Four acting CEOs in five years, lack of accountability, deteriorating infrastructure, intermittent water supply and 30.2% of funded nursing posts not filled.
These are some of the damning findings of the health ombudsman and the Office of Health Standards Compliance (OHSC) after an investigation into allegations of poor management at Helen Joseph Tertiary Hospital in Auckland Park, Johannesburg.
The probe was initiated after a viral video by radio host Thomas Holmes, known as Tom London, which showcased the dilapidated infrastructure, ill treatment of patients and poor service delivery at the hospital in 2024.
Health ombud Prof Taole Mokoena found that only two of Holmes’s allegations were substantial. The probe revealed that the health facility was severely understaffed, lacks adequate governance and fails to maintain basic healthcare standards.
“Helen Joseph as a tertiary hospital is inadequately resourced and thus not fit for purpose. The hospital is understaffed and unable to meet the demands of its patients. There is an urgent need to address staff shortages as skilled nursing professionals resign due to heavy workloads,” Mokoena said.
The report highlighted that the hospital has been operating with outdated infrastructure, with broken hand basins, peeling paint, and non-functional electrical plugs. The hospital’s leadership crisis was also a major concern.
“The absence of a permanent CEO has left a vacuum, leading to staff working in silos without accountability,” Mokoena said.
The hospital has had four acting CEOs since 2019.
OHSC CEO Siphiwe Mndaweni raised concerns regarding poor governance and lack of accountability within the hospital management.
“There is no integration of leadership at Helen Joseph. The investigation observed a siloed approach with a glaring lack of teamwork. Issues such as overcrowding in the emergency department, lack of admission beds, and unavailability of porter services could be alleviated if all staff worked together with a common purpose,” Mndaweni said.
FACT BOX * As of September 30, Helen Joseph Tertiary Hospital, which was established in 1962, had 639 approved beds with 604 usable beds. It has an average bed occupancy rate of 95%;
* It serves a catchment population of 1.5-million;
It has 22 feeder clinics and Community Health Centres, four feeder district hospitals, six feeder provincial hospitals and one upward referral hospital 10km away;
* On a six-month average, the hospital has an 84.7 average bed occupancy rate per month, an average length of stay of 10.2, an average of 1,661 admissions per month, an average of 36,866 outpatients per month, an average number of 3,947 patients seen in the emergency department and an average of 508 theatre cases per month;
* The medical and nursing staff complement comprises 1,655 staff members, with 437 vacant posts. – OHSC
The report is released on the backdrop of growing concerns regarding the deteriorating state of public hospitals in Gauteng and concerns about aging infrastructure.
Last week, patients had to take cold showers after Egoli Gas switched off gas supply to Helen Joseph, Rahima Moosa Mother and Child, Charlotte Maxeke Johannesburg Academic and Edenvale hospitals.
The cut off was due to nonpayment of a supplieer by the department of health.
Mndaweni said they conducted two investigations – in September and December – which showed little-to-no-progress in addressing the problems identified.
Additionally, food shortages at the hospital have become a recurring problem, with patients often receiving inadequate portions.
“There had been challenges in procuring food items due to nonpayment of suppliers by the Gauteng department of health. Non-delivery sometimes led to repetition of meals per day, and there was no system in place to verify if patients were receiving adequate protein portions,” Mndaweni said.
Financial mismanagement was another major issue flagged. Helen Joseph’s financial operations revealed a lack of transparency and oversight in supply chain management.
“There is no clear segregation of duties in the unit due to staff shortages. The same person responsible for procuring services is also making payments, creating a high risk for financial mismanagement,” Mndaweni said.
As part of the recommended interventions, the health ombud has called for an immediate refurbishment of the hospital, an urgent review of staff establishment, the filling of vacant posts, and the appointment of a permanent CEO.
The OHSC report also recommended enhanced security measures, improved linen and food supply management, and stricter compliance with healthcare norms and standards.
Minister of health Aaron Motsoaledi pointed out that the absence of doctors at hospitals is a growing concern linked to the occupation-specific dispensation.
“In the past, hospitals were run by a superintendent, the most senior doctor with the authority to manage the facility. Unfortunately, that system was changed, leading to a situation where senior clinicians earn more than their managers, making it difficult to enforce proper oversight,” he said.
Motsoaledi said the system has resulted in senior clinicians opting to do remunerative work outside public service (RWOPS) instead of being present in hospitals.
“RWOPS has been poorly managed, and it is not an automatic right, yet many institutions treat it as such. Hospitals are understaffed, and yet doctors are allowed to leave for private sector work. This needs urgent review, which has begun with Treasury,” Motsoaledi said.
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