Health MEC threatens legal action over DA’s field hospital claims

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Embattled Gauteng Health MEC Bandile Masuku has threatened action against Gauteng DA MPL Jack Bloom over statement regarding Nasrec field hospital.

According to News24, Masuku has called on Bloom to retract his media statement that, under Masuku’s leadership, R500 000 was spent per patient admitted to the Nasrec field hospital. Bloom claimed that only 700 patients were admitted at the 1 500-capacity facility.

“The Nasrec field hospital was commissioned on 15 June this year and has so far admitted 604 patients for quarantine and isolation, and 96 patients for intermediate care, including oxygen. The total bed capacity is 1,500 but there were only 25 patients as at 28 August 2020,” he said. “The facility has cost about R350m in total, which means that R500 000 has been spent on each patient. This is a colossal waste of money caused by poor judgment and probable corruption as connected people benefited from large contracts.”

Masuku’s lawyer Mojalefa Motalane said Bloom’s statement was factually inaccurate, was aimed at misleading the public, and has tarnished Masuku’s image and professional reputation. “This constitutes a gross violation of his constitutional rights to human dignity. The media release lacks context and is insensitive to the critical task of saving the lives of the people of Gauteng per the COVID-19 Response Plan. In the event that Bloom fails to retract his ‘false’ statement within 24 hours, we will not hesitate to take the necessary action,” Motalane warned.

 

In May 2020, in preparation for the anticipated high demand for ICU beds, the Gauteng government decided to expand its healthcare facilities by building a number of field hospitals to care for those with COVID-19. The province embarked on a programme that sought to increase its ICU bed capacity through the refurbishment of some existing facilities, as well as the building of four ICU field wards.

Mark Heywood writes in Maverick Citizen that despite commendable efforts to increase health infrastructure, an investigation has revealed that the Gauteng government has spent nearly R200m so far on “barrack-style field hospitals” that some experts believe are not fit for purpose, and worryingly are nowhere near complete despite the province passing its COVID-19 peak.

Out of a total provincial allocation of R5.9bn for the fight against COVID-19, nearly R3bn was allocated to hospital refurbishment and construction. Then, to expedite the building process the government opted to construct the new ICU facilities using what is known in the construction industry as alternative building technology (ABT).

Heywood writes that asked to explain this decision Kwara Kekana, spokesperson for the office of the MEC for Health in Gauteng, said: “In the case of ICU units to accommodate COVID-19 patients, the use of light steel frame construction allowed for significant reduction in time for construction, in comparison to the conventional building technologies. The prefabricated nature of the light steel frame building systems also allows for the reduction of on-site building operations and vehicular traffic, which improves overall safety and security for existing facilities in the area. The light steel cladded frame interiors also allow for adaptability and flexibility with future reuse, allowing for a legacy of the infrastructure beyond the COVID-19 pandemic.”

Kekana says these benefits are set out in a 2015 document developed by the national Department of Health’s Infrastructure Unit Support Systems (IUSS) project. However, the benefits of ABT in a high-care setting seem far from being universally accepted.

Heywood writes that it was learned that from the outset the use of ABT and the construction of field ICU hospitals were hotly contested by a number of high care specialists and some hospital administrators. Dr Nathi Mdladla, the chief intensivist at Dr George Mukhari Academic Hospital, north of Pretoria, told a meeting of the provincial war room on 30 May that the building of ABTs “is gross wasteful expenditure as the structures were most likely going to be a white elephant”.

The head of ICU at one of the other hospitals said she had “washed her hands” of the project. Instead, the doctors suggested alternatives that would have strengthened both capacity and quality of care in existing ICU units.

Heywood writes that health workers approached still question whether these facilities will be needed, even if there is a second wave of COVID-19. If they are not going to be needed for the COVID-19 emergency, are they being built in a way that is capable of being repurposed to meet other health needs? Most seem to think not, Heywood says.

A question posed to Kekana about what amount had been budgeted for medical equipment needed to supply the hospitals was not answered, although the Expenditure Disclosure Report says that R400m has been budgeted for “COVID-19 health technology”.

On staffing, the department’s response was, “Staff will be made available. Budget is part of the additional budget given by [the] provincial treasury for additional human resources.”

According to Heywood, given staff shortages, and the levels of experience and training needed by high care nurses and doctors, what this means in practice is far from clear. Preparing for a worst-case scenario is not a bad thing. However, despite projections the system ended up not being over-run in Gauteng. If it had, any extra capacity would have been important and may well have helped save some lives. The problem though is that if the surge had been much worse, most of this extra capacity would not have been ready in time. So, it would seem the planners in the Gauteng Health Department didn’t just miss the boat – there’s a danger that they are actually wasting their time, and our money, on building a ship that’s not fit for purpose.

Heywood writes that the investigation has merely scratched the surface and a deeper investigation is definitely necessary. In the words of Mdladla “the onus is now on the government to prove that the ABT/ICU project is not what it looks like”.

 

Full News24 report

 

Full Daily Maverick report

 

IUSS guides

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