Procurement processes at provincial level hinder service delivery at hospitals, PP's office observes

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  • Deputy Public Protector Kholeka Gcaleka has concluded the Gauteng stretch of hospital tours to assess their state and capacity for service delivery.
  • Processes being handled at provincial level have been a general concern across the province, Gcaleka says. 
  • The office will also be conducting further investigations on the building of field hospitals after concerns of their use post-pandemic. 

The management of some processes and procurement services at provincial level seem to hinder service delivery at public healthcare facilities in Gauteng.

This was the main observation the office of the Public Protector picked up from its inspection of facilities across the province this week.

Led by Deputy Public Protector Advocate Kholeka Gcaleka, the office had been visiting healthcare facilities to inspect and observe first-hand the challenges staff and patients faced.

Among the hospitals visited in Gauteng were those reserved to deal with Covid-19, including George Mukhari Academic Hospital and Chris Hani Baragwanath Academic Hospital.

READ | The state of Chris Hani Baragwanath Hospital: No mask for trauma patient as stretched staff soldier on

Charlotte Maxeke Johannesburg Academic Hospital was the last to be toured in the province on Thursday.    

"The common challenges is the systemic challenges that have of course been highlighted by the Covid-19 pandemic. The complaints, overall, is that of processes which are managed at a provincial level," said Gcaleka.

"In the hospitals that we have visited, which are the central hospitals, the CEOs are only authorised to a budget of up to R500 000. More than that has to be approved at a provincial level, which causes a huge challenge for them and a backlog in procurement of equipment for the hospital."

Complaints by hospitals included ageing equipment, such as in the radiology department.

Management at Charlotte Maxeke, including CEO Gladys Bogoshi, shared the challenges they faced in maintaining radiology equipment and procuring equipment, which they needed for the longest time.

Covid-19 had only added to their frustrations.

Bogoshi said staff at the hospital were under strain from the early days of the pandemic because they were under-resourced. 

She said because the hospital could not fill posts at that time, they relied on agencies and employees working overtime. 

The first staff complement to be appointed to alleviate the pressure was only in June when the hospital received its phase one budget of R30 million.

"At that time, R30 million, as you know, most of the health professionals' salaries are high and so you don't get much out of it. You can only do so much," Bogoshi reported. 

The hospital also received a second phase budget of R63 million which resulted in the filling of around 100 posts from 1 August. 

The budgets were only for contract posts that end on 30 March 2021.

"If it continues beyond March, it may be a challenge if none of those staff contracts are extended," said Bogoshi.

Hospitals also reported receiving substandard Personal Protective Equipment from a centralised warehouse, which they had not been able to use - resulting in the hospitals resorting to getting their own with their limited budget.

Gcaleka said human resource management processes for specialist positions and other senior management posts needing approval from provincial level were also a widespread concern across the hospitals.

Field hospitals

"That also poses a challenge for them; they stay with a high vacancy rate and are unable to fill those because it is not within their authority.

"They are highly short-staffed. It does hinder on the delivery of services to the people."

Gcaleka said the office had already written to Health Minister Zweli Mkhize requesting a hearing for them to share their observations of public healthcare facilities.

"We are going to be busy with further investigations. For example, there are issues of field hospitals that are being built. The other hospitals have raised the relevance of those hospitals moving forward, considering that the surge of the virus has gone down.

"But also there is no futuristic assessment that was done of these field hospitals so we're going to have to engage the departments of public works, infrastructure development within provinces in respect of that as well, because the hospitals are concerned about the wastage around that," Gcaleka said.

The office completed its Gauteng stretch and planned to focus on another province for further assessments before compiling a report with remedial actions where relevant.

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