If by cadre deployment you mean a situation where highly trained and qualified personnel who understand the delivery imperatives of the developmental state and are committed to a high ethical standard embracing a culture and ethos of service, then indeed I am for cadre development.

However, if by cadre development you are referring to bringing incapable and unqualified people into the public service at the expense of delivery, then I can’t support such.

6. Healthcare workers often work under very difficult conditions and surveys have shown that many healthcare facilities are understaffed. What steps will you take as MEC to ensure sufficient numbers of healthcare workers are employed in Gauteng and work under decent working conditions?

Nkomo-Ralehoko: Kindly refer to the response to question 4 above. Additional to that response is that the Turning the Tide plan has also prioritised health infrastructure to ensure that healthcare workers work in a safe environment.

Our Department is now called the Department of Health and Wellness that on its own is a clear indication that issues of wellness will also receive special focus. We can’t preach a message of wellness while our employees are unwell and unhappy. In my first address to the staff at head office on 10 October 2022, I made a commitment to the team that charity will begin at home. For this reason, we will soon be rolling out Wellness Wednesdays, the aim of which is to bring the spotlight on employee wellness and to ensure that we pay more attention to the softer but critical issues that make the workplace a more conducive environment.

7. In your view, what is the key difference between the role of the MEC for health and the HoD of the province’s health department?

Nkomo-Ralehoko: The roles of the Executive Authority (MEC) and Accounting Officer (HoD) are clearly defined by various laws and regulations, such as the Public Service Act, Public Service Regulations, and Public Finance Management Act. The executive authority is the political head and is responsible for policy direction and oversight. The executive authority delegates certain functions to the accounting officer to ensure effective public management and administration.

The accounting officer is the administrative head of the department and is responsible for the day-to-day operations of the department.

8. As MEC, will you listen to and support healthcare workers like Dr Tim de Maayer who blow the whistle when the situation at health facilities becomes untenable, or will you take steps against such people?

Nkomo-Ralehoko: I have made a commitment to staff to work with them to turn the health system around. This means that performance systems and tools will have to be strengthened while we also create a conducive environment that allows employees to be heard. Everyone’s voice matters if it is a voice that seeks to move us forward. We all have a role to play to restore the tarnished image of the Gauteng public health system.

9. As the province’s new MEC for Health, what lessons do you take from the Life Esidemeni tragedy?

Nkomo-Ralehoko: You will appreciate that I am just a few days in office and I am obviously getting appraised with the myriad of issues confronting the healthcare system in the province. One of the commitments made by this 6th Administration was to be a patient-centred, clinician-led, and stakeholder-driven healthcare system. This is a commitment we intend to see through in the remaining period of the term of office. My job is to ensure that patients are at the centre of our work by giving clinicians space to do what they are trained to do while at the same time listening to the voice of the many stakeholders who want to see public health live up to its promise.

10. As we understand, you are not a medical doctor and in a SABC interview you said you are “a politician by accident”. What in your background and experience would you say makes you the right candidate for the role of MEC for Health?

Nkomo-Ralehoko: Yes I said I am a politician by accident given that I was drawn by many lived experiences which harnesses the activist in me that was driven to change things for the better. I am an administrator at heart, but I am also an experienced leader, having led across various structures in society.

I understand the plight of the people of Gauteng and I am committed to putting my skills and knowledge to change things for the better. I may not be a clinician or a nurse, but I do know that the healthcare system is nothing without healthcare workers.

Republished from Spotlight under a Creative Commons 4.0 Licence.

Source: Spotlight

Categories : General Interest HospitalsTags :

Another Fire Breaks Out at Charlotte Maxeke

On By ModernMedia
Source: Pixabay CC0

In what is becoming something of a regular occurrence for Gauteng hospitals, another fire has broken at beleaguered Charlotte Maxeke Academic Hospital on Tuesday night. Fortunately, the fire was contained to a currently unused parking area in a damaged section of the hospital. The situation was deemed not to be serious enough to warrant a patient evacuation.

A fire in April 2021 caused the closure of seven wards, with some 200 beds. Reopening had long been delayed, and there have been complaints of thefts of equipment and construction material. Alleged corruption has continued to dog the full reopening of the 1088-bed academic hospital, overloading other hospitals and also impacting the training of student doctors.

An investigation by Spotlight revealed a number of factors for the 2021 fire including ageing infrastructure, essential equipment such as fire doors not working, low water pressure and incompatible fire hydrants (due to theft), a lack of evacuation plans and a fire service that was woefully underequipped.

Gauteng department of health spokesperson Motalatale Modiba gave a report on the latest fire: “Late on Tuesday night, security personnel reported that there was smoke that seemed to be coming from one of the structures. Firefighters for the City of Joburg immediately responded to the situation and managed to contain the fire which was confined to a small section of the level two parking.”

“The level two parking is one of the areas that was affected by the April 2021 fire and is currently under props and not accessible to the public or staff except for construction people,” Modiba said.

“Upon assessment of the situation clinicians on site together with the facility’s head of disaster made a call that the situation did not warrant for patients to be evacuated as the smoke from the fire was not too thick or high risk for inhalation.”

This comes after two fires broke out within weeks of one another at Steve Biko Academic Hospital.

Categories : General InterestTags :

Child Welfare NGO One of Many Defunded by Government

On By ModernMedia
Photo by Chayene Rafaela on Unsplash

Christelike Maatskappy Raad Noord (CMRN), an NGO in Gauteng which focuses on children’s welfare through the use of social workers, has been defunded by the government. This amounts to just over half of its funding, according to marketing manager Anya le Cornu. Other NGOs have also had their funding cut, she said, as heard via the Auditor General’s office.

This comes in the wake of the COVID pandemic as CMNR had to cope with continuing to deliver services amidst lockdowns. If other NGOs are similarly impacted, . Founded in 1936, CMRN aims to eradicate child abuse and neglect, providing a wide range of child protection service from its 16 centres.

The NGO assists a large number of families of children: 6000 beneficiaries received material or skill support in 2020–2021, its Child Protection Awareness campaign reached 14 500 people, 622 children were protected through the legal system, and 900 children received speech or play therapy.

However, these services are obviously under threat from the significant loss of provincial government funding, which at R7 million, accounted for 53% of its income.

In order to cope, CMNR has been forced to restructure, reducing costs wherever possible. Unfortunately, it has having to slash its social workers from 28 to 17 as of 1 July.

Due to the lack of subsidy and other challenges, areas such as statutory work may be impacted.

According to le Cornu, CMRN will try and secure funding through every means possible. “We will maintain and strengthen our relationship with the NG church, our other funding partner,” she says. “We will also continue with our marketing and fundraising initiatives. Professional fees will also be applied where possible. We will also reach out to schools and other institutions where part time social work services are needed and contract these services out to generate an income stream.”

The organisation remains hopeful despite these challenges. “We do wish to have a good relationship with the Department of Social Development and would apply for government funding in specific programs where the objectives of these programs are aligned to our own and the communities we serve,” says le Cornu.

“The CMR North believes that we will survive this crisis and hope to be a beacon of light for other NGOs who might suffer the same fate. It is our passion to continue bringing hope to the vulnerable and we see these events as an opportunity to re-invent our services so that they can have a broader and positive impact in the communities we serve.”

Hopefully, additional funding can be found so that CMRN can continue to provide its services, but if this is part of a wider pattern, people in South Africa who are most in need and depend on these services will suffer the most.