Northern Cape Health MEC Maruping Lekwene has committed to implementing recommendations from Health Ombudsman Professor Taole Mokoena’s damning report about the Northern Cape Mental Health Hospital and the Robert Mangaliso Sobukwe Hospital (RMSH), both in Kimberley.
(Read the story on the report here).
During a media briefing on Thursday, 31 July, Lekwene said a task team was appointed to fast-track improvements and initiate forensic investigations into procurement processes.
“The key actions include monitoring progress and reviewing monthly updates from hospital leadership, ensuring compliance with financial and healthcare regulations and the Public Finance Management Act, disciplining implicated staff with referrals to professional bodies, investigating suspect procurement and inflated costs, and overhauling clinical governance and standard operating procedures across provincial hospitals.
“The department emphasises system-wide accountability and learning from failures to improve patient care. We are committed to rooting out mismanagement and the misuse of public resources. A top priority is the accelerated review of contracts that do not serve the department’s interests. In consultation with Provincial Treasury, we are initiating the appointment of a forensic investigation team to scrutinise all procurement processes at the affected hospitals.
“The Ombudsman’s report underscores that financial austerity, alongside mismanagement and malfeasance, has contributed to the current state of our facilities. These findings will guide our corrective actions,” Lekwene said.
Two preventable deaths of patients who died under alarming circumstances occurred at the hospitals according to the report. Cyprian Mohoto (37) died on 16 July 2024 at RMSH after collapsing with severe hypothermia and untreated pneumonia. He was being referred from the mental health hospital for treatment. Despite chest X-rays showing multilobar pneumonia, doctors failed to treat the condition. Infrastructure failures left him exposed to extreme cold without heating or adequate blankets.
Tsepo Mdimbaza died from exposure on 3 August 2024 at the Mental Health Hospital. The post-mortem confirmed hypothermia as the cause of death. Staff failed to monitor his deteriorating condition or provide basic thermal protection.
Severe infrastructure challenges, documentation failures
The hospitals faced severe infrastructure challenges, including power outages caused by substation damage and cable theft, resulting in non-functioning heating systems during winter months. Facilities suffered from broken windows, exposed electrical wires and persistent plumbing issues that compromised patient safety and comfort.
Critical healthcare failures emerged from junior staff being left unsupervised to make life-threatening decisions without proper oversight.
Poor medical record-keeping and communication breakdowns between departments created dangerous gaps in patient care. Inadequate handovers between shifts and failed interdisciplinary coordination resulted in patients falling through the cracks in the system.
The investigation revealed that hospitals operated without a formal linen management system for five years. Procurement from Tropical Enterprises delivered substandard clothing that was torn, undersized and deteriorated within months. Patients lacked necessities such as blankets and clean clothing during critical winter months, whilst management failed to address defective procurement despite repeated staff complaints.
Medical staff consistently violated guidelines of the Health Professions Council of South Africa and the South African Nursing Council through systematic documentation failures.
Patient records were incomplete, lacking proper identifiers and often featuring illegible handwriting without proper signatures. Clinical notes remained vague, used non-standard symbols and frequently omitted crucial documentation of patient monitoring during critical periods.
‘Dangerous practice must end’
The report mandates emergency infrastructure repairs and medical equipment procurement within three to six months. Hospitals must immediately end the dangerous practice of allowing unsupervised junior nurses to manage entire wards without professional nurse oversight. Emergency response teams and comprehensive safety protocols must be established urgently, whilst disciplinary action proceeds against all implicated staff members.
Additionally, the investigation demands comprehensive nursing retraining focusing on risk assessment and care planning competencies. Healthcare workers must complete Advanced Psychiatric Nursing courses to properly manage high-risk patient populations. All medical professionals require basic life support training from accredited bodies, alongside mandatory training in proper documentation and handover procedures to ensure continuity of care.
Within six to nine months, hospitals must appoint a permanent quality assurance manager and develop comprehensive standard operating procedures with mandatory staff training. A proper supply chain management system must be established with qualified permanent personnel to prevent future procurement failures. Regular clinical audits and systematic performance monitoring will ensure ongoing compliance with national healthcare standards.
The investigation concluded that both hospitals showed gross negligence and systemic failure, violating patients’ constitutional rights to dignity and healthcare.
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