Gauteng health department avoids 'adverse' report but must fix problems - SAHRC

The SA Human Rights Commission (SAHRC) said on Tuesday that it would not issue an "adverse" report on Gauteng's health department after its probe into baby deaths, long waits for life-saving cancer treatment, overcrowding and critical staff shortages at hospitals.

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The commission visited various hospitals in Gauteng during 2018 as part of its investigation into the department, including Charlotte Maxeke Academic Hospital and Steve Biko Academic Hospital following reports of cancer patients facing long waits for radiation treatment, and Rahima Moosa Mother and Child Hospital and Thelle Moegerane Hospital after learning that babies had died of infections there.

A report would be a “waste of time”, said commissioner Buang Jones. Instead, the commission would have meetings with the provincial health department and require it to submit progress reports on addressing its challenges.

The commission hopes to sign an agreement with the department after the elections and to work together to find solutions to its problems.

Provincial health department head Professor Mkhululi Lukhele was asked questions on Tuesday about what the commission discovered during its inspections. Problems highlighted included:

• no room or space to keep patient files at Thelle Moegerane Hospital, meaning that documents and essential medical records could get lost;
• a shortage of radiation oncologists at Charlotte Maxeke Hospital, meaning cancer patients faced treatment delays;
• medical waste companies removing radioactive waste were on monthly contracts, in breach of tender rules;
• severe and systemic staff shortages, often with one nurse in a ward where 10 should be;
• ageing hospital buildings and infrastructure;
• failed departmental financial audits;
• patients were unaware that hospitals were supposed to have a system to hear their complaints; and
• a lack of clarity on National Health Insurance (NHI), despite it being frequently punted as as answer to systemic health problems.

Lukhele admitted to the commission that there were problems with ageing infrastructure as hospitals had not been maintained.

He said the department had to put out a new tender for medical waste companies to remove radioactive waste and expired medicines. He said an existing month-to-month contract was in breach of the Public Finance Management Act.

He also said the "age of fourth industrial revolution" meant that more medical documents and policies should be online.

Lukhele spoke of severe staff shortages, saying the health system was "jammed". He also said the department had an insufficient budget based on local population figures, when people from around the country sought medical attention in the province.

Jones thanked Lukhele for his honesty. "The fact that you admit there are challenges and have taken steps to address some of these challenges means we will not issue an adverse finding report. This would be a waste of time," he said.

"Instead, the commission would commence with a process of engagement with the department that would culminate in the signing of an agreement."

Jones was at pains to point out that this collaborative approach had worked before. "We have embarked on a similar arrangement with other institutions to ensure they have a protection of human rights … as a focus area," he said.

He added that the SAHRC still had teeth: "We remain independent and autonomous. The commission will continue to monitor your [health department] work. We will continue to work with communities ... to find solutions. We will still continue to assert our powers where there are challenges and failures.

"We are hopeful an agreement will put forward lasting situations."