Newly appointed Gauteng Health MEC Nomantu Nkomo-Ralehoko, responding to concerns raised by the Auditor-General and members of the Standing Committee on Public Accounts (Scopa), conceded numerous challenges within the department but said corrective measures were in place and they were on track to resolve many issues.
She and her senior officials were under the spotlight last week at hearings by Scopa, answering questions about measures to correct poor performance and ineffectual financial management
The committee members, led by chairperson Sochayile Khanyile, expressed particular concern about the repercussions of the Charlotte Maxeke Hospital fire 19 months ago, reports Daily Maverick.
Department head Nomonde Nolutshungu said the hospital was almost fully operational, with progress at 96%.
“Infrastructural remedial work is on track, and in terms of the services, the hospital is back at 96%.” Accident and emergency units were now fully operational, she said, but there were still concerns about security as reports showed the fire was an inside job, despite a new security company being hired six months ago.
“This an internal job, from people targeting copper wires and working on the site. They have all the time to remove wires from the walls; sometimes it takes about three or four days for these removals. They have been arrested. A case was opened … some of them were in jail for some time.”
Asked about services not yet fully operational, she said oncology and radiation remained an issue.
“There is a long waiting time for that treatment, not only because of what has happened at Charlotte but because also we have only two of these types of treatments in the province. We are …in the process of procuring portable treatment machines.”
Medical negligence lawsuits
Nkomo-Ralehoko was asked to list and estimate the value of the lawsuits up until 3 March in which the department was the defendant, and the progress made by 30 September in the finalisation of each one.
In a written response, the MEC said matters listed as medical negligence brought against the department sat at R24bn.
“Further verification of matters was conducted from 1 April 2022 to 31 August 2022, during which time, 347 matters were finalised in courts, but not captured as such in our financial records. These matters have since been removed from our financial records, resulting in a R2.7bn reduction in the contingent liability.”
Asked by chairperson Khanyile whether the department had plans in place to minimise the number of negligence cases and litigation, whether the cause was lack of equipment, incompetence, or just plain negligence, she replied that there was a plan, “including mediation”, which she said was one of the most successful methods to reduce cases of medical negligence.
“Yesterday, we had a meeting on this issue. Another strategy is to strengthen our legal team. We also realised we were weak… now we have a team that will work directly with quality assurances.”
Accruals
And on money spent by the department but not paid to suppliers and service providers, with the chairperson arguing that in previous administrations, this had brought the department to its knees, she vowed this would never happen again.
“We don’t want anyone who will misuse our funds; we will not allow anyone to take us back into that dark hole, we now verify each and every invoice, even… back to 2013.”
Procurement irregularities
Committee member Amanda de Lange questioned officials about their inability to prevent procurement irregularities, including a 2020 scandal with PPE orders worth R500m being placed by the department.
She asked whether there was a plan to deal with bidders who had failed to declare their interests and tax matters, and whether they were doing business with the state as was the case in 2020.
The department said bid committees were not “up to scratch” but they were resolving this by setting up trained committees.
“We have changed our controls and checklist, and have a system allowing us to punch in the names of people tendering and get their directors,” said Mankupane.
Consequence management
Canada Matsaneng, acting chief risk officer, admitted to difficulties bringing those implicated in wrongdoing to account, “as they evade the system”.
“Most of the senior people involved in these incidents… unfortunately, by and large, are no longer here, so we can’t effect consequence management. If we have not been able to discipline somebody since 2012, we don’t have a fighting chance to do that today.”
How to get it right
On what the department needed to do to get this right, Matseneng said: “It’s an ethical culture; we are not a department of police, we are a department of health. We are supposed to be taking care of people, so there is an aspect of societal force on malfeasance and unethical behaviour that as a department we are ill-prepared to deal with.
“It’s a capacity we are building on with other law enforcement agencies as well as the Office of the Premier. But it is a work in progress, it is in its infancy.”
Despite the problems with which the department is grappling, officials echoed the MEC’s sentiments about being on the right track.
“We really do have a fighting chance,” said Matsaneng.
See more from MedicalBrief archives:
Gauteng Health looting and corruption rot ’runs deep’ – nurse activist
Gauteng Health legal head paid R4.7m to twiddle her thumbs at home for 3 years
Gauteng health boss ignored Deokaran’s plea for probe, claims acting HoD
Gauteng Health denies written warning issued to whistle-blower doctor