Question to the Minister of Health - NW3768

24 November 2023 - NW3768

Clarke, Ms M to ask the Minister of Health

(1)What (a) total number of (i) hospital and (ii) clinic staff have been attacked and/or threatened by (aa) patients and (bb) other assailants on the premises of health facilities in each province since 1 January 2022 up to the latest specified date for which information is available and (b) were the circumstances of each incident; (2) what are the relevant details of the measures that have been put in place to address such incidents in each province?

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EASTERN CAPE

(1) (a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
0	4 Circumstances Zwide Clinic Patient threatened Security guard with a gun. Soweto Clinic Staff member in Pharmacy threatened with a firearm by the patient New Brighton Clinic Patient attacked dentist Tshangana Clinic Clerk assaulted by the patient inside the clinic	4
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
0	10 incidents Circumstances Nomangesi Jayiya Clinic Security Guard attacked by 4 thugs. He ran into clinic and locked himself in. Thugs took the exterior security gate with them Staff robbed of personal belongings inside the clinic Mabandla Rehab Staff Robbed at gunpoint Max Madlingozi Clinic Security Guard and driver of vehicle collecting/delivering of blood samples robbed of personal belongings Service provider (repairing plumbing) robbed of personal belongings inside facility Security guard robbed of personal belongings on 1st day of work at clinic staff robbed of their personal belongings Kwadwesi Clinic Staff Robbed at gunpoint West End Clinic Security Guard robbed of cellphone at the guardhouse Middle Street Clinic 3 x gangsters chased rival gang member into clinic where they stabbed him inside the clinic.	10
Total Hospital 0	Total Clinic 14 incidents	Grand total 14 incidents

(2) Measures put in place to address the p

Staff counseled at Wellness clinic
Security enhancements

FREE STATE

(1) (a) (i) (ii) (aa) (bb)

The Free State Department of Health reports that they have had no cases except for the following:

Pax clinic, two groups from township were fighting each other and the fight ended up at the clinic where one group wanted to finish the member of the other group.

(2) The police were called and positively calmed the situation down. The department increased the security personnel and instructed the district to utilize the hybrid security model to strengthen the security service by appointing the private security company for the clinic to work on Fridays, Saturdays and Sundays supplementing the departmental security service.

GAUTENG

(a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
3 Tembisa 1 x staff member attacked by patient 2 x staff members attacked by patient at Charlotte Maxeke	1 Circumstances Lillian Ngoyi. Staff member attacked by patient at the clinic	4
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
4 Tembisa Hospital A police officer (boyfriend) shot a nurse assistant. The boyfriend entered the facility with a police vehicle flashing light, a case was opened at the local police station case 203/03/22 The father to a patient assaulted a nurse in the ward at Tembisa Hospital. The matter was reported to Tembisa police station case 650/3/2023. Charlotte Maxeke hospital 2 x security officers were assaulted by Psychiatric patient	0	4
Total Hospital 7	Total Clinic 1	8 Grand total

(2) Approved Security Policy and Access Control Policy were distributed across Gauteng Health facilities. The department is also conducting security assessments on the current status of CCTV cameras.

The Gauteng department of health is in a process to procuring the new security contract for all the department of health facility with the Hybridge model to address all security concern within the province.

KWAZULU-NATAL

(1)`(a) (i) (ii) (aa) (bb) and (2)

Facility	(ii) clinic staff have been attacked and/or threatened by (aa) patients on the premises of health facilities in each province	(b) were the circumstances of each incident in each Province;	what are the relevant details of the measures that have been put in place to address such incidents in each province?
Fort Napier Hospital	08	1 x case of sexual assault (A female Staff was touched inappropriately by a Patient.) 7x cases of physical assault on staff members by the patients.	In the wards staff members are issued with mobile panic buttons, to use in emergency cases. Cleaners are encouraged to work in pairs as much as tasks allow. Staff members are trained on de-escalation techniques. Security officers are allocated in the wards to assist on security issues. Patient risk assessment is ongoing and risk mitigation is implemented as risk changes are noted.
Niemeyer Memorial Hospital	01	The mentally ill patient attacked the nurse with a drip stand whilst under 72hrs observation.	Investigating Officer appointed to conduct investigation with effect from 23 November 2023. Referral of violent /disruptive mentally ill patients immediately to designated psychiatric facilities.
Greys	01	A Female Nurse who was separated from her husband at the time was assaulted by her husband on the hospital parking lot. Security was called to assist but the perpetrator was armed and threatening verbally.	Local SAPS was called but unfortunately arrived after the perpetrator had left. The wife was assisted by security to the Emergency Dept. the wife completed a J88 in the Emergency Department. A court order was obtained, and the husband can only access the hospital property as a patient.
Townhill	09	5 x Staff injured while restraining MHCU’s. 3 x Professional Nurses sprayed with fire extinguisher by MHCU. Security officer assaulted by enrolled nursing assistant at the main gate	More staff will be sourced to monitor psychotic patients. Ongoing staff re-training on seclusion of psychotic patients. ENA seconded to another hospital while labor relations investigation proceeds
Northdale	07	All cases of staff being attacked by patients involved acute psychosis exhibited by the patients.	Installation of live CCTV cameras to specific wards. Upgrade security patrols around wards to do crowd control during visiting hours.
Richmond	01
Nkonjeni/ St. Francis Hospital	01	A patient brought by relative jumped and kick the window while the OPD clerk was retrieving his file	Strengthened security at OPD.
Vryheid hospital	14	Nursing staff attacked by psychiatric patients	Assistance by Security Guards. Seclusion of psychotic patients. Staff referred to EAP for grief counselling.
Addington hospital	01	Casualty Staff were threatened by a relative demanding urgent attention.	Security strengthened at Casualty.
KEH & ST. Aidan hospital	01	Staff threatened by a Patient who was intoxicated.
Mahatma Ghandi Memorial hospital	05	DR assaulted by MHCU patient in casualty and the Dr’s cell phone was taken and smashed by patient in male medical ward and had her arm twisted Security and Nurse bitten by MHCU in casualty when restrained nurse trying to administer medication Nurse attacked by MHCU that was refusing admission. Security Officer attacked by MHCU from casualty. The patient pulled the security hair.	Security posted inside casualty and another at entry od casualty. Each security has been provided with two way radios to call for backup.
Wentworth hospital	03	Relatives demanding attention	Installation of CCTV cameras. Security guards are posted to all service point areas.
KwaMashu CHC	01	A security guard was hit by a patient who had requested assistance and the Security had a negative attitude towards the client	PRO attended and cautioned patient. Security was subjected to disciplinary action.
St. Mary’s hospital	03	MHCU patient in OPD and another on one the ward threatened staff. MHCU in ward Confused Patient in the ward. Security attack by patient’s relatives Relatives brought in an assaulted patient and were demanding to be seen immediately. Attacked Security and broke the hospital boom gate.	Matter discussed in OHS Committee Meeting, relevant department to keep in stock soft restrains and improve communication with other relevant stakeholders during hand-overs to ensure that status of all patients is known to the new shift employees. The matter was discussed in the OHS Committee Meeting and information cascaded to the relevant ward. SOP of handling confused Patients developed. Ward strengthened communication during handover between shifts should status of patients change. SOP in place to ensure one relative accompanies the patient that is unable to assist themselves.
G.J. Crooks hospital	02	Staff Member was assaulted by a patient Verbal assault of a Doctor and a Nurse.	Access control was intensified and Security was added.
Phoenix CHC	01	MHCU that had defaulted his treatment punched a staff members in the face.	Security personnel are placed throughout the facility at strategic points to ensure the safety and security of patients, community, staff and the facility.
Thonjeni clinic	01	A Security Officer was shot and killed outside the clinic while on duty.	It was an isolated incident as it was nothing to do with work, except that on the day of incident he was on duty.
RK Khan Hospital	05	All were attacked by Mental Health Care Users in Casualty Department.	An additional 7 beds have been added in the Male Psych ward to avoid keeping patients in Casualty.
Port Shepstone hospital	01	Security Officer assaulted while assisting Nurses to control a MHCU.	More than one Security in assisting to control the violent patient
G.J. Crookes hospital	03	Staff Member was assaulted by a patient. Verbal assault of a Doctor and a Nurse.	Access control was intensified. Priority is given to transfer of mentally ill patients to mental health wards. Staff members were referred to EAP.
Murchison Hospital	02	Staff members attacked by a MHCU.	Provided better measures and counselling of handling the mentally disturbed patients.
Isithebe Clinic	01	Armed robbery by five unknown men.	Investigation conducted by the District Security Coordinator. A case was open at Nyoni Police Station and a Team came to take fingerprints.
KwaMashu CHC	01	A Nurse was assaulted by unruly patient. Security deserted post during incident	Security was dismissed and an additional security was posted
Umkhontokayise clinic	01	Armed robbery by two unknown men who had made a hole in the parameter fence.	Investigation conducted by the District Security Coordinator. A case was open at Nyoni Police Station and a Team came to take fingerprints.
Thokozani clinic	01
Ndulinde clinic -	01	A Nurse was attacked by her boyfriend.	Security guards intervened. No physical injuries were sustained.
Sundumbili clinic	02	Break-in where two staff vehicles were taken at gunpoint. Staff members were threaten by the relatives who were accompany the critical ill patient. Staff members were told to pay a special attention to their patient at gunpoint, if a patient dies staff members will be killed as well.	Additional of security personnel and one roving/ patrol vehicle has been made to check all clinics. A case was open at Nyoni Police Station and a Team came to take fingerprints.
uNtunjambili Hospital	03	A staff member suspected to be intoxicated attacked his colleague	A formal investigation was done which resulted in dismissal. Reported to early warning signs system, PSI was discussed in the meetings Nurses were referred to psychologist
GJGHM	02	Patient was aggressive and he wanted his baby to be discharged	Security guards were trained to handle aggressive patients Nurses were capacitated to identify patients showing signs of aggression and how to manage aggressive patient Explained to the father the cause of child’s admission.
Ndwedwe CHC	01	Doctor was attending to a patient with a gunshot wound with fatalities and the relatives were questioning the doctor.	Security guards were instructed not to allow multitudes to accompany patients to service areas.
Nkandla Hospital	03	Psychiatric patients were aggressive to Staff.	Security bars were installed in the ward.
Eshowe Hospital/Clinics	01	Attacked by intoxicated relative of patient in casualty	Reduce number visitors per patient to one Increased security patrols in casualty backup especially during weekends and after hours Stakeholder engagement with local SAPS Revived security committee, inclusive of SAPS representative
Ndlangubo Clinic	01	Robbery	Security do frequent patrols especially at night. Revived security committee inclusive of SAPS. Community leadership engagement for support.
Greytown Hospital	02	Both staff members were attacked by mental health care users.	Both assaults reported as incidents during PSI Meetings and maximum doses recommended for psych patients especially at night.
Church of Scotland Hospital	02	All staff members were physically handled by the psychiatry patient.	Increased security guards in the wards
Mseleni Hospital	02	The Mental Health Care User became violent slapped the Nurse and attacked the security guard who sustained soft tissue injuries.	Staff members were seen by the medical officer in OPD and referred to the psychologist for psychological support. Staff in-service on the handling of a violent MHCU.
Bethesda Hospital	01	A Nurse was assaulted by a MHCU.	Risk assessment of the work environment done by Safety Officer and risks identified. Staff members referred to Occupational Health doctor.
Madadeni Regional Hospital	09	08 Staff members were attacked by MHCU’s. Stray bullet went through the window at the clinic.
Ladysmith Regional Hospital	07	MHCU’s assaulted staff members on separate incidents. A Medical Officer was pushed and fell in an iron bar.	Emergency Medical care for injuries Health Risk assessments done, quarterly. EAP counselling and debriefing Ongoing Staff training and on management of aggressive patients. Increase security in MHC wards.
Eg &Usher Memorial Hospital	03	In casualty a mental health care user attacked a Nurse with a drip stand. A Nurse in casualty was attacked by an aggressive patient believed to be intoxicated. Professional Nurse was attached by patient relative
Estcourt Hospital	03	Two Security Guards and a Nurse were assaulted by a Mental Health care user who was brought in for admission.

LIMPOPO

(1) (a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
4 Circumstances Kgapane Hospital: Patient threatened a Nurse with a knife, demanding to be injected with a small injection. Hayani Hospital: A MHCU patient attacked 1x Security Guard. Maphutha Malatjie Hospital: MHCU Patient assaulted Security guard. Patient assaulted a Nurse	3 Circumstances Morutji Clinic: Assault of 2 x Nurses by a Patient Relela Clinic: Patient assaulted a Nurse.	7
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
9 Circumstances Pietersburg Hospital: NEHAWU Members threatened 8 members of management with violence and disrupted services Lebowakgomo Hospital: A political party leader of an organization called Defenders of the People (DOP) forced entry and verbally abused the PA to the CEO.	2 Circumstances Sambandau Clinic: 1 x Male Nurse assaulted by armed robbers and robbed of a Car, Cellphones and Cash (R100- 00) Same robbers proceeded to rob 1 x Security Officer of a cellphone.	11
Total Hospital 13	Total Clinic 5	Grand total 18

(2) For all incidents of assault against Nurses and Security, criminal cases were opened, security increased in vulnerable areas and counselling arranged for the affected persons.

Material loss is covered by the SLA with Security company(s) and the Service Provider replaced the lost materials.

Threats and disruptions of services by organised labour are handled through negotiations and where there is no agreement court interdicts are applied for, as it was the case with Pietersburg Hospital.

A court interdict was obtained against the Defenders of the People (DOP)for Lebowakgomo hospital.

MPUMALANGA

(1) (a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
0	0	0
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
1 Circumstances Carolina hospital Staff member was assaulted by a group of young men. Case No 59/06/2023 was opened	5 cases Circumstances Mayflower CHC Staff member were attacked by a group of young men Pholansikazi CHC Three young men robbed and shot an EMS crew member. Case number 147/06/2023 was opened. Dwarsloop clinic Armed robbery and Theft of equipment. Case No 55/7/2023 was opened Jim Brown clinic Intruders came and discharged firearm in the clinic at night. Security was robbed of their belongings. Armed robbery case number 24/07/2023 Empumelelweni CHC Four young men entered the facility through the palisade fence and robbed staff and security officers cellphones and stole computers	6 cases
Total Hospital 1 case	Total Clinic 5 cases	Grand total 6 cases

(2) The MDoH has opened police cases with regard to these incidents.

MDoH, has already at some facilities at is in the process at others of improving physical and electronic security. Amongst these measures are increasing security officers, installed walkthrough metal detectors and a bullet proof glass on guard houses.

NORTHERN CAPE

(1) (a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
2 Circumstances Galeshewe Day Hospital (GDH maternity) female patient slapped the nurse NMH Hospital Security guard was assaulted by Mental patient who was trying to escaped	6 Circumstances Pichard CHC security guard was assaulted by a Patient Wega CHC Assault Fight between patient with visitor and nurse Pampierstad CHC patient threatened to stab the nurse with a sharp object Aggressive patient threatened a nurse Valspan Clinic Aggressive patient threatened a nurse Dr Winston Torres Clinic a nurse was threatened by the patient.	8
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
3 Circumstances Hospital not mentioned Patient’s father assaulted security guard alleging that security man-handled his son. RMS Hospital Unhappy visitor threatened the nurse De Aar Hospital security guard was assaulted by police officer. Police officer refused to be searched	1 Circumstances Ritchie Clinic a nurse was assaulted by her boyfriend	4
Total Hospital 5	Total Clinic 7	Grand total 12

(2) Increased security and involved SAPS

NORTH WEST

(1) (a) (i) (ii) (aa) (bb)

Number staff attacked/ threatened by patients in hospitals	Number staff attacked/ threatened by patients in clinics	# Attacked by patients
8	4	12
Circumstances	Circumstances
Witrand Hospital, Mental patient assaulted the staff member Mental patient assaulted the staff member	Park Street Clinic Mental patient attacked 2 staff members.
Job Shimankana Tabane Hospital Arson at Mental Health Care Unit by Mental Patient. Case 554/11/2022 was opened HRT (Refusal of Hospital Treatment) by mental patient who threated nurses. Case 447/04/2023 was opened	Jouberton Clinic Patient who refused to queue threatened staff members
General De La Rey Hospital (v)Patient attacked security guards at the gate Case 282/10/2022 was opened.	Grace Mokhomo CHC (iii)Verbal abuse to a Doctor by a patient under the influence of alcohol.
Mafikeng Provincial Hospital (vi)Patient threatened a doctor (vii)Security Officer was assaulted by an aggressive patient	Botshabelo CHC (iv) Mentally sick patients attacked security officers on duty
Bophelong Psychiatric Hospital (viii)Male staff cleaner was assaulted by Psychiatric patient
Number Staff Attacked/ Threatened by other Assailants in Hospitals	Number Staff Attacked/ Threatened by other Assailants in Clinics	# Attacked by Assailants
13	8	21
Mafikeng Provincial Hospital Health workers were attacked by gangsters at hospital casualty.	Tswelelang CHC (i)Local gangsters were fighting and one got injured and threatened the staff to attend the injured speedily
Job Shimankana Tabane Hospital Group of males (8 in number) forced entry at Ward 5 to check their patient. Group threated the nurses that they must assist their patient fast	Tigane CHC (ii)MMC for Safety and Security threatened staff and attacked patient inside the facility
Koster Hospital Nurse received death threat call from unknown caller. Case 1/4/15-185/2023 was opened,	New Jouberton (N12) CHC (iii)Community members forced entry into emergency unit and threatened nurse on duty needed assistance for their partner who was stabbed,
Tshepong Hospital Doctors were attacked and robbed their cellphones and belongings at gunpointDoctors were threatened by family members due to long waiting time	Orkney Clinic (iv)Job seekers (community members) attacked health worker. Case opened with SAPS,
Bophelong Psychiatric Hospital Staff members on duty were intimidated by community members. Case 497/07/2023 was opened,	Alabama Clinic (v)Nurses were verbally attacked by members of community. Case opened with SAPS
Moses Kotane Hospital Male patient threatened the nurses at Casualty to be assisted first	Empilisweni Clinic (vi)Operational Manager assaulted by officials from legal firm demanding a patient record.
Taung District Hospital Family accompanying patient refused to follow department procedure by opening patient file instead they became violent and threaten nurses and doctors	RB Nzima Clinic (vii)Staff member attacked by unemployed community members demanding removal of personnel not from their area
Taung District Hospital Community members fight outside the hospital premises and followed the one who was taken to hospital for medical attention	Top City Clinic (viii)Staff members were threatened by the local business forum during a site briefing meeting for the renovation of the clinic.
Taung District Hospital Community members fight outside the hospital premises and followed the one who was taken to hospital for medical attention
Joe Morolong Hospital Community members fight outside the hospital premises and followed the one who was taken to hospital for medical attention One of the group was in passion of Firearm threatening Dr, Nurse and security Officers
EMS Station Emergency staff on night duty attacked at gun point. EMS Staff attacked at Jacaranda Informal Settlement by a knife EMS personnel on night shift were chased by a car.
TOTAL HOSPITAL 21	TOTAL CLINICS 12	33 GRAND TOTAL

(2) For some incidents police cases have been opened.

Increased security and involved SAPS

END.

Source file

RNW3768-231124.docx

24 November 2023 - NW3768

Clarke, Ms M to ask the Minister of Health

Reply:

Source file

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