The Health Ombudsman has released a report after investigating claims of neglect at Helen Joseph Hospital in Johannesburg, Gauteng.
The report exonerated the hospital from maltreatment and found that despite challenges, radio broadcaster Tom London received adequate and appropriate care at the health facility.
The report comes after London posted a video on social media in September 2024 complaining about the bad treatment he received from the hospital.
Despite clearing the hospital, the ombudsman made damning findings against the hospital and highlighted issues that needed to be addressed.
1. Human Resource issues
The investigation found serious issues within the HR unit, as good working relations between the HR manager and some subordinates were non-existent.
The investigation revealed that unresolved labour issues were postponed due to a lack of collaboration between the HR manager and the LRO.
2. Leadership problems and lack of teamwork
The investigation found that there was no integration of leadership and observed a siloed approach with a glaring lack of teamwork prevalent.
The investigation also established that problems such as overcrowding in the emergency department, lack of admission beds and unavailability of porter services could be alleviated if all staff worked together as a team with a common purpose.
Furthermore, it was mentioned that the institution has not had stable leadership for a long time and the posts of CEO and other senior managers were occupied by acting personnel.
In a bid to improve the situation, the Gauteng Provincial Government deployed an acting CEO, two clinical managers, and a nursing service manager.
3. Linen shortage, food issues, security
The investigation found poor linen management in the hospital and no linen control systems in place. Frequent washing machine breakdowns at the Johannesburg laundry led to shortages of clean linen and stacks of soiled linen.
The investigation established that there were challenges procuring some food items at HJTH in the 2023/2024 financial year. Two employees explained that the service providers refused to deliver the food items ordered because the department had not paid their previous invoices.
The kitchen supervisor indicated that non-delivery of food items sometimes led to repetition of meals per day. The investigators could not verify the patient’s protein portions as there was no system in place.
The investigation identified significant challenges related to vandalism and theft of hospital infrastructure.
While security guards are posted at all entrances, there was laxity regarding searching people and vehicles entering or leaving the hospital. When checking visitors and/or staff bags/laptops, no due diligence is exercised as the security never verified the laptop serial numbers as required.
4. Staff shortage
The investigation established that there were staff shortages at the hospital as the 2006 organisational structure is still being utilised. An employee explained that while the proposed organisational structure has been approved, it remains unfunded.
The investigation found that about a third (over 30%) of the funded nursing posts were vacant, especially professional nurses. The nurse shortages placed a strain on the already short-staffed professional nurses.
5. Finance and supply chain management
It was found that there was no clear segregation of duties in the unit due to staff shortages. There is no supervisor responsible for managing stock in the stockroom, as the same people receiving stock also manage the stock, which creates a risk.
6. Nursing challenges
A 2023 South African Nursing Council (SANC) report highlighted glaring problems within nursing services e.g.
a. Emergency trolleys were not locked
b. Defibrillators not checked
c. Student nurse inductions and the macro programme were not available
d. Drug counting is not done in operating theatres
e. Shortage of linen and linen lying on the floor
7. Governance challenges
The investigation revealed a lack of governance at the hospital, resulting in staff not adhering to protocols during their duties, or in some cases, the absence of protocols altogether. In five wards and support service departments where walkabouts were conducted, standard operating procedures had either expired or were completely lacking.
Above all, the investigation found that poor governance at the hospital is compounded by chronically unstable leadership, as sometimes no one takes accountability.
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