By Nompilo Gwala and Hannah Chibayambuya

A history of financial challenges has bubbled over as the management of the Chris Hani Baragwanath Academic Hospital (CHBAH) go into crisis management mode after a nightmare week. Disgruntled workers have aired their concerns over two burning issues – food shortages due to contract mismanagement and non-payment of suppliers.

CHBAH CEO, Dr. Nkele Lesia, said the hospital did not run out of food. However, she confirmed that they didn’t have bread for any of the patients for three weeks because the Gauteng Department of Health hadn’t been paid suppliers.

Bread not on the menu
“We had challenges with the delivery of bread, not with any other food items. Patients still received their normal breakfast, lunch, and dinner,” she said during a briefing at the hospital on Friday 11 March.

“It doesn’t mean that we are not giving them other snacks in the absence of bread. Patients, especially those who suffer from diabetes, had snacks in between meals. So, with the assistance of our dietician, snacks were provided according to the disease profile of the patient,” said Dr Lesia.

She said the shortage had lasted for three weeks. She said the hospital had made alternative plans like procuring bread by using petty cash as well as baking bread in their own kitchens.

Her statement follows reports of how nurses had clubbed together to raise money to buy food for their patients. Various non-government organisations (NGOs) also jumped in and donated food.

One Small Act of Kindness, a Johannesburg-based organisation, donated 100 loaves of bread and 400 sandwiches on Wednesday 9 March. They also offered to deliver 400 loaves daily, an arrangement which kicked in on Thursday 10 March.

Gauteng MEC for Health, Dr Nomathemba Mokgethi, allayed fears over patients not having enough to eat.
“Bara is not only servicing the people of Gauteng, but it’s also servicing people from other provinces. Those that have loved ones at Bara, we know there has been an issue of bread supplies, but it has since been resolved. The service provider didn’t supply bread due to non-payment. But as for other foodstuffs, food has been available at CHBAH,” said Mokgethi.

Food shortage an old problem
In 2012, food services staff at the hospital told Health-e News that patients were often served rotten and contaminated food and food preparation guidelines and menus designed by dieticians were ignored.

A hospital spokesperson refused to comment while the then Gauteng Health Department spokesperson Simon Zwane failed to reply to important questions. He claimed, at the time, that all the correct procedures were followed in the preparation of food, but alluded to the fact that they were facing budgetary constraints.

A dietician working at the hospital confirmed that they had been facing ongoing problems since 2009. She said that dieticians had raised their concerns a number of times with management, but nothing was done.
She claimed that the hospital had said the reason patients were served poor food was because there was insufficient food to go around, due to suppliers not being paid.

Temporary posts cut
The health department’s decision to cut posts at various state-run hospitals, created to deal with the Covid-19 pandemic, has fuelled tempers. It has been revealed that more than 800 temporary contracts will not be renewed.

According to the department, it received a Covid-19 grant budget amount of R2.2 billion. This was for the compensation of employees to respond to the pandemic. However, the budget has since been cut in half forcing the department to terminate contracts.

Gauteng Health Chief Financial Officer, Lerato Madyo, highlighted the difficulties faced.

“The initial budget for 2022 was reduced to R1.1 billion. That, on its own, poses a challenge with the current staff.

“Unfortunately, we won’t be able to reappoint all the employees that were hired. We understand that the virus is still with us, but we cannot reappoint all of them because that will be highly irregular and could expose us to unnecessary audit queries with the Auditor General,” said Madyo.

She said the department received a budget of R56 billion at the start of the financial year. It was increased by R3 billion, but by the end of February 2022, 85% had been used up.

“I don’t want to dispute the fact that we have financial challenges. These challenges are not necessarily caused by the budget allocation or shortfalls, but because of historic cases. This contributed to us not being able to pay service providers on time,” she explained.

Situation ‘out of hand’
Dr. Tristan Pillay, an orthopaedic surgeon at CHBAH, said the situation has gotten out of hand, affecting waste disposal, food availability, and resources.

“We’ve been struggling with the number of resources we have been allocated, both in human personnel, as well as workable resources in equipment,” said Pillay.

He also said healthcare providers felt the need to stand up for themselves and for patients to try and improve care.

“As clinicians, we felt we needed to band together and really advocate for patients so that they can get the treatment they deserve. We found that we’ve had to come together as a clinical fraternity, to find solutions on the ground,” he said.

Dr Pillay said the posts created due to the pandemic have helped the hospital carry the burden. However, prior to having extra hands, CHBAH was already in deep trouble due to a high demand and staff shortages.
“Bara was already at a tipping point because we’re a hospital that’s often under strain. We face very extreme demands with very little staffing,” he said.

“We are worried that in the coming days, our ship might sink without these posts. It’s something we can’t afford, not only for our patients but for our local community at large.”

Another orthopaedic surgeon, Dr Yenzi Ngema Madlakovu, said CHBAH staff members always have to look for additional ways to accommodate patients.

“We’ve been dealing with shortages in theatres and resources in the wards. At Bara, it’s always important to make plans A, B, C, and D, because plan A isn’t always available.

“We usually have to go and find things ourselves or buy things for our patients and ourselves,” she said.
Dr Madlakovu added the hospital has carried an extra burden since the Charlotte Maxeke Johannesburg Academic Hospital shut down after a fire ravaged some parts of the facility last April.

“We have had to take in a lot of referrals from Charlotte Maxeke Johannesburg Academic Hospital. Now, we are taking on even more work than before, not that we mind working hard. But when you have a system that doesn’t support you, it’s really disheartening,” she said.

The department also announced that the decision to appoint staff for the 2022/23 financial year will be based on service needs at each hospital and the allocation of the budget in each facility.

– Health-e News