Committee Report on KwaZulu-Natal oversight

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31 October 2018
Chairperson: Mr A Mahlalela (ANC) (Acting)
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Meeting Summary

The Committee discussed the report on its oversight visit to KwaZulu-Natal (KZN) from August 14 to 17, which listed the health facilities which had been visited, and the successes and challenges encountered at each. The observations and findings covered matters involving human resources, infrastructure, laundry services, high teenage pregnancies in the area, and management issues at the Cato Manor community health clinic (CHC).

Members drew attention to a number of recommendations which would require follow-up by the KZN Department of Health. These included the urgent need for infrastructure development, sewage issues in Umgeni Psychiatric Hospital, differences in salary scales by employee who perform the same duties in different hospitals, and service providers not delivering according to their contracts, or wastefully providing things that were not needed. It had been found that some equipment had not been calibrated for three years, while it was standard practice for calibration to be done at least every six months, and this posed a health risk to the public,

The Committee emphasised the need for service agreements with approved companies so that when machines broke down, they were contracted to fix them, and not some other company that could cause more damage. Companies that did not complete projects for which they were contracted should be blacklisted from receiving tenders from any provincial department. The process for filling vacancies had to be shortened, to reduce delays. The hospitals’ filing systems needed to be reviewed, because patients either took them home and did not have them when they returned, or left them at the hospital, and they could not be found when the patient came back. A long-term solution was needed.

Meeting report

KwaZulu-Natal oversight visit: Committee report

The Committee discussed the report on its oversight visit to KwaZulu-Natal (KZN) from August 14 to 17. during which it had visited:

  • Msunduzi Local Municipality: Imbalenhle Community Health Centre; Mpumuza Clinic; Edendale Regional Hospital; Fort-Napier Psychiatric Hospital; and Grey’s Tertiary Hospital.
  • Mshwathi Local Municipality: Cramond Clinic; Gcumisa Clinic; Appelsbosch District Hospital.
  • uMngeni Local Municipality: Mpophomeni Clinic and Umngeni Psychiatric Hospital.
  • eThekwini Metropolitan Municipality: Umlazi V Clinic; Cato Manor Community Health Centre; Prince Cyril Zulu Communicable Diseases Centre; and Addington Regional Hospital

It had noted the successes and challenges at each of the facilities visited, and had held a meeting with the Member of the Executive Council (MEC) and highlighted its observations and findings. These covered matters involving human resources, infrastructure, laundry services, high teenage pregnancies in the area, and management issues at the Cato Manor community health clinic (CHC).

A long list of recommendations had resulted from the visits. These dealt with human resources, financial management, infrastructure, medical equipment, pharmaceutical services and medicine availability, essential support services, information systems, and governance and leadership. It was also recommended that Umlazi V Clinic be closed completely and the patients relocated to the nearest health facility.


Dr P Maesela (ANC) asked how the Committee could discuss a report about issues noted during the visits, when nothing that had been observed or the concerns raised could be verified..

The Chairperson responded that the purpose of the meeting was to ensure that everything that was observed had been captured in the report, so that when it got adopted it could go to Parliament for discussion and further deliberation. He added that ever since he had been on the Committee, the process had never being effective in terms of implementing resolutions that had been adopted.

Ms P Kopane (DA) said that when she was a Member of the Social Development Committee, it would normally delegate Members from different province to do progress check-ups, and this had been effective in monitoring the resolutions of the Committee. She commented that it was probably too late in the term to implement a similar process in this Committee, ahead of next year’s general elections.

The Chairperson said that during his term as chairperson of another committee, he had developed a tracking system so that when a department came to the committee to give reports, it would first have to give a progress report on the previous resolutions. This was done through having a standing item on the agenda..

He said that the Committee had visited all the provinces except for the Western Cape and the Northern Cape. However, the resolutions made during the visits could not be followed up, and that was the challenge that faced most Committees.

The Committee continued with its page-by-page consideration of the report.

The Chairperson said that Umlazi V Clinic, which was discussed in the report, had been shut down after their visit and this had been in the news. When the Committee had discussed the conditions at the clinic with the MEC, the MEC had been under the impression that the clinic had long been closed.

The Committee continued its consideration of the report, and Members indicated they had no concerns with the contents related to the Cato Manor Community Health Clinic issue, or with the Prince Cyril Zulu Communicable Diseases Centre, which was discussed on page 29 of the report.

The Chairperson referred to the concerns regarding Addington Hospital, and said the reason why there had been a scheduled visit to the hospital was based on the findings the Human Rights Commission, which had influenced the Committee to visit the site.

The Members were asked if they accepted the summary findings of the report.

The Chairperson referred to the findings for Fort Napier Hospital, pointing out the issues involving the laundry machines and the difference in salary scales for employees that performed the same duties but received different remuneration.

Ms E Wilson (DA) said she did not think the Committee should involve themselves in that issue because the salaries of the laundry workers were a union-negotiated deal, so the Committee’s role was not to impose themselves on such processes. However, on the issue of upgrading the laundry machines, she thought they needed to be upgraded urgently because their condition was shocking.

The Chairperson replied that he did not understand the issue of salaries as a trade union issue, but rather as a departmental issue where employees were paid differently for the same work all of them performed. The difference in payment was a Cato Manor issue, where employees were treated differently by the department, whereas the laundry machines were a Fort Napier Hospital issue. The Committee was only noting this as a concern in the report so that the department could look into the matter.

Ms Wilson asked if, as a Committee, they were mandated to address such issues and meet with staff.

The Chairperson said that the Committee should look into the matter and even meet with the staff, because they were part of the human resources for which the Committee was responsible. He referred to an incident that happened at one of the hospitals, where a staff member had been classified as a level one employee when that level had long been abolished, so it was important that the Committee addressed HR matters. .

He asked if the Committee had an issue with the section dealing with Greys Hospital.

Dr Maesela said the situation where the clinic was using one machine to fix another was ‘cannibalisation,’ and should be addressed.

The Chairperson asked if the Committee had an issue with the findings on Cramond Clinic.

Dr Maesela commented that Cramond Clinic was clean and efficient, but the department needed to look into expanding the facility because it was too small to be regarded as a community clinic.

The Chairperson observed that there was a sewage problem at Umgeni Psychiatric Hospital that needed addressing.

Dr Maesela said that the last point under the summary findings of for Mpophomeni Clinic needed to be clarified and well written, so that people who had not been present would know what machines needed to be sterilised. He also asked for clarity on the findings for Addington Hospital with regard to machines not working. Was it because they were awaiting licensing?

The Chairperson replied that the reason the machines were not working was because they were understaffed. Each machine required eight people for it to function, and there were two machines and only 12 staff members responsible for them, so only one could be used.

Ms Kopane said that the process of filling posts at hospitals was lengthy, and suggested that the department shorten it to ensure that the posts were filled and hospitals were staffed as soon as the post was available.

She also referred to the last point in the financial management section, and suggested that the service providers of the department who did not deliver should be blacklisted from rendering their services ever again, because most of them take money from the tenders and did not deliver what they had been contracted for.

She said that in one of the clinics, the kitchen service was outsourced and run by people who were hired by the clinic. The department needed to look into cutting out the middle man and hire people to look after the clinic, and stop hiring people to look after people who looked after the kitchen. The middle man was unnecessary.

The Chairperson asked if the Committee had an issue with recommendations under the infrastructure section, and suggested that the report should describe what the Committee had found and also be specific as to what hospitals were of concern to the Committee.

Under the medical equipment section, Ms Kopane suggests that there should be a discussion with the department regarding the general infrastructure development at each hospital, because service providers just came and built things without asking what the hospital needed to develop. This was causing unnecessary and sometimes wasteful expense on things that were not needed.

Ms Wilson said the issue of machines not being calibrated for over three years needed to be addressed, as it was standard practice for machines to be calibrated every six months.

Ms Kopane suggested that for every machine purchased, the department had to have a service agreement with an approved procurement company so that when the machines did not function, the service provider would fix them.

Under the Information Systems section of the report, Ms Kopane suggested that there should be a discussion around the filing system in most of the hospitals, because both the patients and staff members complained that files went missing. This was either caused by patients going home with their files and not coming back with them when they got sick, or the patients saying that when they left their files at the hospital and came back, they often did not find them because the staff might have lost or misplaced them.

The Members had no issues with other sections of the report and adopted it with the proposed amendments.

The meeting was adjourned.

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