'Why are our hospitals dirty? It is this system called tenders'

The SA Health Review and District Health Barometer released this week sketches a bleak picture of dirty hospitals, huge underspending and severe skills shortages

Health Minister Aaron Motsoaledi briefed reporters on the documents in Pretoria.

The content tell a tale of persistent under-expenditure on the country’s health infrastructure projects due to the lack of skilled staff, poor supervision of projects, and failure by contractors to do their jobs in provincial health systems.

The minister received the review, which focused on key policy issues affecting the health sector, and the District Health Barometer which focused on the performance of the health system.

In 2010/11, according to the document, under-spending on health capital amounted to around R2.3 billion. The health department had, in some instances, withheld funds due to slow and poor spending on the hospital revitalisation grant.

Motsoaledi said though most of the country’s health institutions had not fared well in the barometer, efforts were being made, working with health institutions’ leaders, to improve the situation.

“We have set very high standards for ourselves (on cleanliness). When 74% of our institutions do not meet the standards, it doesn’t mean any of our institutions look like a pigsty.

“Why are our hospitals dirty? It is this system called tenders.

“The companies (given government tenders) pick people who are stranded in the street and give them cleaning jobs at our clinics.

“Those employees only take instructions from their bosses, not the hospital staff.

“The same is happening with our hospital security.

“Companies just pick people in the street. We have many foreigners coming into the country, and they get hired as security guards. When time for payment comes, the company owners call the police and say arrest these illegal immigrants.” 

Lack of good security at the country’s health institutions came under the spotlight recently after several doctors and nurses were attacked or killed at work.

He said national government had come up with several intervention strategies, working together with local authorities.

“In this weekend’s newspapers you are going to see advertisements for at least 92 hospital CEOs (chief executive officers). We want to ensure that we have the right people with the right skills and experience in our hospitals.” 

Motsoaledi said the reason for advertising was not only to hire the adequately qualified personnel, but also to make permanent appointments for posts that had been filled on an acting basis.

“Research has shown that CEOs who perform well at our hospitals are those with a background in health. Those without that experience are struggling to cope. We will be redeploying them elsewhere, we don’t want to fire them.” 

Motsoaledi said 20 staff from his department had trained in the United Kingdom and would be made hospital inspectors.

“They are now back and itching to be unleashed to inspect our public institutions.” 

He said the thrust of the National Health Insurance (NHI) model was to empower health authorities, at district level, to make more significant decisions than in the past.

The minister said all sections of the National Health Act, passed in 2003, had been proclaimed by President Jacob Zuma and would be in force by March 1.

Motsoaledi said prices being charged by private healthcare facilities were excessive and needed to be regulated.

“The exorbitant prices have to come down. Poor service being given in public institutions does not give anyone a right to exploit our citizens. Pricing in the private sector has to be regulated.”

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