Staff get meat, patients bones
At a Gauteng government hospital, kitchen staff preparing patients' meals pulled chicken meat off the bone, served the bones to the patients and sold the meat.
From the back doors of hospitals to the desks of senior officials, health sector corruption has become so routine that it is now a feature on the population health agenda. It even attracts its own research funding.
Stealing hospital patients' meals is just one example of the corruption uncovered by Wits School of Public Health staff, revealed at a conference two weeks ago.
Explaining why research into health sector corruption was starting to get public funding and "conference time", the head of the school, Dr Laetitia Rispel, said "corruption can undermine population health" as much as poverty and unequal access to resources can.
With the assistance of her colleague, Dr Pieter de Jager, the school interviewed 16 health sector "insiders" and analysed newspaper articles and other reports, including the auditor-general's.
According to employees interviewed, fraud is "at uncontrollable levels" and is being "committed by people who know how to cover their tracks".
One report by the auditor-general showed that 40.5% of the 2010-2011 Northern Cape health department's budget was irregularly spent.
Corruption Watch CEO David Lewis said anonymous information received by his non-government organisation showed that there was a high incidence of tender fraud in provincial health departments.
One third of anonymous tip-offs revealed "staff awarding tenders to friends and relatives". Another third suggested that a "corrupt relationship [exists] between health departments and their suppliers".
Corruption Watch has also received reports from rural towns in the Free State, KwaZulu-Natal and Eastern Cape showing that smaller hospitals are rife with nepotism, with managers hiring family members and human resources officials "selling jobs".
Last week, Corruption Watch said it would go to court to force the Special Investigating Unit to hand over a report into corruption in the Gauteng health department.
Jack Bloom, the DA's spokesman on health in the province, said he was concerned that prosecutions had not been initiated though he had been told "everything has been with the [National Prosecuting Authority] since November".
In the Gauteng legislature Bloom has repeatedly asked health MEC Hope Papo to release a report into corruption at the Auckland Park depot that distributes medicines to Johannesburg's Charlotte Maxeke Hospital.
Health Minister Aaron Motsoaledi is not unaware of the problems.
Two weeks ago he admitted that "most or all depots are hotbeds of corruption", resulting in hospitals running short of medical supplies.
He said a team had been established in Limpopo to decide what changes were needed to enable hospitals to bypass the supply depots and buy their own medicines.
De Jager warned that, for as long as corruption continued unchecked, healthcare would be poor.
The IMF and the World Bank both use corruption indices as a measure of a country's health and education adequacy.