Following the passage of the National Health Insurance Act, the challenge is to bring public hospitals up to an acceptable standard, writes MedicalBrief. It will be a mammoth task, as highlights this News24 report on Gelukspan District Hospital, once a rural health flagship but now dubbed the “hospital of death” by locals.
The hospital, near Mahikeng in North West, is avoided by locals it because it no longer operating theatre or kitchen – they were demolished and never rebuilt. Patient food is allegedly delivered in a bakkie that also doubles as a refuse collection vehicle.
When News24 visited the hospital last month, only a handful of patients were waiting at the casualty, there wasn't a single patient in the maternity ward, and there were just a few people in the surgical wards. This is because locals call the institution the “hospital of death”.
Doctors’ living quarters at the facility – marked by overgrown grass and dilapidated buildings – are inadequate, and patients also complain of difficulty in accessing medication.
Nurses said the hospital had no kitchen because a contractor who was supposed to upgrade it had destroyed it in 2022. News24 saw patients’ food being delivered in an open bakkie, and staff confirmed the truck doubles as a food delivery vehicle and refuse collection vehicle.
However, North West Department of Health spokesperson Tebogo Lekgethwane denied food was delivered in an open bakkie, or that it also transported refuse.
“The hospital has a kitchen that is among older wards and is shared with Tlamelang Special School. A kitchen facility is being utilised near the hospital for expanded kitchen capacity.
“The food is not served cold. The catering company, Duduza, serves warm, nutritious meals to the patients. The hospital has two [Nissan] NP200 bakkies with canopies, and food is collected by one of these bakkies.”
Refurbishment
Insiders told News24 that the department had advertised a tender for upgrading and refurbishing the kitchen, theatre and mortuary in September 2021, and appointed a contractor in March 2022 who started work five months later. However, “they went entirely off the rails”.
“They flattened the entire kitchen. We think they didn’t understand what they were supposed to do. We were told they were supposed to renovate the existing structures, but they completely destroyed everything.
“They built a new boiler, but did not connect any steam pipes, and the boiler has never worked. Then, after destroying the theatre block, the mortuary, the kitchen and the laundry, they left, and that is the present situation.”
But Lesedi Mashao, the director of Kolwana Holdings which was awarded the tender, denied the claims, and said his company did not misunderstand the scope of work.
“Our mandate was to demolish old structures and build new ones… but we did not build the new ones because we terminated the contract due to the department’s non-payment,” he said.
Some patients also complained about a shortage of medication and cold food, others said medication stockouts, including for diabetes treatment, were frequent.
Staff quarters shoddy
Most of the doctors’ housing on the property was empty and badly neglected, and staff said there had been no maintenance on the buildings at all, despite frequent requests for repairs to blown-off roofs, broken windows, and electrical faults.
Lekgethwane dismissed all claims as untrue, saying staff accommodation was recently renovated and only a few houses had not received upgrades. These would be completed once budgets were approved, he said, blaming the previous contractor for the lack of progress on the upgrades.
“From the outset, the contractor did not perform or provide what was required per the contract. He was issued with four default notices between September and December 2022, and a recommendation to terminate the contract was prepared in mid-December 2022.
“In early January, the contractor issued a default notice for late payment to the department and subsequently terminated the contract for the same reason. The payment was not late, but rather, it required additional information and supporting documents. This was timeously communicated to the contractor.
“Due to the limited progress, the termination was not challenged. Between August 2022 and January 2023, the contractor demolished the existing theatre and mortuary, started on-ground preparation for the new kitchen, and started on foundation trenches for a new MDR-TB ward.”
He said the community “is fully utilising the hospital”, that the bed occupancy rate was satisfactory, as the hospital had achieved its target of 65% occupancy as stipulated in the departmental annual performance plan.
He dismissed allegations that it was a “hospital of death”, saying the maternal mortality ratio had been reduced from 161 out of 100 000, to zero.
“The hospital morbidity and mortality meeting held every month shows the mortality rate in male medical care, which increased after the closure of Thusong [District] Hospital, is also statistically reduced. The multi-disciplinary approach in providing patient care in the hospital positively improves the standard of care,” he said.
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Civil society report on medication collections at North West health facilities
North West Health HOD and Finance MEC acquitted of job-fixing charge
North West Health HoD gets bail in alleged corrupt tender case