A week earlier, a doctor and five patients at Bara were stabbed by a patient wielding a pair of scissors.

The hospital's administrators are unable to explain how this happened - Bara, with a budget of R20-million for security, deploys 86 guards during the day and 60 patrol at night.

But the parlous state of security is not exclusive to Bara.

At a parliamentary health portfolio committee briefing in August, the health department admitted that the standard of security at public hospitals across the country was inconsistent.

Only one province, KwaZulu-Natal, has a comprehensive safety plan and set penalties for incompetent security guards.

A report presented by Malebona Matsoso, the department's director general, said there were "weaknesses in safety and security at health facilities."

The report also said there was no uniformity in the location of guards or in how security contracts were awarded and monitored.

The report found that security was not regarded as a core business of health facilities and was not included in annual performance employ a security manager.

Some of the more disturbing findings in the report were:

The master keys to some facilities were in the possession of "unknown" individuals;

CCTV images were not recorded for later viewing;

Security guards left their stations unmanned because they had to double as porters;

Late payment, or non-payment, of guards made them susceptible to bribery; and

Patients at TB hospitals cough up sputum and threaten to spit in the security guards' faces when they want to abscond - guards flee in fear.

Fidel Hadebe, spokesman for Health Minister Aaron Motsoaledi, said after the parliamentary briefing that an audit had been undertaken to gain a better understanding of the situation.

'"Though not all facilities were assessed, the results reflect what we suspect is the case nationally - there is a need to improve security in our facilities but this can only be done incrementally, given our limited resources and competing priorities," said Hadebe.

He said the authorities were "terribly worried" about the spate of attacks at hospitals but suggested that they are indicative of the "many social ills in our society".

The acting chairman of the SA Medical Association, Mark Sonderup, believes the situation is getting worse.

"The number of violent attacks, some resulting in death, has definitely spiked in the last two to three years," he said.

"We marched to the Union Buildings and handed over a memorandum to the president. I am not sure where we should go now."