Wrangle puts patients' lives at risk

A wrangle over a R500 million contract for the leasing of equipment is denying patients at many public hospitals in KwaZulu-Natal the life-saving scans and radiological treatment they need. The department signed the five-year contract for the supply of all its equipment needs nearly 11 months ago, but concerns over “value for money”, have stalled the procurement process. Now, with just a few weeks before the end of the financial year, nothing has been procured through the contract. This is according to a source in the department’s Health Technical Services unit who told the Daily News that the deal was signed on April 22 last year, but no equipment has since been procured. Concerned doctors have provided the Daily News with a list of hospitals with no scanners, and those that have dysfunctional equipment. The source said there were divisions in the Department of Health’s management over the contract, and that Dr Sifiso Mtshali, the department head who assumed duty on July 1 last year, was reluctant to allow the commencement of the deal.

“Since his appointment he has been scrutinising the contract. It (specifies that the appointed company, Resultant Finance Pty (Ltd) should provide the department with equipment from furniture to radiology machines. “The latter should have been a priority due to the nature of conditions it treats. This deal however, was pushed through too fast, seemingly without cost analysis being done. “It doesn’t make sense to lease equipment for R500 million for five years,” said the source, who cannot be named because he is not authorised to speak to the media. The source said the contract disadvantaged the department because at the end of the contract, it would be left with no equipment. Meanwhile, there were more pressing concerns. “One can only wonder how many patients have died of, say cancer, because it was discovered too late, that it is in an advanced stage, and cannot to treated because of the unavailability of the required machines for diagnosis and treatment,” said the source.

The Daily News has a copy of the contract signed in April by the then acting department head, Dr Lindiwe Simelane, in the same month she was appointed in an acting capacity. The contract stipulates that it was to begin on May 1, 2015, and continue to 30 April 2020. But the source said it was “disturbing” that to date nothing had been procured through the contract. “There are divisions in the management level because of the contract. “When the new department head was appointed, he scrutinised the contract and has since displayed his reservations. “This is a loss to the department because nothing has been delivered to our inventory and now it would seem they are trying to find a way to negotiate around the contract to procure the much needed radiology machines,” he said. A reply to parliamentary questions by the DA reveals that in the 2012/13, 2013/14 and 2014/15 financial years, the department contracted the Independent Development Trust (IDT), a government entity, as an implementing agent to handle the procurement of professional service providers and installation of furniture and equipment.

The deal was worth more than R905m for infrastructure projects and more than R59m for specialised medical and radiology equipment. IDT’s media relations manager, Thabisile Dhlomo, said the trust only dealt with infrastructure. “I will investigate our involvement in the medical equipment procurement,” she said. Dr Mdu Gama, chief executive of Resultant Finance, confirmed that his company was contracted by the department and that no services had been delivered at this stage. “The delay is caused by the department. Unfortunately the client has to be happy with the terms and conditions of a contract, so the delivery of services depends on the department. “Our task is to provide and see to it that the machines are serviced,” he said. Mtshali confirmed that the contract was signed before his tenure at the department. “When I assumed my duties I decided to take another look at the contract. “It is indeed worrying that close to the financial year no procurement has been made but we have to look at all the pros and cons of the contract. I can’t get into details at this stage,” Mtshali said.

Asked if it made business sense to spend R500m on a lease for five years instead of buying equipment outright, Mtshali said there were different models of leasing and that in some instances the lessee has an advantage of not having to carry out maintenance of the equipment. DA spokesman for Health in KwaZulu-Natal, Dr Imran Keeka, said procurement should be done in-house to save money. “It is very unfortunate that in awarding this tender, all that was achieved was a change in the supplier where the same system is perpetuated. “Worse still, at the end none of the equipment will belong to the department despite hundreds of millions of rand spent,” Keeka said. He said the handling of the matter showed the department lacked capacity and did not care about the proper use of state funds. He said the capacity of the department needed to be developed so it could better handle procurement “and that the process of sorting the mess of not having a proper asset register must be expedited”. “We also sent a parliamentary question regarding this tender that the MEC never replied to. “That in its own is suspicious,” Keeka said.

Concerns about the lack of working radiology machines and CT scanners in KwaZulu-Natal public hospitals, have been raised by two Durban doctors employed by the provincial Health Department. They listed eight hospitals in the province where the vital treatment and diagnostics machines were not working and another two where they were functioning intermittently. The doctors, and a source at the department’s Health Technical Services unit, said the department had no service maintenance agreement for 95% of its machines. The source said: “Officers in the Health Technical Services satellite offices around the province have lost faith in us as we are the ones who dispense these machines to them. Unfortunately everything is done by supply chain and ours is to sign procurement documents without asking questions.” One doctor, who cannot be named because he is not authorised to speak to the media, said as far as he was aware, CT scanners had failed because of inadequate maintenance.

“The provincial Department of Health chose to undertake the maintenance themselves rather than pay suppliers, but does not have enough technical staff. “The department is in crisis, patients requiring urgent brain scans have to wait up to three weeks. Up to half the beds in neurology and neurosurgery at Albert Luthuli are occupied by patients waiting for scans,” said the doctor. He said three hospitals – Inkosi Albert Luthuli Central, uMlazi’s Prince Mshiyeni Memorial and King Dinuzulu (formerly King George V), in Sydenham – had functioning scanners. Scanners at Chatsworth’s RK Khan and Ngwelezane hospitals were functioning intermittently. At King Edward VIII, Addington, Port Shepstone, Stanger, Grey’s, Edendale, Ladysmith and Madadeni hospitals, the scanners were not working. About two weeks ago, department spokesman, Sam Mkhwanazi, acknowledged the shortage of certain medical machines. In response to a set of questions from the Daily News, Mkhwanazi said: “Breakdown of equipment is a challenge that the department is addressing by, among others, devising plans to ensure quick turnaround to fix or service equipment that require this.”