Hospital investigation, Part 5 

Gauteng Infrastructure Department fails to answer important questions on the billion-rand ICU spend

By Mark Heywood 22 October 2020

Ongoing construction of the ICU ward at Kopanong Hospital. (Photo: Mark Heywood)

A R1.2-billion Gauteng government project, which was supposed to be a lifebuoy when the Covid-19 peak hit (it has now passed), was not put out to public tender, instead the companies were chosen from a pre-approved list of providers. While this in itself could possibly be above board, the Gauteng Department of Infrastructure Development has declined to answer important questions, hiding behind the fact that a Special Investigating Unit probe has kicked off.

Maverick Citizen visits to the construction sites at some hospitals made it clear that promised projects are still far from complete and that they may, as health workers warned, end up being white elephants. This is because their design is specifically geared for intensive care and will need further money to repurpose it for other uses.

The Covid-19 ICU field hospital programme is on the radar of the Special Investigating Unit.

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

The Presidential Proclamation R.23 of 2020 states: “The Special Investigating Unit are to investigate:

  1. The procurement of, or contracting for, goods, works and services, including the construction, refurbishment, leasing, occupation and use of immovable property, during, or in respect of the national state of disaster, as declared by Government Notice No. 313 of 15 March 2020, by, or on behalf of, the State institutions, and payments made in respect thereof in a manner that was:

(a) not fair, competitive, transparent, equitable or cost-effective;

When Maverick Citizen started its investigation, having been alerted by frontline health workers, the main issue we were probing was why four Intensive Care Unit (ICU) field hospitals were still far from complete long after the first wave of the Covi-19 surge had passed, rendering them near-redundant.

Read parts one, two, three, four for background. 

Construction of the ICU Ward at Kopanong Hospital is still ongoing. (Photo: Mark Heywood)

One month later, questions about planning and timing of the 1,440-bed R1,2-billion project still have not gone away. However, in part prompted by Maverick Citizen’s investigation, there is now a growing focus by the Special Investigating Unit (SIU) on whether the long hand of corruption might not have stopped at PPE procurement, but also have established a firm grip on the lucrative construction sector.

In an interview with Newzroom Afrika on 28 September 2020, Gauteng’s MEC for Infrastructure Development, Tasneem Motara, insisted the tender process for building the hospitals was above board. She stated:

“… we followed not an emergency process for the alternative building technology procurements, we followed a tender process. And that would be the normal process that we follow for all the construction that we do.”

Since then Maverick Citizen has been probing the Gauteng Department of Infrastructure Development (GDID) with questions aimed at uncovering details of the “normal” tender process.

However, this week the trail went cold.

Construction continues at Jubilee Hospital. (Photo: Supplied)

On Monday morning GDID spokesperson, Bongiwe Gambu, having promised to provide answers to a third set of questions we sent changed her mind and she told us:

“As you may be aware, all our Covid-19 infrastructure projects are currently under investigation by the Special Investigation Unit (SIU) and we are no longer in a position to engage further and would rather submit ourselves to that process. Engaging on these projects while the investigation is underway will prejudice the process and expose the Department to a court of public opinion.”

This was after Gambu sent an email on 14 October where the GDID had confirmed that the tenders were not advertised publicly, but “selected from a pre-approved list of service-providers”. 

In the same email Gambu had promised that the tenders “submitted and their prices are available and can be furnished on request”.

The half-constructed Chris Hani Baragwanath Hospital ICU ward. (Photo: Mark Heywood)

On the vexed issue of the use of Alternative Building Technology (ABT), she stated that:

“… due to the urgency of the project a different approach of design and build RFP was proposed whereby the contractor will be responsible [for] design, construction and commissioning. This option provides a shorter programme and early contractors involvement assist the entire process. The method of construction (alternative building technology) allows significant reduction in time for construction in comparison to the conventional building method.”

“Speed of construction” has become the stock answer as to why ABT was chosen for these hospitals – but they are still far from finished.

When Maverick Citizen visited the construction site of the ICU hospital being built at the dilapidated Kopanong district hospital in Vereeniging last week, the 10 new buildings were far from complete.

An aerial view of the ICU wards being constructed at Kopanong Hospital. (Photo: Sanjo Fabtech Sterling)

On a site tour with two directors of  Sanjo Fabtech Sterling, the company whose ABT is being used in the construction agreed that even after they hand over the buildings in November, equipping, furnishing and readying the hospital meant it would not be available for use before 2021.

Pictures we have been sent of construction at Jubilee hospital show that it, too, is far from ready.

And George Mukhari looks like expensive cattle sheds.

According to Dr Sifiso Maseko, appointed head of Infrastructure in Gauteng health last year after being removed as CEO of Chris Hani Baragwanath hospital, “innovation” and suitability for repurposing is another reason for using ABT. But it is clear from the sites that we have visited that the building design is very much with Covid-19 in mind. Recognising this, the premier’s office and GDoH are now consulting clinicians on repurposing the units — something that will bring additional costs.

 What’s it costing?

Kopanong Hospital. (Photo: Mark Heywood)

According to the Special Adjustment Budget the total amount allocated for the 1,400 ICU beds is R1,218,314,000 (R1,2-billion).

Kopanong: Budgeted R220,636,000 (R220-million).
Paid by end July R56,809,005 (R56-million)

CHB: Budgeted R496,306,000 (R496-million).
Paid by end of July R173,876,656 (R173-million)

George Mukhari: Budgeted R233,445,000 (R233-million).
Paid by end of July R46,604,661 (R46-million)

Jubilee: Budgeted R267,927,000 (R267-million).
Paid by end of July R87,856,380 (R87-million)

 (Source: First Gauteng Expenditure Disclosure report & communication from Gauteng Health Department)

By late July, R356,145,702 (R356-million) had been paid out.

Ominously for the taxpayer, in response to our question: “How does that tender award price compare with the final account value at completion?” Gambu replied: “The projects are not yet completed and a final account is thus not yet available.”

This seems to confirm fears, expressed by some in the building industry, that the unusual “turn-key” contracts being used in these tenders and the absence of independent quantity surveyors, risks giving a blank cheque to the builders.

The ICU wards being constructed at George Mukhari Hospital. (Photo: Supplied)

When asked who approves the payment certificates submitted by the builders, Gambu answered “the Project Management Unit in the GDID and GDoH” but the question of who the Project Management Unit is composed of is one of the questions she has declined to answer.

In the meantime, the office of the Attorney General, which earlier reported concerns about the field hospitals, has told us that “an update on the matter will be provided in the second Covid-19 report which we will release before the end of the year”.

The Gauteng and National Treasury also seem worried. A senior employee at the national treasury questioned whether this was fruitless expenditure and even suggested that projects might need to be stopped before they consume even more money.

Mr John Sukazi, head of Communication at the Gauteng treasury, told us “we are looking into these companies that received work from the province. I will definitely let you know”. He also pointed to the third Gauteng Expenditure disclosure report, due out in early November.

Up to now, our investigation has focussed on Gauteng’s infrastructure programme. However, we have been informed by sources that there may be similar issues in KwaZulu-Natal and the Eastern Cape.

Interestingly, ABT appears central in South Africa’s much-touted infrastructure push worth R1-trillion by 2024. Ahead of President Cyril Ramaphosa’s economic reconstruction and recovery plan released on 15 October, the investment and infrastructure office in the Presidency energetically plugged ABT as the means not only to speed up infrastructure delivery, but also to contain costs. And the government is pursuing the standardisation of designs for social infrastructure, like schools and clinics, that would use ABT.

Red flags are flying and it would seem that the SIU is going to have its work cut out.

For the record, these are the questions the DID chose not to answer:

  1. Please could you supply the actual tender document that stipulates the closing date and time, address to be delivered, etc. The one sent to us appears to be a draft/proposed version.
  2. The list of pre-approved CIDB Grade 8 & 9 contractors as per Framework Agreement referred to under question 2.
  3. When was this pre-approved list compiled?
  4. Please could you send me the list of tenders submitted in response to the RFP and their prices which you say (at para 4) is available on request.
  5. Please could you tell me the exact designations of Mr. Samuel Mahapa, Ms. Zanele Zola and Ms. Kamogelo Kgalegi in the DID.
  6. Who in the Gauteng Department of Health defined the scope of work and drew up the RFP?
  7. Was the RFP signed off by the SG and the MEC?
  8.   In relation to para 7: What particular ABT system was chosen in advance, why and what was the price estimate?
  9. Who were the members of the Bid Evaluation Committee and the Bid Adjudication Committee and what are their qualifications?
  10. Please could you provide the two technical analyses referred to in para 14.
  11. Who are the members of the Project Management Unit? DM/MC
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All Comments 3

  • Mark, why do you ask all these difficult and intelligent questions when the short answer is cadre deployment and through feeding?
    A question that bothers my is in what shop do you buy blankets at more than R 446 per blanket for hospital bedding?

  • ooo look all this ca$h , have to spend it on something !
    My builder buddies need some work , lets through some ca$h at them .
    1400 beds icu type !
    All well and good .
    Are those just the building costs ?
    Excluding ‘beds and stuff ‘ ?
    It a farce !
    Have no idea of staffing %s , 1 nurse / 10 patients ? For 3 shifts a day .
    Guess there are 400 + trained experienced icu nurses just hanging around ?
    Will we need more Cuban doctors ? Are they still here , at what cost ?
    It is a non starter !
    Where is the staff to run it ? How would they get paid and for how long ?
    then go back to their day job ?
    In China it took them about 3 weeks to get their places up and running .
    Ignoring a CCP brag about building one in days , post later removed !
    They moved in 40000 + staff into Wuhan , leaving other patients back home !
    It is a con job !

  • To clarify, ICU nursing is 1 to 1 so you need approximately 4 full time nurses for each bed to cover 24/7. A rule of thumb is that however much you spend on building a hospital, you will need 25% of that amount every year to run it.
    Even if these buildings are completed it seems highly unlikely that either the staff or the funding will be available.
    I’m afraid white elephants are inevitable.
    We already have the Nelson Mandela Children’s hospital in Parktown as a white elephant, we don’t need more.

  • DM168

    Zukiswa Kota, a thoughtful champion of public service

    By Zukiswa Pikoli

    Gingers have a resistance to electrical pain but a lower threshold for thermal pain. This is due to a mutation of their melanocortin 1 receptor.