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Toxic mess: Debt crisis leads to medical waste pile-up at Eastern Cape hospitals

Bags and buckets of hazardous medical waste pile up at Livingstone Hospital after the Eastern Cape Department of Health found itself unable to pay the waste collector because its bank accounts had been frozen by an attorney. (Photo: Screengrab / Facebook)

Hundreds of containers of hazardous medical waste are piling up at health facilities around the Eastern Cape after the provincial department of health was unable to pay the service provider responsible for removing the waste.

A court order attaching the funds of the Eastern Cape health department has left it unable to pay service providers. One of the consequences is that hazardous medical waste is now piling up at health facilities.

The department’s bank account was frozen by attorneys enforcing court orders linked to medico-legal claims. The department has staggering debts running into billions of rands owed to successful litigants and service providers who have not been paid.

Last week, hundreds of buckets and bags containing hazardous medical waste were seen outside Livingstone Hospital in Gqeberha (formerly Port Elizabeth) after the health department failed to pay the waste company hired to collect it.

The hospital is one of the province’s designated Covid-19 facilities. Its acting CEO, Dr Mthandeki Xamlashe, confirmed that “waste collection was paused as a result of payment issues”. He said this resulted in noticeably higher volumes of medical waste.  

“We now have a safe storage facility that meets the South African national standards,” he said.

Livingstone Hospital’s permanent management team was suspended in November 2018 after a strike by Nehawu members. Since then, the facility has had seven acting CEOs. Despite promises by former health MEC Sindiswa Gomba that they would headhunt a permanent CEO, this has not happened.

Eastern Cape health department spokesperson Sizwe Kupelo said the funds in the department’s bank account had been attached by attorneys, but that “partial payment” had been made to service providers on Friday, 5 March.

“I think waste management was one of the companies that were paid. We are facing constraints due to the fact that lawyers took our money out of the bank,” he said.

After Sindiswa Gomba was fired by premier Oscar Mabuyane, the department installed Xolile Nqatha as acting MEC. Gomba is on trial for allegedly being part of a conspiracy to misappropriate funds intended for former president Nelson Mandela’s funeral while she was a councillor in the Buffalo City metro. 

The Special Investigating Unit also recommended that action be taken against her for her role in the procurement of “ambulance scooters” using R10-million in Covid-19 funds.

The health department also has an acting head, Dr Sibongile Zungu, after former superintendent Dr Thobile Mbengashe resigned and was appointed as a consultant in premier Oscar Mabuyane’s office. Mbengashe faces disciplinary proceedings for his part in the failed ambulance scooter project.

The Democratic Alliance’s Retief Odendaal said attorneys were also attaching department of health property as there was no money to pay bills.

He said that according to the DA’s numbers, the department has unpaid bills of R3.8-billion and a total of R37-billion in medico-legal claims against it. 

“The department of health has already used 10% of their 2021/22 budget,” he said. “They are factually bankrupt and should be put under administration.” 

As provincial MEC for finance Mlungisi Mvoko prepares to present his budget on Wednesday, 10 March, the health department poses enormous difficulties.

Of 2020’s R86-billion health budget, R57-billion went on salaries. 

The province does not budget for medico-legal claims, but instead takes the money from the operational budgets of the facilities where the patients were injured or suffered damages.

In August 2019, Mabuyane’s spokesperson Mvusi Sicwetsha indicated that the health department would approach the Constitutional Court for a ruling on whether it should pay exorbitant medico-legal claims at the expense of health services.

The case has not yet been heard.

In 2019, a task team was established to “create a lasting solution” to the increasing number of claims against the province, and to come up with a strategy to prevent the department’s bank accounts from being attached.

A spokesperson for the Eastern Cape health crisis action coalition, Thoko Mtsolongo, said they were deeply concerned about the unresolved issue of medical waste not being collected at Livingstone Hospital.

“We raised these issues with then health MEC Sindiswa Gomba and former superintendent-general Dr Thobile Mbangashe and were assured that Livingstone Hospital would receive urgent attention from the Eastern Cape department of health. 

“When Dr Sibongile Zungu was appointed to head up the project management unit to manage the Eastern Cape’s response to Covid-19, we were hopeful that the numerous issues at the hospital would be fixed.

“Unfortunately, whatever measures were implemented since Dr Zungu was appointed as acting superintendent-general are insufficient to deal with the historic lack of strong leadership at this hospital and many others across the province. 

“It is telling when a medical waste company refuses to continue rendering a service to Livingstone Hospital as a result of long-term debt being owed to them. It speaks of mismanagement not only at provincial level, but at the facility level. 

“An absence of a permanent leadership structure in place at Livingstone Hospital has an impact on other levels of management, and failure to ensure that a basic service such as this is provided is indicative of a limping health system within that facility and ultimately the delivery of sub-standard health services to the people of Nelson Mandela metro,” she said. DM/MC

  • A subbing error indicated Dr Zungu was being investigated for the scooter saga. It is Dr Mbengashe. We regret the error and apologise to Dr Zungu.

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  • And the ANC wants to create an NHS ? These billions will be trivial compared to what is to come if the NHS project actually transpires.