The most complained-about hospitals in South Africa – with Gauteng in trouble

Ten Gauteng hospitals top the list for health ombud complaints, which some say reflects serious systemic issues in the economic hub’s healthcare management system.

The Office of the Health Ombud—a body that investigates health-related complaints—recently presented its 2023/24 annual report to the Parliamentary Portfolio Committee on Health.

Health Ombudsman Emeritus Professor Taole Mokoena outlined that since the start of the 2019/20 financial year, the Ombud received 14,556 complaints – 57% of which stem from the country’s most populated province, Gauteng.

This was followed by the Western Cape with 13%, and KwaZulu-Natal with 11%.

“These, in the main, reflect the proportion of human density in those provinces. But, also, most of the tertiary hospitals and higher level of hospitalisation occurs in those three provinces,” said Mokoena.

Looking at the facilities with the most complaints since the start of the 2019/20 financial year, these were:

• Chris Hani Baragwanath Academic Hospital – 221;
• Steve Biko Academic Hospital – 194;
• Tembisa Tertiary Hospital – 174;
• Dr George Mukhari Academic Hospital – 172;
• Charlotte Maxeke Johannesburg Academic Hospital – 149;
• Helen Joseph Hospital – 120;
• Thelle Mogoerane Regional Hospital – 104;
• Kalafong Hospital – 101;
• Leratong Hospital – 81; and
• Tambo Memorial Hospital – 73.

It should be noted that these ten health facilities are among the largest and busiest operating hospitals in the country.

Mokoena told Newzroom Afrika that “what stands out is that the majority of complaints are actually to us what we can describe as ‘minor or trivial’, but of course to the people that do place the complaints, they’re not trivial to them.”

“What we consider the ‘serious cases’ amount to 10% of the cases, and of that 10%, only 2% end up being investigated [as these] cases have resulted in serious injury or death” due to the treatment that they had or had not received, said Mokoena.

He added that these occur in both public and private healthcare institutions, but “by far the public has got the most complaints.”

“I’ve done investigations outside my current position and what we have discovered… is that in the public sector, the management is actually in disarray,” said Mokoena.

“I know that’s a very strong characterisation, however the disarray can be seen from the fact that… the senior management in the provinces are acting, and acting managers have got very little authority on the people that they are leading,” he added.

He did emphasise that it is, however, unfair to paint all healtchcare professionals with the same brushstroke, as most most serve the profession with integrity and professionalism; although he admitted that there were some bad apples “in the minority.”

Gauteng healthcare criticism

These complaint figures come on the back of a string of horror stories and claims of neglect and malpractice at Gauteng’s public hospitals.

One of the most recent viral stories was a video by former broadcaster Tom London posted after his admission at a Gauteng public hospital.

Mokoena said that the Ombud is investigating London’s video, which “showed some preliminary evidence that there’s something… there”.

“The issues that he brought up about infrastructure is real, and the investigation that [we] are doing shows the breakdown of infrastructure both in terms of the hospital itself as well as the breakdown of equipment,” said Mokoena.

DA MPL serving in the Gauteng health and wellness portfolio, Jack Bloom, told BusinessTech that he is “not surprised” by the Ombud’s statistics, alleging that the Gauteng Health Department (GDoH) “is notoriously mismanaged and corrupt,” meaning effective healthcare often comes second.

For example, News24 reported that whistleblower within the GDoH, Babita Deokaran, tried to stop R100 million in dodgy payments and flagged nearly R850 million in other suspicious transactions in the department just days before she was assassinated in a hit-style killing outside her south Johannesburg home. 

“Inadequate and broken equipment also contributes to the high number of patient complaints,” said Bloom.

Last year, there were more than 7,000 recorded Serious Adverse Events in Gauteng public hospitals. Bloom said “the problem is that there is a lack of consequences for medical mistakes and maltreatment.”

According to the GDoH, it is currently sitting on R13.2 billion in medico-legal claims.

Bloom said that his party “has called for a complete overhaul of top management in the Gauteng Health Department,” including the newly appointed HOD.

GDoH response

GDoH head of communication Motalatale Modiba told BusinessTech that “the Gauteng government is committed to improving infrastructure of hospitals and clinics throughout [and is] actively preparing its healthcare facilities to be National Health Insurance (NHI) ready.”

Modiba said that it is doing so in various ways.

Firstly is by enhancing its Infrastructure Unit, which “has developed a maintenance and refurbishment plan,” for 17 public hospitals across the province.

Additionally, the department is looking to add four new hospitals in Deveyton, Orange Farm, Soshanguve and Diepsloot to expand healthcare access.

“The GDoH also has plans to leverage on technological innovations to improve the provision of health care services,” said Modiba.

Initiatives include implementing an Integrated Health Information System for real-time monitoring, digitising patient records for efficiency, and establishing a Queue Management System to streamline patient flow.

The department has also refuted allegations that it is freezing all new posts, despite a shortfall of more than R500 million in its employee budget due to a wage agreement from the previous year that was not fully funded by Treasury. Bloom does not believe this and said that it “is going to worsen the problem.”

However, the GDoH said that it will “prioritise the filling of critical clinical vacancies, including nursing positions and leadership roles (heads of departments and units) as funding becomes available.”

Modiba said that since early 2023, it has prioritised filling clinical posts, with most now occupied. However, clinical support roles, such as cleaners and porters, remain vacant. Non-clinical positions are on hold pending approval from the Provincial Treasury.

The GDoH employs over 85,000 staff, with just over 1,100 vacancies remaining.

Looking at patient satisfaction with treatment, the GDoH said that it has recently launched initiatives to improve patient experiences, including a toll-free complaints line and the “I Serve With A Smile” campaign to enhance staff attitudes.

Additionally, patients can participate in the annual Patient Experience of Care (PEC) survey to provide feedback on their experiences.

According to the GDoH, out of 1.67 million questionnaires responded to in the PEC survey which took place between July and September 2023, “a total of 1.41 million were responded positively to.”

However, according to Gauteng City-Region Observatory’s  Quality of Life Index survey, two-thirds of Gauteng households use public health facilities, with a satisfaction rate of 57%.

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