Mess-ups mean Gauteng has no money left to fight third wave

Frantic efforts to stem the Covid-19 third wave tsunami in Gauteng are being thwarted by a cash crunch, with government calling on the private sector to help its strained healthcare system.

The province has come under attack for its failure to plan for the deadly third wave, which has brought unprecedented levels of infections amid claims of staff shortages and poor enforcement of Covid-19 regulations.

SA’s third wave is on course to surpass the peak of the second wave after the arrival of a new variant of the infection, acting health minister Mmamoloko Kubayi said on Saturday.

The money snag follows several Covid-19 related scandals in Gauteng last year, including irregular payments of millions of rand for dodgy PPE contracts and school sanitation. These contracts are under investigation by the Special Investigating Unit, which hopes to get some of the millions back.

Sunday Times Daily has established that:

• Government is engaging NGOs such as Right to Care and Gift of the Givers to come on board to assist “troubled” Gauteng.
• The R100m budget available to fully refurbish Charlotte Maxeke hospital in Johannesburg, after it closed in April following a fire, is unlikely to be enough.
• First Rand Bank gave R1.5m for renovations at Charlotte Maxeke, which is being spent on fire doors and dry wall. The Solidarity Fund has also contributed.
• FNB and RMB provided 12 buses to transport patients and healthcare professionals to various hospitals in Gauteng during April and May.
• There is no money to place 280 medical student interns, who could potentially ease the strain of critical staff shortages at state hospitals in Gauteng.
• The health department is hoping “colleagues” in the health industry will volunteer their time at state hospitals, as there is no money to pay them.
• It has also approached the Solidarity Fund to pay for additional nurses needed to man Covid-19 beds.

Kubayi told the Sunday Times on Friday that there was no money for additional beds and staff in Gauteng.

“Unfortunately we do not have a budget, so we can’t. We were hoping that some of the colleagues would volunteer. We are looking at various areas – there are conversations with the Solidarity Fund to assist, and in Gauteng they are looking at additional nurses to help us with the surge.”

While she did not know exactly how many nurses would be needed to restore stability at hospitals, “we are hoping for about 480 [from Solidarity] and hoping they can come quickly”.

The minister said administrative staff shortages were also preventing plans from being properly implemented.

Last week she had approached public service and administration minister Senzo Mchunu to try to help bring in capacity in the administration of the department.

“There were challenges where people were leaving. Now there is an acting CFO, acting HOD, and you have challenges of capacity in terms of administration.

“There must be people in place to implement and run these plans from the department so we can see these plans going into the hospitals.”

To address this issue, acting HOD of the Eastern Cape health department Sibongile Zungu has been seconded to Gauteng.

Zungu was last year seconded to the Eastern Cape from the office of health minister Zweli Mkhize.

“She will come and act as HOD in Gauteng until they can stabilise the system,” Kubayi said.

Kubayi said it was an “indictment” that student doctors needing to do their community service were not being placed.

Sunday Times Daily reported this week that 288 junior doctors due to begin their two-year internship had not yet received a posting.

The junior doctors are all fully qualified but unemployed and unable to work in the health sector without completing a mandatory internship at a public health facility in SA, allocated to them by the department of health.

“I have asked the team to explain to me what is the story of the student doctors ... who have not been placed because apparently there is no money,” Kubayi said.

“It does not make sense to me. Every year, surely we should know we have this amount of students ready to be placed where there is a shortage.”

Gauteng infrastructure MEC Tasneem Motara told the Sunday Times that while the oncology unit at Charlotte Maxeke would open on Monday, there was no deadline for the rest of the hospital.

“Every year the department of health budgets for maintenance of their facilities. This year they budgeted R100m [for Charlotte Maxeke] and that is what we have [to use for the refurbishment after the fire].

“For any additional budget that is required, we will have to go back to treasury.”

“I am more than certain [the refurbishment] will cost more than R100m.”

Motara said private business had stepped up after acting director-general of health Thabo Masebe made a public call for assistance.

Sipho Silinda, FNB CEO Public Sector Banking, said one of the big hurdles to reopening was installing fire doors, a requirement for a certificate of safety compliance.

First Rand Bank gave R1.5m towards the refurbishment, so the Solidarity Fund could source the 19 fire doors.

“FNB together with RMB also provided 12 buses to transport patients and healthcare professionals to various hospitals in Gauteng during April and May. Their donation funded the 19 fire doors and dry walling to help reopen the oncology ward, which was deemed urgent.”

Charlotte Maxeke CEO Gladys Bogoshi said the speed with which FNB leadership came to the rescue of committed staff, who took long trips to follow their patients as far as Steve Biko Academic hospital after the fire incident, was appreciated.

“It turned a situation that seemed impossible, possible,” Bogoshi said.

Gift of the Givers founder Imtiaz Sooliman said his organisation had promised full support to “provide whatever is possible in terms of resources”.

“We visited Charlotte Maxeke Hospital, discussed the challenges, engaged the Solidarity Fund, chief whip in parliament Pemmy Majodina, and [on Thursday] had a discussion with [Kubayi] and Gauteng premier David Makhura on speeding up the reopening of the hospital, which at the peak of the second wave managed 400 Covid-19 inpatients.”

The response was positive and very encouraging, said Sooliman. He said the organisation was engaging hospital management to see what was required.