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Some hospitals spared from power cuts while others face mounting costs to run generators

Some hospitals spared from power cuts while others face mounting costs to run generators
DA spokesperson for health, Michéle Clarke (Photo: Bienne Huisman / Spotlight)
Thabo Molelekwa
By Thabo Molelekwa
17 Oct 2022
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Health minister Dr Joe Phaahla recently announced several measures to mitigate the impact of load shedding on healthcare services — a move met with mixed responses.

At least 37 hospitals have so far been exempted from load shedding and work is under way to include more across the provinces. According to Foster Mohale, spokesperson for the national Department of Health, the number has increased, but the updated numbers are not yet available.

‘Inexplicable’


hospitals power cuts phaahla Minister of Health Dr Joe Phaahla. (Photo: Gallo Images / Luba Lesolle)



Dr Aslam Dasoo of the Progressive Health Forum tells Spotlight they are pleased that Health Minister Joe Phaahla intervened in the crisis caused by load shedding at hospitals, but he questions why it took so long. 

He says it is “inexplicable that after years of load shedding, it took only two days after the minister’s intervention for City Power in Johannesburg to start exempting public hospitals from the blackout schedules”.

“It was possible for hospitals in the Western Cape to be exempted four years ago through normal engagement between the municipalities and the provincial department of health. What was the Gauteng provincial health department doing all that while?” he asks.

“To have neglected something as elementary as exemption of hospitals from load shedding — causing untold distress and death — is unforgivable.”

‘Everything is delayed’


Prof Adam Mahomed, head of the Department of Internal Medicine at Charlotte Maxeke Johannesburg Academic Hospital, says the load shedding exemptions are a positive move by the health department because it will make life easier for the big hospitals.

“But this is the first aspect of it. I think we tackle the biggest emergencies and are the biggest users of diesel for the biggest generators and I’m happy with where we are. But it has to filter down to all healthcare structures. 

“It can’t just be about the big tertiary hospitals or the big hospitals… it must filter right down to all the primary healthcare clinics,” says Mahomed.

In most hospitals, Mahomed explains, a generator is an option when the power goes off, but a generator doesn’t supply power to the entire hospital — only to areas designated as critical.

“So non-critical areas will not get power, but there will still be patients there requiring service delivery. So those patients end up getting seen [to] inadequately in the dark. And everything is delayed — from opening up a file, getting medication, seeing a doctor and getting procedures done,” he says.

power hospitals fuel According to the health department, most hospitals have already exhausted their budget for fuel, which means that they are forced to shift budget from other line items to keep lights and machines on in critical care departments. (Photo: iStock)



When Phaahla announced the interventions, he also said the backup power supplies in medical facilities were not designed to provide electricity for a long period of time.

“Some of these generators are old, while others lack the necessary capacity to power the entire facility. Thus, generators have been proven not to adequately meet the increasing demands during load shedding in health facilities, hence some hospitals are forced to switch off some critical areas, which compromises patient care,” said Phaahla. He said this is why provinces like Limpopo have resorted to putting elective surgeries on hold until further notice.

While the move by the department to exclude some hospitals from load shedding was done in conjunction with other departments, Mahomed says that from a legal point of view, “the law has to be changed to make us [medical facilities] critical service areas so that we can be excluded, because we don’t want another government coming in and changing, or Eskom changing, the rules of engagement”.

The Democratic Alliance has since called on the health minister to work with the National Energy Regulator of South Africa to amend the relevant rules so that hospitals and medical centres are excluded from all future load shedding.

How it will work


“Discussions are ongoing to exempt all hospitals according to the priority lists submitted by provinces,” says Mohale.

“Due to the complexity of electric configurations, some hospitals are connected on the same feeder lines with Eskom customers, which makes it difficult to immediately exempt. In such cases, they will still use generators and UPS systems until a long-lasting solution is found.”

Phaahla said the department will work with Eskom to install new feeder lines for hospitals that are now using the same lines as communities. This will make it possible to keep the power on at a hospital while it is off in the surrounding area.

However, it is not clear who will be responsible for paying for the installation of the new feeder lines. Mahomed suggests that asking health departments to pay would be unfair and would put a strain on the healthcare budget for patients.

The City of Johannesburg’s power utility, City Power, has also said it is difficult to exclude all the facilities in the City of Johannesburg from load shedding because of the network configuration.

“From the list we received, there are over 130 health facilities, including clinics and hospitals within the City of Joburg. On that list, and based on the assessments of our network, we are only able to exempt about 10 facilities, for now, in our supply network,” the metro said in a statement. 

Other alternatives 


Mahomed suggests green energy sources should be considered for health facilities. Phaahla has indicated that government is doing just that, although it is not yet clear whether any such projects will in fact be implemented.

The minister said last week they were considering a phased approach to solar power installations and that feasibility studies would first have to be done. He also pointed out that such installations are not yet budgeted for and that money will have to be found.

hospitals power solar Health Minister Dr Joe Phaahla said government is considering a phased approach to solar power installations at health facilities and that feasibility studies will first have to be done. (Photo: Valli_Mark / Flickr / Spotlight)



“Solarised energy will be prioritised for areas such as theatres, intensive care units, and hi-tech and advanced equipment,” he said.

But while solar energy solutions might be on the distant horizon for public healthcare facilities, the backup power option that facilities will continue to rely on for the foreseeable future remains diesel generators.

Diesel budgets blown


Since most health facilities still depend on generators for backup power, keeping the lights on during load shedding has been costly. The responsibility of running the generators and buying fuel (diesel) comes out of the budget of that individual hospital, Mohamed explains. He says there are provisions made in the budget for running generators for emergencies, but not for the type of load shedding we’ve been experiencing.

“That (extra) money comes from the healthcare budgets and the proportion normally used for patient care.” He says the money used is meant for delivering healthcare to patients.

Mahomed is also concerned that the department will run into financial problems.

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“If you listen to the minister, a lot of the budget allocated for diesel for emergencies has already been used and now they are supplementing it with budgets from elsewhere, and it’s not clear where that money is coming from.”

In Gauteng, for example, the provincial health department, in response to a question by DA MPL Jack Bloom, said there were 181 generator failures at the province’s health facilities this year due to diesel shortages. The province has already spent R42-million running its generators — almost double the amount spent last year.

According to Mohale, most hospitals have already exhausted their budget for fuel, which means they are forced to shift budget from other line items to keep lights and machines on in critical care departments.

“The shifting doesn’t affect the budget of critical services, but mainly support services items,” he says, adding that discussions with Treasury are ongoing regarding budget issues.

hospitals power cuts clark DA spokesperson for health, Michéle Clarke. (Photo: Bienne Huisman / Spotlight)



DA spokesperson for health, Michéle Clarke, says all health facilities should be exempted from load shedding. While many hospitals do have generators and UPS systems, she says, they cannot cope with the load shedding the country is forced to deal with at the moment. She says generators and UPS systems were not designed for these conditions and are breaking down.

Clarke is also concerned that the sheer volume of load shedding is depleting budgets faster than anticipated. She says this is something Treasury would have to consider in the Medium Term Budget Policy Statement.

Private sector also affected


According to Andre Nortjé, National Environmental Sustainability Manager for Netcare Limited, the private sector is not currently exempted from load shedding and hospitals are experiencing the same blackouts as other businesses.

However, he says it does happen on occasion that some of their facilities are spared from load shedding because they may be connected to a specific business that is exempt. Netcare Sunninghill Hospital, for example, is on the same line as Megawatt Park (Eskom).

While all Netcare facilities have standby generators, Nortje says that with the increasing frequency of load shedding, the facilities have used more than double the amount of diesel compared with previous years.

“We have no option but to make provision for backup power to keep our hospitals operational,” he says.

Nortjé says Netcare has also invested in green energy. 

Currently, Netcare has more than 14 MWp of solar capacity installed on its facilities’ rooftops and carports. However, he says these systems are grid-tied solutions and do not have battery storage. So when load shedding kicks in, or the grid drops away, the solar systems also switch off.

“This is done to protect the generators from damage, given that this is the hospitals’ ultimate fallback in providing care to our patients. As battery solutions continue to develop and grid interruptions continue to occur, Netcare is investigating full battery backup solutions as an alternative to the use of generators,” he says.

Just like public sector hospitals, private hospitals are also spending more on diesel than they had budgeted.

“Unfortunately, we are not remunerated by medical schemes or private patients for the additional costs to ensure that safe, sustainable care is delivered without disruption to our patients,” says Nortjé. DM/MC

This article was published by Spotlight — health journalism in the public interest.

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