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Patient safety advisory for all Mpumalanga government hospitals - Health Department "under curatorship"

Written by With comments by Vicki Pinkney-Atkinson.

Report by the SA Government News Agency 24 June 2014 second edition.
(Click here to see the press release.)
Editorial comments by Dr Vicki Pinkney-Atkinson, PHANGO, former Vice Chair of the Gauteng Government Facility Accreditation Project


The Mpumalanga Health Department been placed under curatorship from 21 June 2014 as the provincial health system is in dire straits. The curator will be tasked with ensuring the provision of food, linen and waste management in all the provincial hospitals urgently. (Editor. Questions citizens should be asking. What does curatorship mean in this context? Who is in charge of health in the province? Is this financial curatorship or something else or both?)

Zibonele Mncwango, the spokesperson for Mpumalanga Premier David Mabuza, said the treasurer and the Office of the Premier will now carry out the process of appointing a curator meant to improve health service delivery in the 33 Mpumalanga government hospitals. “The intervention is meant to improve the situation in the health system and once the situation is back to normal, the curator will be removed.” (Editor. Questions that citizens should be asking. If it is the Mpumalanga Department of Health, then why are the hospitals only being targeted? It sounds like a health system wide failure. How wide is the crisis in district clinics in Mpumalanga?)


Meanwhile, Premier Mabuza called on hospital CEOs to commit to work hand-in-hand with him and the curator in turning around the situation. (Editor. Questions that citizens should be asking. If the curator has not been appointed yet what happens until then?) Premier Mabuza made the call on Monday during a meeting with CEOs of all the provincial hospitals. The meeting aimed to deal with severe mismanagement and other challenges perceived to be threatening the lives of the patients. (Editor. Questions that citizens should be asking. Is this a perception as implied in the news release, or is it the reality? Read the list below.)

During the meeting, where the Premier spent over five hours interacting with the CEOs of all 33 provincial hospitals, Mabuza received verbal reports from CEOs of their challenges. The information painted a negative picture in terms of infrastructure, human resources, leadership and contract management in the health system. The list below is what CEOs reported according to Many of these are issues that the National Department of Health Office of Health Standards Compliance and it governing board should be reporting to the public as a matter of urgency. Transparency is needed for the citizens of Mpumalanga.

  • All hospitals had infrastructure problems which were broad ranging with the following examples:
  • ageing and dilapidated buildings
  • dysfunctional boilers and laundry machines
  • lack of life saving equipment
  • leaking roofs
  • lack of accommodation (EditorQuestions that citizens should be asking: Doese this mean bed for sick people? How does this affect the safe delivery of babies and their mothers?)
  • Surgical procedurers
  • insufficient budgets for operations
  • lack of theatre tables
  • Basic human needs
  • Serious water shortages at some hospitals  -(Editor. Questions that citizens should be asking. How does this impact the control of leathal hospital aquired infections? Why are the hospitals without water not being shut down with immediate effect?)
  • Running out of groceries - (Editor. Questions that citizens should be asking. Is this a euphemism for no food? Does this mean that patients are not getting food? Should relatives bring food in? This needs clarification.)
  • Linen for beds and for operations -linen istaken and cleaned at faraway hospitals with equipment (Editor. Questions citizens should be asking. What happens if there is no linen delivery? Are patients to bring their own linen and get it washed? Does dirty and contaminated linen stay on the beds as a source of infection? Where are the piles of dirty linen stored?)
  • Financial issues
  • Non-payment of some suppliers (Editor. Questions citizens should be asking. Is this like the Gauteng Government's failure to pay suppliers? If yes, how long is the list, what do they supply and how long have they been waiting for payment? Are the food suppliers on this list?)
  • No budgets for surgical procedures
  • Human resources
  • CEOs also complained that many of them were employed in an acting capacity (Editor. Questions citizens should be asking. How many CEO are in an acting capacity and what is the holdup?)
  • Workmanship at the hospitals was also a challenge
  • And last but not least patient safety was compromised as there was inadequate fencing.

Patient safety severely compromised

Editor: It would appear that patient safety is seriously compromised by all of the above, least of all by the lack of fencing! Questions citizens should be asking. How does this match the South African Patients' Rights Charter which the government supports?

"A healthy and safe environment
Everyone has the right to a healthy and safe environment that will ensure their physical and mental health or well-being, including adequate water supply, sanitation and waste disposal as well as protection from all forms of environmental danger, such as pollution, ecological degradation or infectio

In response, Premier Mabuza acknowledged that the situation needed urgent attention. “We are going to rework their entire budget structures. We must further intervene with immediate effect in terms of infrastructure. Every hospital must be given a minimum number of people in order to be functional. (Editor. Questions that citizens should ask. Were these budgets approved? Has the money for hospitals been diverted to other provincial line items? How much has is due to wasteful or corrupt expenditure or inappropriate district administration costs?)

“As the provincial government, we will work on some powers which we think should be delegated to the CEOs. However, they must not abuse them. We want to ensure that they get certain delegations and they must be able to handle the finances,” said Premier Mabuza. He said provincial government would to ensure that systems at the hospitals were strengthened. The premier further urged the CEOs to manage the hospital as expected to ensure that health system was not collapsing. (Editor. Questions citizens should be asking. Does the Premier actually mean "collapsED"?)

Editor. Suggested additional reading is the District Health Barometer 2013 (Published by Health Systems Trust Click here to download.) This report suggests a budgeting problem in the three Mpumalanga districts with

  • District hospitals having decreased budgets over time
  • Primary health care budgets inadequate from the beginning and still below the national average
  • District administration being above the national average.


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