The Public Protector has found that the Gauteng departments of Health and Infrastructure Development failed in their constitutional and statutory obligations, leaving Charlotte Maxeke Johannesburg Academic Hospital partially non-operational years after a devastating fire.
Charlotte Maxeke Hospital fire repairs delayed by years of departmental failures
The Public Protector, Advocate Kholeka Gcaleka, on Friday released findings from an investigation into allegations of undue delays by the Gauteng Department of Infrastructure Development (DID) and the Gauteng Department of Health in repairing structural damage caused by a fire at Charlotte Maxeke Johannesburg Academic Hospital.
The report found that the root causes of the delays were systemic and administrative, including delayed regulatory approvals, disagreements over the hospital’s custodianship, failure to adhere to project plans, poor project management and a persistent lack of coordination between the two departments.
“The investigation has further shown a recurring trend or pattern of lack of coordination in the issue of use of public resources,” Gcaleka said.
Tensions between the two departments became so severe that former premier David Makhura intervened, transferring the hospital’s custodianship from the DID back to the Department of Health on 9 February 2022.
This dispute alone contributed to project delays of more than 15 months.
Following the intervention, the DID handed the project over to the Development Bank of Southern Africa (DBSA) as the implementing agent on 16 February.
“The decision to transfer the study in the hospital repair works project from the Department of Infrastructure Development was necessary due to the substantial delays under the Department of Infrastructure Development,” Gcaleka said.
Billions allocated, billions wasted
The financial picture painted by the investigation is stark.
Of the R666 million allocated across the financial years from 2021 to 2024, only R324 million had been utilised by the end of March 2024, a budget utilisation rate of just 51.3%, meaning nearly half of the funds set aside for critical hospital repairs were left unspent.
Gcaleka noted that the underspending was particularly severe in the 2022-23 financial year, describing it as an illustration of “significant maladministration, poor project management, administrative delays, procurement bottlenecks, [and] irregularities” between the two departments.
She added that these delays also triggered cost escalations due to inflation-related adjustments.
“The consistent underspending of funds and the account of the deliverables of the multiple financial years, the department of health and the department of infrastructure development, reinforces a finding of maladministration, which is consistent with the risk to service delivery, delayed infrastructure readiness and weak regulatory timelines,” she said.
The total cost to complete the facility has since escalated from R1.1 billion to R1.7 billion, and that amount is still reported to be outstanding.
In contrast, private donors, including the Gift of the Givers and the Solidarity Fund, efficiently delivered and completed their portions of the innovation and technology projects, resulting in the reopening of areas such as the accident and emergency unit and dry store.
It was only in the 2023-24 financial year that almost 100% of the allocated budget was utilised, which Gcaleka said pointed to improved project execution under the DBSA’s project management.
Public Protector orders accountability from premiers and MECs
Gcaleka confirmed that the conduct of both the Gauteng Department of Health and the Gauteng Department of Infrastructure Development constitutes maladministration as contemplated in the Public Protector Act.
“Poor record keeping and incomplete documentation reflect on internal control of agents, contrary to the requirements of the Public Finance Management Act and good governance standards, which makes systems susceptible to irregularities,” she said.
The remedial actions issued include directives to the Gauteng premier, relevant MECs, and heads of department.
The premier is required to exercise executive oversight of remedial actions and to initiate a skills assessment and performance review mechanism for DID personnel involved in public procurement and capital infrastructure project management.
Gcaleka recommended that the premier consider subjecting officials at both departments responsible for supply chain and financial management to ongoing risk-based lifestyle audits, conducted in collaboration with the Special Investigating Unit.
Within 30 calendar days of receiving the report, consequence management must be initiated against implicated officials still employed by the state who were involved in the hospital fire repair project.
“The longer it takes to address these repairs, the more the cost is delivered,” she warned.
Both the Head of the Department of Health and the Head of the Department of Infrastructure Development are required to submit action plans within 30 days detailing financial management mechanisms, budgetary controls, and internal measures.
The Head of the Gauteng Provincial Treasury must, within 60 days, provide an action plan indicating oversight measures to be put in place by both departments and assist the Department of Health in building capacity for efficient financial management.
The matter has also been referred to the Auditor-General to consider performing an audit of the fire repair project, cumulative amounts paid and any pending payments.
