Seven years later, still no permanent CEO for NMB’s Livingstone Hospital

The Eastern Cape Department of Health has confirmed it has now advertised the job of CEO for Gqeberha’s Livingstone Hospital for a third time in the hope of appointing a suitable candidate.

On 31 October 2018, the last permanent CEO at the hospital, Thulane Madonsela, was marched out of the hospital by unions who were unhappy about several issues.

Madonsela – and his entire management team – was suspended pending an “investigation”, the results of which were never made public. They were neither presented at the Bargaining Chamber nor at a subsequent review application in the labour court. The department also failed to hold a suspension hearing. 

Madonsela was awarded six months’ salary as damages for the way he was treated by arbitrator Clarence Randal, sitting in the Bargaining Chamber. 

The hospital has since had several acting CEOs. The first acting CEO resigned within a month. 

The situation at the hospital deteriorated, and in 2021, Eastern Cape Director of Hospital Services Mtandeki Xamlashe admitted that the hospital was failing. 

Read more: Mtandeki Xamlashe: The doctor breathing new life into Gqeberha’s ailing Livingstone Tertiary Hospital

In an interview with Daily Maverick, Xamlashe admitted that Livingstone Hospital came close to collapse, citing its vast underfunding (at the time, it operated a 1,000-bed facility on a budget meant for just 600 beds), collapsed facilities management and dire staff shortages.

Several managers have been sent to the hospital amid the search for a CEO.

Eastern Cape Department of Health spokesperson Siyanda Manana said the search for a Livingstone Tertiary Hospital CEO had been advertised three times since the departure of Madonsela, but they had been unable to fill the post for several reasons. 

Manana said that in 2023, applicants did not meet the minimum requirements for the post. Head-hunting was initiated through a recruitment agency, but again, candidates did not meet the minimum requirements.

Last year, three candidates were shortlisted. However, on the day of the interview, one candidate declined to continue with the process. The department nullified that process due to the limited number of candidates to assess, Manana said. 

Securing a CEO for Livingstone Hospital formed part of Eastern Cape MEC for Health Ntandokazi Capa’s promise to appoint permanent CEOs for all the province’s major state hospitals by the end of her first six months.

During her policy speech in August 2024, Capa said: “We have an obligation that the Department of Health has a stable leadership and administration. With the executive council intervention in the Department of Health, we commit to [stabilising] critical leadership positions like the chief financial officer, and chief executive officers for all identified hospitals within six months.”

Read more: Nelson Mandela Bay state hospitals face collapse – doctors resign on ‘unprecedented’ scale

Manana said the search for a CEO continued in 2025. The position was advertised and interviews were conducted on 27 May 2025. 

“The candidates were subjected to personnel suitability checks, ie competency assessments, pre-employment checks and verification of qualifications. The selection committee is considering the outcomes of personnel suitability checks. Once concluded, a recommendation for appointment will be made to the executive authority for consideration and approval,” Manana said.

Meanwhile, the hospital is buckling under severe staff shortages. 

In a document seen by Daily Maverick that was sent to the department in May, doctors complained that there had been no routine replacement of medical staff since February 2024. In April, 10 medical officers were appointed at Livingstone Hospital, but that still left 25% vacant posts.

The exodus of doctors from the hospital was also highlighted by the Democratic Alliance’s Jane Cowley in June. 

“In just two years, 74 doctors have left, including 41 medical officers, 15 registrars and 18 specialists. Those who remain shoulder an unbearable load while patients wait in fear and pain.

“This outflow is no accident. It stems directly from the Eastern Cape Department of Health’s austerity drive, which freezes funded posts and diverts ring-fenced salaries to settle debts.

“The human cost is staggering. The intensive care unit’s capacity has been reduced to 14 beds and exhausted clinicians work illegal overtime simply to keep the doors open after hours,” she said in a statement issued at the time. DM