Health

(1) (a) On 23 June the regular supplier stopped routine supply of food to the hospital. This was due to a situation where there was a difference between order quantities and the timing of deliveries. The company was only paid for the food quantities as per placed order.  Quantities in excess of the placed order were managed by creating an additional order.  However, this resulted in irregular expenditure as supply chain management procedures as goods were then seen to be received before an order was placed.  In the process of sorting out this problem, there was an outstanding payment amount to the company and they then refused further deliveries to Nelspoort hospital until the account was settled.

Food was supplied from Murraysburg Hospital and Beaufort West Hospital assisted with petty cash for procurement of food.  During this time all patients received three meals a day.

The situation was brought to the attention of the district management, sub-district management and chief Director: Rural DHS with the SABC visit to Nelspoort.  A meeting was convened at Nelspoort on 21 July 2014 to address the problem.

(b) (i) Medicine provision:

Medicine supply to facilities in Central Karoo is managed by the Deputy Director: Pharmaceutical Services stationed at Beaufort West Hospital. There is good communication between facilities and possible shortages that may occur are dealt with immediately.  Stock is moved between facilities that are in short supply, and emergency stock can be procured from Eden facilities when needed. Where appropriate, alternative pack sizes or medication is suggested to clinicians. The budget for medicine for Nelspoort for 2014 is R217 000.

(ii) Shortage of food

Prevention of recurrence of non-payment of orders resulting in non-delivery of food:

1. All outstanding accounts have been settled

2. The Devolved Internal Control Unit did training on Supply Chain management procedures and assisted in setting up the stores and updated bin cards for the various food stores.

3. A register was implemented to keep track of all invoices received from Nelspoort with a designated person at Beaufort West to take responsibility for the processing of invoices.

4. Improved measures were put in place to monitor the payment of invoices, overseen by the Devolved Internal Control Unit with regular reporting to the Eden District Office.

(iii) Proper management of Nelspoort hospital:

 Nelspoort hospital falls under the management of Beaufort West sub-district.  The day to day operations is managed by the Operational Manager, Mrs James, and the administrative head is Ms James. 

(iv) Availability of doctors and nurses:

Doctor Support:

Beaufort West district hospital is the receiving facility for any medical emergencies occurring in Nelspoort hospital.  Doctor support is rendered from Beaufort West Hospital three days per week.  This is mostly to the clinic, but ill patients from both the TB wards and the psychiatric wards are presented to the visiting doctor.  A highly skilled TB doctor sees the TB patients once a month and there is a monthly psychiatric outreach from either a psychiatrist or the psychiatric Medical Officer.

Nursing staff:

There are a total of 19 staff members.  An additional sister, staff nurse and nursing assistant will be of value.

Nelspoort Hospital functions as an Intermediate Care facility. There are currently 62 psychiatric patients and 36 beds available for TB patients.  Psychiatric patients (46 males and 16 females) are admitted from facilities in Eden or Central Karoo. There is a Primary Health Care clinic on site rendering a comprehensive Primary Health Care service to the population of Nelspoort.

(2) The department has already conducted an internal investigation into this incident and the findings and preventative measures have been shared with the House through the comprehensive answers to Question 1.