The meeting was a follow up to the 8 November 2018 one which dealt with a petition from workers and union members on health and safety issues at the Khayelitsha District Hospital and which led to investigations and reports by the Public Service Commission and the Department of Labour. The Committee heard more evidence from staff and union members about alleged financial mismanagement, poor health and safety practices and victimisation of staff who tried to raise concerns with senior managers.
The Committee heard emotional testimony from workers who said their mental and physical health had suffered as a result of the conditions under which they worked.
The Chairperson informed the Committee that the Western Cape MEC for Health had refused to attend the meeting and that Parliament’s legal advisers were in the process of serving a subpoena on the MEC.
The Chairperson started the meeting with an announcement that the MEC for Health in the Western Cape had been called to attend the meeting, but had refused on the basis of a legal opinion that a member of the provincial executive could not be summoned by the national parliament. A parliamentary law adviser had advised the MEC that her interpretation was wrong, but she had nonetheless declined to attend the meeting. The Chairperson said a process to serve a subpoena on the MEC was underway. He agreed with a Committee member’s suggestion that the Committee postpone further discussion on this matter in order to deal with the petitioners’ complaints.
Dr Moses Witbooi, branch secretary of the National Education, Health and Allied Workers' Union (NEHAWU) told the Committee that they had made little progress in resolving issues affecting the vulnerable community the hospital served. A big issue was financial mismanagement. There was a lack of transparency and a failure to spend budgets effectively.
Another big issue was the way in which staff were treated by senior managers who reacted dismissively to complaints directed to them about working conditions and patient welfare. Complaints from staff were not handled quickly and grievances were dealt with in a biased way. On the other hand, disciplinary action against staff was swift. The situation had resulted in staff suffering mental stress and illness and having to be hospitalised. Dr Witbooi said he had brought witnesses to tell the Committee how they were victimised for speaking out.
Dr Witbooi said patients and staff needed a safe and healthy environment in the hospital, but when concerns were raised though proper processes, word came back that nothing was wrong.
Eventually the national labour department sent an inspector to investigate. Dr Witbooi said they were impressed by the way he conducted his inspection. When union members walked with him on his rounds, management sent people to intimidate them.
Dr Witbooi accused hospital management of cover-ups when they faced audits or inspections. For instance, management had initially been reluctant to admit that a fire had broken out at the hospital. Management staff had quietly walked out of the building without a general alarm being sounded or patients and staff in the wards being made aware of the fire.
Dr Witbooi said senior management seemed determined not to adhere to proper procedures and he questioned why they persisted in this. It seemed almost that they had support “from somewhere.” Staff wanted to solve their problems in a peaceful manner, but they were growing impatient and were prepared to picket again as they had done last year.
A member of the delegation told the Committee that they had been made to submit leave forms in order to attend the meeting, in spite of a previous letter from the chair that people called before Parliament should not have to take leave.
The Chair said he would write a letter to Khayelitsha District Hospital (KDH) management telling them that their action was illegal. He accused the Western Cape Government of refusing to recognise national parliament.
A witness called by Dr Witbooi said she was involved in the running of the KDH women’s health unit which dealt with pregnancy complications. She received an email from an obstetrician asking why a competent nurse had been transferred from the unit, leaving only one nurse who could deal with abortions. When she approached her seniors she was told to use staff from nursing agencies. However, few of these nurses were competent for the work of the unit.
The witness said she was unhappy with the way in which incidents of gross negligence were handled. In one, a patient was kept waiting for treatment because the nurses on duty were sleeping. The patient lost her baby, but apart from one written warning, there were no consequences for anybody. In another incident, nurses refused to go to a theatre for an emergency caesarean operation. In September last year the hospital was closed because there were no staff on duty, yet there was no investigation.
The witness said she was victimised for raising such issues and had to receive psychiatric treatment and was placed on medication. Patients needed to be given priority, but it was difficult to work in an environment where things were not right.
Another witness described the recruitment and selection of staff as being in a mess. He said many of the staff had a psychiatric nursing background and were not suited for work in a general hospital. When he applied for a promotion he was told that he did not meet the requirement of three years’ management experience. Yet the person who got the job had only one year.
There was no policy of caring for the carers. Three nurses had been diagnosed as being depressed. Their manager had been made aware of this but had defied doctors’ order by refusing to put them on light duty.
The psychiatric ward had grown from 30 beds to 65 with more patients waiting to be admitted. Cleaning of the ward was compromised and blocked toilets had to be cleared three or four times a day. The location of the ward on the first floor presented a danger with one patient having to be restrained from throwing himself from the ward.
Another witness said patients were victims of bad management. She said two babies had died because blood transfusions were performed by an inexperienced nurse, A patient had died of suspected cardiac arrest and in agony because an intravenous drug had been administered wrongly.
Another patient had become confused and jumped from the second floor of the building, sustaining multiple injuries.
The witness said she felt defenceless and suicidal because of the way she was treated by senior managers. Her grievances were not dealt with and she was still being victimised. She had been issued with a final written warning without due process being followed.
A former human resources manager, Mr Abdul Ragman, said he was dismissed last year without due process being followed. The case was now in arbitration. He said administrative sub-structures were able to to do as they pleased and abuse their authority because they had support from the provincial legislature.
The Chairperson invited discussion by Committee members after ruling that the Public Service Commission and the Department of Labour (DoL) should not make presentations as their reports had already been tabled at the November meeting.
Committee members commented on the absence of the MEC for Health and the absence of DA members of the Committee.
Ms T Mokwele (EFF, North West) said the Western Cape executive was treating the hospital workers with disrespect. Responding to the sometimes emotional testimony by the witnesses, she urged them not to lose hope and be distracted from the good work they were doing. She said it was painful to hear what competent people were being subjected to because of the colour of their skin.
Ms T Wana (ANC, Western Cape) said she was deeply affected by the workers’ testimony. The Minister of Health should be briefed on the situation at the hospital. She accused the Public Service Commission and the Department of Labour of delaying cases brought before them.
Ms G Oliphant (ANC, Northern Cape) said there was a lack of concern about the situation at KDH because it was a black hospital. There were too many dismissals at the hospital, leading to a loss of skills.
Ms Oliphant questioned why the Public Service Commission investigation into staff issues at the hospital had been handled by a commissioner from North West Province.
Public Service Commissioner, Dr Moeletsi Leballo, explained that at the time there was no resident commissioner in the Western Cape. He told the Committee that he was concerned about letters sent to the PSC accusing it of a cover-up in its investigation. He assured the Committee that the PSC operated without fear or favour. The PSC report submitted to the Committee in November contained 12 recommendations. If all of these had been implemented, the situation today would have been different.
Ms Wana and Ms Mokwele said the Committee would have to discuss ways of ensuring the PSC recommendations were acted upon.
DOL Chief Inspector for Occupational Health and Safety, Mr Tibor Szana, said prohibition notices issued after its inspection had been complied with except for one item where an extension of time had been requested. He would forward a report on a follow-up inspection to the Committee. If staff felt that any shortcomings had not been addressed, he would send in another team.
The Chairperson said the Committee would study the Public Service Commission recommendations and decide whether further investigations were necessary.
The meeting was adjourned.
- Investigative Report: NEHAWU Complaints against the Management of Khayelitsha District Hospital 23 April 2018
- National Education Health & Allied Workers Union petition
- Witness submission
- NEHAWU Khayelitsha District Hospital branch petition
- Public Service Commission - Khayelitsha District Hospital investigation