MEDICAL CRISIS
‘Horrifying’ — doctor blows whistle on CT scanner disaster at major state hospital
Patients are suffering and even dying, says medical insider. Vital CT scans at Ga-Rankuwa can’t be done because machines have broken down and management has failed to renew maintenance contracts.
One of the biggest public hospitals in South Africa has been operating with just one back-up CT scanner – leading to patients having their treatment delayed, receiving inadequate care and even dying, says a whistle-blower doctor.
For nearly three weeks, Dr George Mukhari Academic Hospital in Ga-Rankuwa, north of Pretoria, had no functioning CT scanners at all.
Computed tomography, known as a CT scan, is a diagnostic imaging procedure that uses X-rays and computer technology to produce images of the inside of the body.
A doctor at the hospital, who asked not to be named out of fear of victimisation, told Daily Maverick the problems with the scanners began in 2023.
He described the situation as “horrifying and gross mismanagement”.
They are fully aware of this problem. They are fully aware that this is causing deaths and suffering.
“I know of at least one patient who, owing to this, has passed away. Owing to the nature of the problem, I can only assume that a significantly larger number of patients have passed away,” he said.
A significant number of patients have had treatment delayed, have suffered unnecessarily or received inadequate care, he said.
“Instead of lying in casualty for one day, they lie there for four to six days with illnesses that cause them significant suffering and no one can intervene because they can’t get the information from the CT scanner that we should have,” he said.
Failure to renew warranties
The doctor explained that two of the CT scanners are fairly old – between eight and 10 years – and that a new scanner was installed in 2023. However, the new one has low specifications.
“It can’t handle significant patient load. It’s more just to supplement what we can do on the other two scanners,” he said.
Those two had stopped working in 2023, the first in June or July and the second in about November. The new low-specification scanner stopped working early this month – leaving the hospital with no CT scanners.
“The way that it works with our suppliers is that, once the machine is bought, they give you a five- or eight-year warranty. Once that warranty expires, you need to pay for an additional warranty,” he said.
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According to the doctor, these warranties were not renewed by hospital management.
Typically, when a hospital cannot manage emergency patients, it is placed on divert – meaning that patients are sent to other hospitals nearby, said the doctor.
“Our management team has been very reluctant and has denied putting our hospital on divert,” he said. “They are fully aware of this problem. They are fully aware that this is causing deaths and suffering.”
The doctor explained that the CT scanners were supplied by two manufacturers, one of them Philips. The contract for the Philips scanner was set to expire in June 2023.
“Towards the end of 2022, our head of department issued a purchase order to… management knowing that we’re going to have to renew these contracts,” he said. According to the doctor, the paperwork lay stagnant until April 2023.
This is a problem that everyone has been aware of for longer than a year and a half.
“A meeting was then held with our supply chain [management], who at that point said: ‘Why have we not issued these documents earlier?’ But those documents were issued and they were just sitting on someone’s desk,” he said.
He explained that suppliers renew maintenance and warranty contracts for three to five years as an industry standard.
“Our hospital at that point felt that the cost was not something they could budget for, so they asked us to go back to Philips to negotiate,” he said.
Philips offered a six-month contract in the middle of 2023.
“They then sat on that six-month renewal contract again at supply chain and management until about November/December,” he said.
Although doctors had tried to make do, patients were being harmed, with some falling through the cracks or having to be rescanned and subjected to more radiation than they needed to be.
A meeting was held at the beginning of this year, when it was revealed that the hospital could not afford a six-month contract. It would need to renegotiate with Philips for a three-month contract, as the 2024 budget for the hospital only takes effect in April.
“The fact of the matter is, this is a problem that everyone has been aware of for longer than a year and a half. We have been constantly going to them with this problem, and they keep throwing in a new excuse or new forms or new stipulations.”
A computed tomography (CT) scan is used to obtain detailed internal images of the body. For nearly three weeks, Dr George Mukhari Academic Hospital in Ga-Ramkuwa had no functioning CT scanners, according to a whistle-blower. (Photo: iStock)
Other hospital technology affected
The hospital’s picture archiving and communication system also relies on Philips.
“That allows, when we do a scan, whether it’s a CT scan, MRI, X-ray – those images go onto the local network, allowing the radiologists to report on those studies, and the clinicians can view the images on their computers in whichever department they are, as well as the reports,” the doctor said.
According to the doctor, the system has had limited functionality for almost two years. “It is a running joke in our department that it pretty much stops working for like a week every month, and you revert to writing stuff by hand, and the clinicians can’t see the images,” he said.
“We’ve been instructed by management to make do.”
The doctor added that Philips had been providing good service, compromising and going out of its way to help the hospital.
“At some point, if you aren’t being paid for a couple of years, you need to draw a line somewhere,” he said.
Siemens is set to implement a new system at the hospital.
“That system is going to be implemented towards the end of January, beginning of February this year, but there have also been constant delays with that,” he said.
Patients bearing the brunt
The hospital has lost studies and CT scans of patients for a year and a half. They had been stored on the archiving system on two hard drives. One of the drives failed and could not be repaired, while the other was stolen.
“With a patient on chemotherapy, what usually happens is that they’ll have a scan before they start treatment, then follow-up scans after that to see if they are responding to treatment,” the doctor said.
“But because we can’t access these old studies, there’s nothing for us to compare.”
Although doctors had tried to make do, patients were being harmed, with some falling through the cracks or having to be rescanned and subjected to more radiation than they needed to be, said the doctor.
The situation was now “horrifying and people are actively dying”.
The doctor said a head of department and another doctor had been engaging with the hospital management, to no avail.
“I know for a fact that they’ve been banging on that door for months,” he said.
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On 16 January, one of the scanners had started working again, but the machine was overloaded and could break down again.
“It is the back-up machine, so we can only do a fraction of the cases we need to do… but at least we can do most of our emergencies now,” he said.
“Management is still delaying the fixing of our other two scanners.”
Daily Maverick asked the Health Department for comment on 17 January and again on 22 January, but there was no response by the time of publication. DM
This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R29.
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Criminal negligence.
THIS is why the NHI should never be allowed to happen
The situation is tragic and needs to be exposed. Kudos to the whistle-blower.
However in the interests of good journalism it’s necessary to be accurate. The accompanying photo is of an MRI machine, not a CT scanner, and the doctor is holding a plain film Xray, not a CT scan image.
Correct! Eish! Same like the hospital. Sorry for the peepull!
Indeed!
Let’s be honest here – the government’s complete failure in the health sector is, to my mind,, the South African version of genocide. I have long believed that the breaking down of the health system is a way of ridding society of the weak among us. NHI if and when it is introduced will be an extension of this.
What an odd thing to take away from this story. This is typical mismanagement and theft, same as everywhere else in government. Except in this case applied to hospitals with predictably dire results. The consequences of the NHI would be similarly dire and predictable. You give the govt too much credit with your conspiracy theory.
May sound like a conspiracy theory but I truly believe that the ANC government is hoping that the most vulnerable citizens in the country will die sooner rather than later. And the shambling health sector is hastening this.
The less they have to spend on treating old and ill and poor citizens the more available money to steal.
Started way back with Mbeki who infamously said of AIDS patients “it’s cheaper to let them die than to treat them”
And under NHI, all hospitals in South Africa will soon have to reside under this very same department. Scary
Criminal Irresponsibility?
SNAFU #50037
You’re missing a few 0’s on the end there
Thanks to an immoral ANC thieving goverment
That’s why the NHI will not work in SA..it’s implemented by incompetent bunch with no proper research done on the impact it will add on these government hospitals, they’re a chaos right now.
This is how the NHI will be run.
The comrades have ruined state health— now taking over efficient,
world-class private health care to inevitably do the same.
Beyond tragic.
They won’t care how it’s run as long as it provides a new trough to feed from.
Appointment of unqualified, lazy people pretending to do a job and taking a huge salary for doing nothing at all. Yet another shocking failure in the hands of the ANC.
The problem goes further than that. The cadres deployed to these managemnet positions are so busy with their own schemes to milk money out of the hospital budget that they do not have time to do their jobs and they are stealing the money that should be used for maintenance contracts etc. In this case the service provider probably refused to pay a backhand (because there is proably no other service provider that can supply this sort of specialised service) and now the comrades are sitting on this wondering if they can make another plan “while Rome burns”.
The ANC actively fights against private medicine, private industry, and private anything that works well. Our private medical services are on par with (and often better than) international medical facilities. Even a first world country like the UK’s NHS is unable to match South Africa’s private medical service. The ANC in a sick vote buying exercise is pushing through the NHI which will never work, apart from becoming another conduit for corrupt proceeds into ANC pockets. Almost every state hospital is a sick as the Dr. George Mukhari facility, and, believe it or not, this is a training hospital for young doctors. The Ozymandias opening line says it all, “Look upon my works ye Mighty, and despair”. Could have been said by the ANC…
You can’t compare UK public health (NHS) with South African Private Health. There are plenty of good Private Health Schemes in UK.
Time to charge some hospital CEOs for murder. Administrative bungling costs lives and yet there is money in the millions for “Digital Vibes” etc. Name and shame those incompetents on whose desks these applications sit.
Why do ANC caders not understand the concept of maintenance? State Hospitals & clinics, ESKOM, Transnet, water reticulation plants, the list is endless?
Are they also not taking their R1 million SUVs for service?
Don’t they understand that you have to start negotiating replacement contracts at least 6 months before the existing contracts expire? It boggles the mind!
“Are they also not taking their R1 million SUVs for service?”. That makes my day.
Its simple…supply chain management is sitting on their hands until a back hander can be negotiated with suppliers…standard operating procedure.
How can I get more involved ?
Can I suggest by turning into a CT scanner … or is it scammer ? Apologies to Malibongwe also .. who I have not heard from recently!
Back to the mid 1990s when the Howick municipality was shocked that it had to insure its fire engines every year, and that they needed to be serviced.
Both had been scrubbed from budget lines so cash could be transferred for a new car for the “director of services.”
The solution was to ban fires.
This kind of a report makes the prospect of NHI absolutely terrifying!
And we are supposed to look forward to National Health. the `State cannot take care of what it already has too. Simply pathetic, very difficult for seriously ill people to defend themselves.
Cadre cANCer
This a problem in the majority of state hospitals and not limited to CT Scanners but includes other medical equipment. Am i an idiot to ask why is there no national contract with suppliers for specialised medical equipment .
A few years ago there was a report that one hospital was unable to get repairs carried out on critical diagnostic equipment because of an outstanding account of around R1-million, so it seems the problems are still ongoing.
Pretty standard fare from Health Department – maintainence not a priority and paper work lies dormant for months. Cancer patients suffer and emergency care is compromised for the lack of a functional CT scanner while so called “management” -ie useless cadres funded by money meant for desperately needed new medical staff- loot what can’t be nailed down and waste the time of doctors still remaining in the public domain with endless, non-productive futile meetings. But fear not Comrades for the NHI will miraculously put things right while allowing us to loot the country into bankruptcy for decades
On 5 December 2023 I was seen by a neurologist who determined that I may have suffered a minor stroke and was given a form to book an MRI. My appointment date is 27 July 2024, almost eight months later. I consider this wait outrageous, a joke. By July the condition which may well have caused this, polycystic kidney and liver disease which is at end stage, stage 5 kidney failure may well have already killed me or caused me to have another more serious stroke.
???
Medical professional here. Yup. This is pretty standard across many hospitals. Worked in one where it was not fixed for 6 months.
“Daily Maverick asked the Health Department for comment on 17 January and again on 22 January, but there was no response by the time of publication.”
As a responsible citizen, I am demanding a response from the Health Department. And if they do not, I think we need to find a mechanism to lay charges of criminal negligence against the Minister.
This is worry some and disturbing at the hospital of that caliber and the Pro once I am going to check at my local hospital of how is the situation thanking the doctor who blew the scandal, please doctors keep on informing us so that we take the matter up, we the people on the ground we keep blaming the clinical staff for shody work at hospitals keep on!
Does the word “maintenance” exist in any African language?
Seems not
How do you go bankrupt? At first slowly, then all of sudden, completely. Same with a failed administration: at first the decline is bearly noticeable, then all of a sudden, the disastrous state of the administration is there for all to see.
Wait till the public finds out about the quality of the “nurses” there. Went to emergency with an employee with a injured hand. Free flowing blood constantly, all they did was wrap his hand in bandages without stopping the blood flowing, told to sit on a chair and wait for a doctor. Blood soak through the bandages in seconds but they just kept wrapping his hand without treating the wound. 2 hours later, in casualty in 2010 in Ga-Rankuwa, they wrapped his hand bigger than his head.
And the blood kept flowing.
I pity the souls that have nowhere else to go.
This by the very people that accuse Israel of genocide.
THAT IS WHY THE NHI MUST BE SCRAPPED IMMEDIATELY!!!! AT PRESENT THE CRIMINAL ANC CAN’T EVEN MAINTAIN THE GOVERMENT HOSPITALS!!!!! WHAT THE HECK DO YOU THINK WILL HAPPEN IF WE ALLOW THAT BILL TO BE IMPLEMENTED??? THEY MUST GO, VOTE THEM OUT!!!!
…to summarize the article; the hospital management (i.e. it’s administration) has been sending its radiology department (i.e. senior medical officers in charge of radiology) from pillar to post without lifting a finger to fix or procure new CT machines – this is a classic example of what happens when we let our medical facilities be run by people with no background in medicine or health administration (i.e. they can’t distinguish between what is urgent and what is not in a hospital environment). It also seems like someone in management or procurement is not very keen on continuing the contract with phillips and are trying very hard to destroy the investment that has been made in this contract; the implications are that a new contract (i.e. new Siemens CT machines and infrastructure need to be procured, and by implication new financial outlays on the new Siemens system intended to replace Phillips).
A look into the future. How are they going to run a new NHI service when they continue to destroy the current system?
How many doctors (local and international) do you need to call out the ANC’s incompetence as ‘Horrifying’ before anything is done???