The findings of an investigation by the Health Ombudsman into conditions at the Helen Joseph Hospital have confirmed some allegations by former broadcaster Thomas Holmes (aka Tom London) last year.
A report by Health Ombud Taole Mokoena and the Office of Health Standards Compliance (OHSC) described fly-infested wards, litter-strewn grounds and so few working toilets that staff are forced to use a nearby shopping mall to relieve themselves.
More importantly, they exposed extensive governance failings, ranging from a dysfunctional hospital board to no proper oversight of procurement processes, that leave the hospital open to corruption.
Little wonder patients frequently wait for days in the over-crowded emergency department, only to be admitted to a ward in which they are unlikely to be provided with clean linen or nutritious food, said Business Day editorial.
Immediate action
Mokoena highlighted peeling paint on the ceilings, broken basins and taps, as well as non-functioning electrical plugs that the office had noted during its probe.
He also identified a number of major safety issues, pointing out critical issues demanding “immediate action”, and noting “several significant infrastructure challenges indicating a systemic problem”, reports News24.
The risk-based inspection by the OHSC revealed “serious contraventions of the prescribed norms and standards regulations for quality and safety and other applicable laws to ensure safe and quality healthcare services”, and the infrastructure of the hospital was described as being “in poor condition, with leaking water from a steam pipe and a sagging ceiling posing safety risks to patients and staff”.
The report said some critical areas required immediate attention, and these included enhanced training for staff on professional conduct.
Serious issues were identified within the human resources department, with working relations between the HR manager and some subordinates labelled as “non-existent” – as well as “leadership problems”, with “no integration of leadership” and “a glaring lack of teamwork”.
The report said the institution has not had stable leadership for a long time, and that the posts of CEO and other senior managers were occupied by acting personnel.
Issues around poor linen management and “challenges procuring some food items” were also flagged, with reports that service providers had not been paid.
Priority to fill posts
Other problem areas included the “laissez-faire” attitude of security contractors, staff shortages, finance and supply chain management and governance issues.
The report made various recommendations for the Gauteng Department of Health and called for the urgent filling of key positions within six months.
Mokoena also wants a competent CEO appointed and a two-year turnaround strategy developed for the hospital.
He called for the leadership and management problems to be urgently addressed and the hospital refurbished.
Safety issues
Holmes welcomed the findings, but was unhappy that his claims of patient Nicholas van Burick’s body lying neglected for hours after his death in the ward were found to be “unsubstantiated”.
The patient's mother, Cicilia van Burick, who only learned of her son’s death – and that he was even at the hospital – after he featured in the videos posted on social media by Holmes, told News24 when she had contacted Helen Joseph, the staff could not even confirm he was there.
This was apparently because his details had been captured incorrectly on his hospital file.
Among his claims, Holmes had said the body of a patient – who later turned out to be Van Burick – had been left in his ward four several hours after he had died.
Both the OHO and OHSC, however, said the body was registered at the mortuary two and a half hours after he was declared dead, which was standard operating procedure.
But on other claims by Holmes, specifically around the hospital’s deteriorating infrastructure, they made damning findings.
DA MPL Jack Bloom said: “Obviously, this report shines a light on one hospital, but these issues are common to other hospitals in Gauteng as well … The problem is deep-rooted.”
Section27 attorney Khuselwa Dyantyi agreed, labelling it a “systemic issue”.
There have also been concerns raised over when, and even if, the laundry list of recommendations contained in the reports would be implemented.
Bloom pointed to the recommendations contained in the Ombd’s 2022 report on the Rahima Moosa Mother and Child Hospital.
"Late last year, I got a reply (in the legislature) that of 44 recommendations, only 22 had been fully implemented. The others were all in process,” he said.
Gauteng Health said that “the process of filling the CEO post at Helen Joseph is prioritised for the new financial year starting in April 2025, after the only suitable candidate declined an offer after the interview process.”
Negligence
This is not the first investigation into a Gauteng public hospital, the BusinessLIVE editorial noted.
The Ombud’s probe into the death of Shonisani Lethole at Tembisa Hospital during the Covid-19 pandemic revealed gross negligence, severe staff shortages and extensive administrative failures.
The Special Investigating Unit (SIU) has placed this hospital at the centre of an extensive corruption network running to more than R3bn, in which officials allegedly siphoned off money with inflated contracts.
Whistle-blower Babita Deokaran was assassinated for raising the alarm about these fishy contracts, yet more than three years later only her killers have been prosecuted. The mastermind behind the hit remains unknown and the SIU has yet to ensure any of the officials implicated in the scandal face criminal charges.
An investigation into the Rahima Moosa Mother and Child Hospital in 2022 found expectant mothers forced to sleep on the floor, overflowing toilets and unheated wards.
Former Ombud Malegapuru Makgoba’s report detailed the facility’s failings and provided a blueprint for fixing them: two years later, only half of his 44 recommendations have been implemented, and the independent forensic team that was supposed to be appointed within two months to assess the hospital’s management team has yet to be established.
In 2016, the Wits Centre for Health Policy characterised Gauteng Health as a department in which mismanagement and corruption were rife. Almost a decade later, nothing appears to have changed.
The department’s budget deficit now stands at R7.3bn, and as has become the norm towards the end of every financial year, it has frozen posts and is leaving suppliers unpaid until the next financial year begins on 1 April. The cash crunch means surgeries are postponed, hospitals risk running out of essential medicines and staff are forced to work in increasingly difficult conditions.
There is clearly no political appetite to address these problems. Year after year, scandal after scandal, there are shamefully few consequences for individuals who are at best incompetent and at worst corrupt.
All of this does little to build faith in the public health system, or trust Health Minister Aaron Motsoaledi’s promises about National Health Insurance.
If he really wants to garner public support for the scheme, fixing the rot in the Gauteng Health Department would be a good place to start, the editorial suggested.
See more from MedicalBrief archives:
Health Ombud to investigate Helen Joseph Hospital
Patient’s viral video highlights state of public healthcare
Helen Joseph doctors’ plea for action as hospital in 'dire straits'