Catalogue of chaos – 12 years of ill-health in Gauteng

The story of the Gauteng department of health over the past 12 years has been one of a downward spiral and a damning track record of corruption, maladministration and neglect – and that might be the good news. Worse news is that a snapshot over a 12-year timeline shows that the slide into dysfunction is far from being successfully arrested.

2010 – President Jacob Zuma authorises a Special Investigating Unit (SIU) investigation into Gauteng health MEC Brian Hlongwa. The ANC provincial chief whip held the MEC position between 2006 and 2010. The investigations centre on corruption allegations during Hlongwa’s tenure to the amount of R1.2-billion.

2011 – The DA sounds the alarm that the incompetent management of infrastructure projects in Gauteng’s ailing health facilities will mean R83-million stands to be lost. That year, National Treasury allocates R143-million for sorely needed repairs in Gauteng public hospitals, but only R26-million is spent over six months.

2012 – The department’s accrual debt is flagged by public-interest law centre SECTION27. Mismanagement of budgets means it begins each year paying off debt from the previous year before it can use what’s left to purchase goods and services for hospitals and clinics. Though the department announces that it has paid off years of debt, it comes at the cost of appointing essential staff and the reallocation of budgets.

2013 - Wits University plans litigation against Gauteng Department of Health over its failures to ensure quality care and services at the teaching hospitals it where the University has joint staff with the Health Department and conducts teaching, care and research. A settlement is reached with then Health Minister Dr Aaron Motsoaledi. 

2013 – Treasury appoints PwC as administrator for the department. The official line is that the auditing company will “re-engineer business processes” and that “the province is not under administration”. But the province will also acknowledge that external intervention has been needed to “address all historical issues… in relation to payment of suppliers, revenue management and personnel administration”.

2014 – The department racks up an outstanding bill of R900-million owed to the National Health Laboratory Services, leading to the suspension of its services to the province.

2015 – Backlogs at hospitals mount and lead to patients being placed on a two-year waiting list for surgeries. MEC Qedani Mahlangu admits to a shortage of personnel and equipment.

2016 – Headlines explode with the horrific deaths and neglect of 144 people with mental health conditions as a result of the department’s decision to end its contract for the care of these patients with Life Esidimeni. This was done in favour of turning over patients to cheaper facilities that proved to be unlicensed and grossly ill-equipped to care for these patients.

2017, February – Mahlangu resigns before she can be held to account for the Life Esidimeni disaster. No one is charged.

2017, November - Sheriff confiscates desks and computers from Gauteng Health department due to non-payment of court-ordered legal payments.

2017, November – Gauteng Premier and Minister of Health appoint a “fix-it” team including Michael Sachs, Mkhululi Lukhele and Craig Househam. The province acknowledges “critical inadequacies in the capacities and capabilities, and competencies to run the system”.

2018, June – The SIU report on its investigation into Hlongwa is made public. It took seven years to complete, was handed over to Zuma in 2017 and only released a year later. The findings confirm irregular expenditure and also name 11 other people implicated in looting the department’s coffers. The SIU recommends criminal charges be pursued.

2018, 5 September – A fire breaks out at the Bank of Lisbon building in downtown Johannesburg, the department’s head office. It claims the lives of three firefighters and the building is demolished a year later.

2018, September – Superbug Klebsiella pneumoniae rips through neonatal units in the province. Investigations point to an outbreak arising from overcrowding and unhygienic facilities. The number of dead babies is disputed; although the government confirms the death of five babies, nurses union Denosa goes on record to say many more babies have died and that it has been raising the alarm for months. Another nine babies die of the same drug-resistant bug at the Rahima Moosa hospital.

Read in Daily Maverick: “How to steal a health department and get away with murder”

2019, March: Former Deputy Chief Justice, Dikgang Moseneke, publishes his Award at the conclusion of the Life Esidimeni Arbitration, including a number of recommendations to improve mental health care services and compensation of 1,2 million Rand to each of the families of the people who died in the disaster. 

2019 – The province admits that it faces R1.1-billion in medical negligence claims in that year alone, with 150 claims registered against the department. Gauteng has the second-highest medico-legal claims made against it, after the Eastern Cape.

2020, July – As the Covid-19 pandemic deepens, the shocking scandals of corruption in the acquisition of personal protective equipment explode.

2020, October – Health MEC Bandile Masuku is fired.

2021, April – A fire rips through large parts of Charlotte Maxeke Academic Hospital in Johannesburg, leading to units having to close down completely for weeks and only partially reopening more than 18 months later.

2021, August – Members of the Treatment Action Campaign stage a sleep-out outside Premier David Makhura’s offices in Newtown. Their protest is a stand against the damning slide in services across the province, including inaction in contingencies for patient care after the fire at Charlotte Maxeke; a shortage of staff; the resignation of medical staff from public service; and the overall poor delivery of health services in Gauteng.

2021, August – The department’s acting chief financial officer, Babita Deokaran, is shot dead outside her home in the south of Johannesburg. Deokaran was working on unveiling a criminal syndicate at the department involved in fraudulent Covid-19 contracts and tenders. She was also working with the SIU to bring criminals to book.

2022, January – Nine officials from the Gauteng health and infrastructure development departments are put on precautionary suspension after an SIU report on the awarding of contracts for the refurbishment of the AngloGold Ashanti Hospital on the West Rand. The hospital was intended for the treatment of Covid-19 patients.

Read in Daily Maverick: “What has changed at Gauteng Health Department since damning 2020 Public Protector report?”

2022, March – Doctors picket outside Chris Hani Baragwanath Academic Hospital over “intolerable strain” at the largest hospital in the country as the department ends contracts with 800 staff members who had been employed during the pandemic and played a vital role in bolstering human resource capacity in the province.

2022, March – The DA reports assaults on staff at Helen Joseph Hospital by psychiatric patients. Some patients are also being restrained crudely because there are not adequate facilities to accommodate them. The hospital continues to buckle under the pressure of patient overflow because of Charlotte Maxeke Hospital’s psychiatric ward still being closed nearly a year after the fire.

2022, May: Pediatric gastroenterologist Prof Tim De Maayer publishes an open letter about conditions at Rahima Moosa Mother and Child Hospital leading to his brief suspension, then reinstatement. The threats against De Maayer sparked a petition signed by thousands of health workers who declared themselves the I Am movement.

May 2022: SECTION27 launches litigation against the Policy Implementation Guidelines on Patient Administration and Revenue Management, 2020, as brought into effect by Gauteng Department of Health Circular 27 of 2020, which limited health access to migrants.

2022, June: Memorandum of Agreement signed between Gauteng Health and Wits University governing management of health services in academic hospitals in Gauteng. 

2022, September – Maverick Citizen publishes the South African Police Service’s forensic report into the Charlotte Maxeke fire, confirming that it was an act of arson. 

October 2022 – Panyaza Lesufi elected premier of Gauteng and appoints new health MEC, Nomantu Nkomo-Ralehoko, the eighth since 2010. DM168

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R25.