1. Khayelitsha District Hospital Investigation
08 November 2018

2. OVERVIEW OF THE PRESENTATION
Investigation grounded in the Constitutional Values and Principles (CVPs)
Step by Step Investigation Process
Overall findings and specific recommendations
Update on implementation of recommendations

3. CONSTITUTIONAL VALUES AND PRINCIPLES
Professional Culture
Services must be provided impartially, fairly, equitable and without bias
Transparency must be fostered
Professional Behavior
High standard of professional ethics must be maintained
People’s needs must be responded to and encouraged to participate in policy making
Systems/Oversight
Efficient, economic & effective use of resources
Public administration must be development-orientated
Public administration must be accountable
Institutional
Good Human resource management and career development;
Public administration must be broadly representative 3

4. Step by Step Process
The Public Service Commission investigative team engaged all affected parties during this investigation and gathered all the necessary information. The process included:
Step 1
Preliminary meeting conducted with NEHAWU leadership at the institution level. This took place on 08 March 2018.
Step 2
Development of Terms of Reference for the investigation.
Step 3
Investigative meetings conducted with all parties [NEHAWU; Khayelitsha District Hospital Management; and Metropole Management]. These meetings [19 and 20 March 2018] were conducted to gather oral evidence directly from the complainants, the leadership of the institution and the regional management.

5. Step by Step Process Step 4
Scrutiny of all documentary evidence provided by all parties. NEHAWU provided evidence and the HR unit of the substructure provided evidence.
Step 5
Analysis of evidence and drafting of report. This included additional evidence requested from the substructure HR unit and requesting other relevant information.
Step 6
Submission of report to PSC Chairperson, NCOP Chairperson, and engagement with all parties on content and recommendations.
Feedback sessions were conducted with each of the parties, including the MEC and HoD of Health. The content of the report was discussed and questions responded to by the investigative team. This took place on 05 and 06 June 2018.

6. Overall Findings in Brief
The PSC found that there was merit in most of the allegations made by NEHAWU.
However, the severity and veracity of certain conclusions drawn by NEHAWU were contestable.
The PSC found that whilst the facts around specific allegations differed, it nonetheless pointed to a level of procedural or systemic failures.
In the case of Employment Equity targets it pointed to a policy review to be undertaken by the department.
The decision-making processes were highly questionable in the case of annual leave payouts and continued utilization of retired staff.

7. Specific Recommendations
ISSUE
RECOMMENDED ACTION
RESPONSIBILITY
1. IMLC Resuscitation
A mediation process to be instituted to normalize relations between the parties.
Metropole Management
2. Staff shortages and advertising of posts
Information to be made available to IMLC members regarding posts, vacancies, and criteria for advertising of posts.
Metropole and Hospital Management
3. Recruitment and Selection Standards
Delegations to be revoked as an interim measure; training to be provided; and stringent monitoring of R and S processes.
4. Employment Equity
Policy to be reviewed in terms of regional targets; a more nuanced approach to targets must be explored.
Department Head Office
5. Managing of service providers
A more rigorous measure of monitoring service level agreements to be instituted.
Hospital Management
6. R60000 donation
IMLC members to develop a joint plan on activities.
IMLC
7. Unused leave payouts
Stringent monitoring to be instituted leading to nil payouts.
8. Skills Committee training approval
A protocol and procedure to be developed and communicated to all staff.
9. Staff doctor available for staff
A viable arrangement to be made that allows for access to a doctor.
10. OHSA compliance
An independent evaluation of compliance to be undertaken.
11. Quality Care Manager post
The contract to end on 30 Jun The post to be advertised.
12. Grievances
Grievances procedures to be observed; training provided.
PSC

8. Update on Implementation of Recommendations
ISSUE
RECOMMENDED ACTION
DEPARTMENT’S RESPONSE
1. IMLC Resuscitation
A mediation process to be instituted to normalize relations between the parties.
Numerous attempts have been made to revive the IMLC with no success. Attempts were even made to ask for assistance from NEHAWU’s Provincial Office with no success.
2. Staff shortages and advertising of posts
Information to be made available to IMLC members regarding posts, vacancies, and criteria for advertising of posts.
The information could not be provided to the IMLC due to the fact that it has not been revived.
3. Recruitment and Selection Standards
Delegations to be revoked as an interim measure; training to be provided; and stringent monitoring of R and S processes.
The delegations have been elevated to the Office of the Chief Director: Metro Health Services (CD: MHS). Additional capacity was allocated to the function at Hospital level and the function is quality checked at CD Office level as from 01 August 2018.
4. Employment Equity
Policy to be reviewed in terms of regional targets; a more nuanced approach to targets must be explored.
The Department has changed its current targets from regional (Sub-structure) to Institutional (Hospital and Primary Health Clinics).
5. Managing of service providers
A more rigorous measure of monitoring service level agreements to be instituted.
Daily inspections are conducted per area; monthly meetings are held with the service providers and if needed penalties instituted.

9. 6. R60000 donation
IMLC members to develop a joint pl an on activities.
Hospital Management has committed to a Staff Function; however the proposal could not be tabled at the IMLC due to the fact that it has not been revived.
7. Unused leave payouts
Stringent monitoring to be instituted leading to nil payouts.
The practice of leave payouts has been addressed and stringent monitoring measures have been put in place to prevent the payout of unused leave.
8. Skills Committee training approval
A protocol and procedure to be developed and communicated to all staff.
The implementation of the current SOPs is closely monitored and a process is underway to review the Terms of Reference of the Skills Committee and the SOPs in question.
9. Staff doctor available for staff
A viable arrangement to be made that allows for access to a doctor.
Staff clinic is available to staff on a daily basis from 08h00 to 12h00.
10. OHSA compliance
An independent evaluation of compliance to be undertaken.
An independent evaluation would be a very costly exercise. The Department provides the capacity by way of an OHS Nurse per Hospital, who is qualified to conduct such an investigation and reports annually. All areas in the Hospital must be covered over a two year period.
11. Quality Care Manager post
The contract to end on 30 Jun The post to be advertised.
The recommendation was implemented. The post is in the final stage of being permanently filled.
12. Grievances
Grievances procedures to be observed; training provided.
The training was conducted by the CD: MHS in partnership with the PSC, over four days to cover all managers and supervisors in the Hospital.