MEC Gwen Ramokgopa: State of health in Gauteng

29 Nov 2018

A statement by the Gauteng MEC for Health, Dr Gwen Ramokgopa briefing members of the media about state of health in the province on

With the World Quality Day being in November, the department takes an opportunity to reflect on achievements made, reaffirm its commitment to continuous quality improvement and recognize those amongst our employees who inspire merit and excellence.

We are now beginning to see the results of our continuous efforts on Service Improvement and Quality Assurance for good patient experience and outcome. These initiatives are firming up as Centers of Excellence endorsed by even independent third parties. I personally bore witness to many of these during my announced and unannounced visits in my 20 months in office as MEC of Health since last year. Working together with a relatively new management team we have spent hours designing solutions with those who are in the frontline of services. We have also strengthened the decentralization and delegation system in line with the envisaged policy framework of the NHI. We must improve services where it matters most – at the frontline. In this regard I am happy to announce the following:

1. On strengthening governance and management: The Hospital Boards of Central and Tertiary Services will from the 1st of January 2019 assume more streamlined roles as Oversight Boards instead of Advisory Boards they currently are. Regional and district hospitals will follow at a later date informed by their capacity and state of readiness. A regulatory framework is being developed and will be based on the NHI Act once promulgated.

2. On improving patient experience and health outcomes: The Head of Department has established a Provincial Clinical Governance Committee which consist of multidisciplinary expert teams with a focus on Primary Health Care; Maternal and Neonatal; Mental Health and Trauma Services respectively.

a. Already a draft Strategy for Promoting Health, Wellness and Happiness has been developed for public comment and a 3-year campaign launched to strengthen Primary Health Care and reduce the Burden of Disease. This program will be funded within current resources supported by the Surge Program aimed at achieving the 90-90-90 targets for combating HIV and TB. Professors Deb Basu and Jannie Hugo co-Chair the programme.

b. The Mental Health Recovery Plan has been submitted to the Health Ombud and include inputs from stakeholders. An implementation plan thereof has been approved and will be funded from reprioritization of the current budget. Additional funding will come from the awaited Economic Stimulus Fund announced by the President. Prof Barnard Van Rensburg Chairs the programme.

c. Maternal and Neonatal Service Improvement Plan has been a focal area this year and an additional R100 million has been reprioritized in the budget adjustment to ease pressure areas such as critical shortage of staff, infrastructure upgrading and business process improvements in Maternity Obstetrics Units, as well as in Maternity and Neonatal wards. This is in addition to posts approved earlier this year. A further 50 Ultrasound machines will be purchased this year to support midwives in our MOU’s. Two CT Scans and two Linear Accelerator Machines will also be added to regional and central hospitals respectively. Professors Lawrance Chauke andDineo Mawela co-chairs this priority area.

I must make it categorically clear that these interventions, whilst they will ease the pressure on the huge demand on services, the impact of the reduction of funding over the MTEF period in the aftermath of the Global Recession is still substantive. This financing hole needs to be plucked and the NHI Bill fast-tracked to ensure equitable distribution of resources and sustained quality care. The Gauteng Health System will remain in a crisis if these are not addressed.

Our staff at the frontline of services are the reason for the resilience demonstrated by the Health System over the past years, including carrying additional pressure from other provinces, other countries and from the private sector as the number of lives covered by medical aids is shrinking.

Over 26 million patient visits were serviced with 20 000 mothers delivered in the service platform in the financial year 2017/ 18. In addition, the health facilities remain the largest national premier training platform for various health professionals in nursing, medicine and allied health areas.

Against all odds Gauteng prides herself as number one for having the highest proportion of Ideal Clinics in the country, as accredited by National Department of Health. Seventy-nine (79) percent of the 372 Primary Health Care facilities attained the Ideal Clinic status from silver to platinum. For a facility to be recognised as an Ideal Clinic, it should have good infrastructure, adequate staff and medicine supplies as well as good administrative systems and sufficient bulk supplies. The clinic should also implement applicable clinical policies, protocols and guidelines.

We are working hard to introduce the Ideal Hospitals Accreditation system in line with the Ideal Clinic System. To realise this, we have appointed a panel of eight professionals as the Gauteng Health Accreditation Committee (GHAC) whose main purpose is to sustain and expand this Ideal Clinic status and realise the Ideal Hospital system and specifically to:

Provide guidance on systems, protocols and standard operating procedures;
Evaluate the status of the Patient Safety and Medical Litigation faced by the Department and the risk factors associated thereto;
Conduct inspection that are meant to enhance compliance with National Core Standards in all health facilities;
Make recommendations in the high-risk areas identified during inspections and during internal investigations of patient safety incidents;
Assist the Department in establishing the Patient Safety and Medico-legal Centre;
Receive monthly reports from the Provincial Patient Safety and Risk Audit Committee, analyse and make recommendations;
Generate reports on a monthly and quarterly basis or as needed from time to time.

These Accreditation Committee members are:

Dr. C. Mini – a medical doctor who chaired the previous Gauteng Health Accreditation Committee and has vast experience in the medical aid field;
Dr ML Majake – is a Public Health Medical Specialist from the Private Sector, whose focus is on quality and was a member of the IIPSMLAP;
Prof Y. Veriava – is an eminent leader in the health sector, a Professor emeritus in Medicine and was a co-chair IIPSMLAP;
Ms M. Sithole – Retired Nurse and former HOD in Mpumalanga and had gone through various areas of the Nursing Profession including Regional and Chief Nursing;
Mr M. Motsoane – Qualified Registered Nurse who has gone through various nursing stages and facility management. Has extensive experience in Hospital and General Management process and involved in Clinical Risk Management process;
Mr M. Mbewu – A qualified Albertina Sisulu Executive Management Leadership in Public Health. Experience in OHSC and Health Facility Management. Specialises in Hospital Management Programme;
Dr M Govender – Qualified Medical Doctor, Public Health Specialist, Academia and Lecturer at the Wits University. Has Occupational Health and Safety background;
Ms L Vilakazi – A Legal Expert; Specializing in Supply Chain Optimisation. Has extensive experience in Risk Management and has been involved in accreditation of various companies.

We have adopted a zero-tolerance attitude to absenteeism, poor performance, wastage of resources, and non-compliance with any other public service values, ethos and regulations and are working with several state agencies like SIU to ensure consequence management as we restore the trust of our people in their own health system. We reaffirm that many health workers are caring, competent and dedicated to serve their people.

Most importantly, tonight we’ll recognize those employees who have demonstrated dedication, innovation and going beyond the call of duty in ensuring continuous quality improvement and positive patients experience. These Khanyisa Service Excellence Awards will be held at Ghallagher Convention Centre from 18:30.

We’ve commissioned a filming of several centres of excellence which are oasis of hope.

Categories are as follows: