This is Part One of Maverick Citizen’s investigation. Read Part Two here:

Gauteng’s Covid-19 infrastructure splurge: Where’s Andy, the multimillion-rand floor man, and why was he paid so much?

The Gauteng government is facing increasing scrutiny over its health infrastructure spend. The pressure is such that Premier David Makhura is reported to be planning a press conference on Thursday 8 October at Chris Hani Baragwanath Hospital to provide “a comprehensive update of all the infrastructure projects”.

Over the weekend there were also media reports that the premier had asked the Special Investigating Unit to extend its Covid-19 investigation to infrastructure development.

Nevertheless, last week the MEC for Infrastructure Development, Tasneem Motara, was holding firm. In response to issues raised in an investigation by Maverick Citizen, she defended the building of 1,400 highly specialised intensive care unit (ICU) beds in four rapidly constructed (but still not ready) field hospitals using alternative building technology (ABT).

Big questions loom over Gauteng’s billion-rand ICU field hospitals

Contradicting doctors who have told us that the beds cannot be easily repurposed for use other than by intensive care patients, on 28 September Motara told Newzroom Afrika that tender processes had been followed for the hospitals:

“The additional bed space that we are making available at the four hospitals is a combination of ICU, as well as general beds. And with all the support mechanisms that go with it.

“In fact, once we have concluded discussions with the Department of Health, the Bara additional facility will actually become the Lillian Ngoyi Hospital, which was always in the long-term plans of the Department of Health.”

On the controversial use of ABT, she added:

“The beauty of using the alternative building technology is that the inside space can be converted. So if, for instance, the 500 beds after, in about two years, they need a maternity space, we can then reconfigure the space internally to give them maternity wards, or to give them either trauma units or to give them spaces where they can do operations.”

But as the questions mount, the Gauteng Department of Health appears to be trying to get out of the line of fire. It has referred all questions on the hospitals to the Department of Infrastructure Development (DID). Acting Health MEC Jacob Mamabolo is apparently keeping mum on issues he should be better placed to speak about than Motara.

A significant amount of the pressure can be sourced to growing questions about the R1.2-billion ICU field hospitals.

Maverick Citizen’s first report, based on interviews with health experts and a study of available documentation, asked:

• Why did Gauteng ignore expert advice and go ahead to build the hospitals?
• Why did it choose ABT?
• Why, at that stage, were none of the costs recorded in the Gauteng Treasury’s first Expenditure Disclosure Report, covering the period April to June?

Since that report, sources tell Maverick Citizen, the Gauteng government has been scurrying to find plausible explanations for the ABT wards. It has yet to say publicly how they will be staffed or how they will be equipped with the sophisticated and expensive medical technology that is required by ICU units. However, Maverick Citizen has been informed by a source in the department that one possibility being considered is approaching the Solidarity Fund for funding for ICU equipment.

In this context, Maverick Citizen is not the only entity raising questions about these hospitals.

In late August, the Association of South African Quantity Surveyors (ASAQS), together with the South African Council for the Quantity Surveying Profession (SACQSP), issued a media release warning that “PPE corruption focus hides the bigger picture”. They pointed out that while detailed information had been provided “on the unit of measure, price per unit and quantity required on the procurement of PPE for contracts from as little as R1,000” there was “very little detail on the specifications for the infrastructure projects and how they were procured”.

“Only a single amount, together with a very brief description of the work, is provided. This lack of detail does not allow for a basis to benchmark these costs against market norms. It is therefore extremely difficult to determine whether government obtained the expected value from the infrastructure expenditure.”

Maverick Citizen confirmed the quantity surveyors’ critique.

According to the latest Covid-19 Expenditure Disclosure Report produced by the Gauteng Treasury, R365-million was paid to construction companies in August and September. Yet, costs are stated baldly as being for the “design, construction and commissioning of the hospital facilities on a turnkey basis”.

When asked to explain this, Bongiwe Gambu, spokesperson for the DID, said:

“Turnkey basis means the service provider is responsible for the planning, design, construction and commissioning of the facility. The service provider will provide a full suite of disciplines from the design team (architects, engineers, quantity surveyor, OHS, etc) and the construction team. Turnkey contracts are sometimes referred to as EPC contracts (engineering, procurement and construction) as they have similar models of delivery.”

This would explain why the companies that Gauteng Health Department spokesperson Kwara Kekana said had procured the ABT technology (SANJO Technology, Trumod, Prefab Sprout International, Futurecon) are still not listed in the latest expenditure report. One has to assume that their costs are subsumed in the contractors’ costs – although Maverick Citizen was reliably informed that at least one constructor had said “they were told that they had to build using ABT materials even though traditional building materials would have been better value for money”.

It is hard not to suspect that something is awry.

According to building industry sources, “turnkey projects are very rarely used in South Africa”. There was also a feeling that ABT was being used as an excuse. One industry insider said that “there was no apparent innovation in the buildings” and that “use of prefabricated drywalling did not in itself amount to alternative building technology”.

When approached for comment, Deen Letchmiah, the president of the SACQSP, a statutory body, confirmed that letters had been sent in August to the SIU, Treasury and Auditor-General’s office offering assistance, but no replies had yet been received. Letchmiah explained that the involvement of independent quantity surveyors was vitally necessary because “we are the accountants in the building industry. We are best placed to ensure that government gets value for money.”

Larry Feinberg, the executive director of the ASAQS, confirmed to Maverick Citizen that they had not seen tenders or the scopes for the hospitals and were therefore not in a position to evaluate their cost, but that there were inherent dangers in turnkey contracts that needed to be considered. He warned of a “blank cheque scenario” and that “building for an emergency didn’t mean you can’t have checks and balances”.

Minutes before the 5pm deadline on Monday, Maverick Citizen was provided with the Request for Proposals document developed by the DID. It is not dated, nor does it give any dates as to when tenders should have been submitted. It does, however, confirm that the request to use ABT formed part of the tender proposal.

The August media statement by the quantity surveyors proposes 14 basic questions that government departments should ask to avoid writing blank cheques for infrastructure projects and “to establish whether due process was followed in awarding the infrastructure tenders”.

Whether these questions are now being asked by the Auditor-General and the SIU, which are now investigating the field hospitals, we don’t yet know. DM/MC

This is an ongoing investigation. Anyone with information should contact [email protected]