KZN Health resolves service provider payment delays after food supply issues at hospitals
Image: Pixabay
The KwaZulu-Natal Department of Health says it has resumed payments to service providers following a delay caused by a system transition, an issue that contributed to food supply issues at some healthcare facilities.
Acting Head of Department (HOD) Penny Msimang said in a recent radio interview delays occurred after the National Treasury implemented a change to the Basic Accounting System (BAS), which the department uses to process payments.
'There was a transition from the system that we use to pay service providers called Basic Accounting System (BAS). National Treasury had a transition from Version 5 to Version 6 of BAS. So during that process, we were not able to process the payments of some service providers."
'However, that has been sorted, and as of last week, we are making those payments,' said Msimang.
But the Democratic Alliance (DA) has slammed the department for what it calls a preventable crisis, saying the department had enough time to plan for the transition and should have communicated with service providers to avoid disruptions to essential services.
DA KZN spokesperson on health Dr Imran Keeka said: 'This matter was foreseen and raised long before it became a crisis. The Department knew about the transition to BAS Version 6. Treasury communicated about it, and planning should have been done accordingly.'
He said the non-payment of service providers led to hospitals being unable to provide adequate food, including at Northdale and Vryheid hospitals.
'People's lives depend on hospitals running properly, including food provision. This matter should have been better managed,' said Keeka.
The incident at Northdale comes after a power outage at the hospital last week resulted in hospital staff resorting to cooking food on an open fire outside.
A video of the incident circulated on social media. The department said that disciplinary action would be taken against the staff as cooking outside on an open fire was against regulations.
The Umkhonto Wesizwe (MK) Party has since strongly condemned Health MEC Nomagugu Simelane's handling of this matter, accusing the department of shifting blame to workers instead of addressing infrastructure failures and the lack of contingency planning.
'The MK Caucus views their actions not as misconduct, but as heroic intervention at a time when the Department's systems had collapsed,' said MK Caucus Whip Siphiwe Mbatha Moyo.
'We strongly reject the scapegoating of workers while leadership hides behind bureaucratic language.'
The MKP said it was 'completely unrealistic and inhumane to expect kitchen staff, in the middle of a blackout crisis, to coordinate sourcing food from other hospitals without clear operational support,' and demanded that disciplinary measures against the staff be withdrawn. It also called for a full forensic investigation into the state of hospital infrastructure and emergency response systems.
Responding to the incident, Msimang confirmed that there had been a power outage in the area, and that although the hospital has three generators, one of them which powered the kitchen, failed during the blackout.
She added that the generator was off for about 10 hours and only affected a section of the hospital.
'The one generator that stopped working was supplying power to the kitchen. As that generator was not working, plans were made to have the meals prepared at a nearby hospital in Richmond, but there was miscommunication between the CEO and the person responsible for the kitchen, who saw that time was running and decided to start an open fire and cook outside.'
'Although they were trying to help, we do not commend this act as the Department of Health because we have procedures to follow in such instances. There were also safety concerns because someone might get burnt and hygiene, as the food may be affected.'
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(See a detailed explanation of the situation here). The R132-million issued by Treasury is supposed to assist some of these researchers. It will be followed by another R268-million over the following two years. The Gates Foundation and Wellcome Trust are chipping in an additional R100-million each – though in their case, the funds are being provided upfront. All of this money – R600 million in total – is being channelled to the SAMRC, which will release it to researchers via a competitive grant allocation system. According to SAMRC spokesperson Tendani Tsedu, they have already received the R132-million from Treasury, though they are still 'finalizing the processes with the Gates Foundation and Wellcome Trust for receipt of [their donations]'. The SAMRC is also in negotiation with a French research body about securing more funds, though these talks are ongoing. In the meantime, the SAMRC has sent out a request for grant applications from researchers who have lost their US money. The memo states: 'Applicants may apply for funding support for up to 12 months to continue, wind down or complete critical research activities and sustain the projects until U.S. funding is resumed or alternative funds are sourced.' 'The plan,' Tsedu said, 'is to award these grants as soon as possible this year.' Professor Linda-Gail Bekker, CEO of the Desmond Tutu Health Foundation, told us that the hope is that the grants could fill some of the gaps. 'This is a bridge and it is certainly going to save some people's jobs, and some research,' she said, but 'it isn't going to completely fill the gap'. Indeed, the SAMRC has made clear that its grants aren't intended to replace the US funding awards entirely. This is unsurprising given that the money that's being made available is a tiny fraction of the total grant funding awarded by the NIH. It's unlikely that research projects will continue to operate as before, and will instead be pared down, said Bekker. 'It's going to be about getting the absolute minimum done so you either save the outcome, or get an outcome rather than no outcome,' she said. In other cases, the funds may simply 'allow you to more ethically close [the research project] down,' Bekker added. For some, this funding may also have come too late. Many researchers have already had to lay off staff. Additionally, patients who had been on experimental treatments may have already been transitioned back into routine care. It's unclear how such projects could be resumed months later. In response, Tsedu stated: 'For projects that have already closed as a result of the funding cuts, the principal investigator will need to motivate whether the study can be appropriately resurrected if new funds are secured.' The SAMRC has established a steering committee which will adjudicate bids. They will be considering a range of criteria, Tsedu said, including how beneficial the research might be for the South African health system, and how heavily the project was impacted by the US funding cuts. They will also consider how an SAMRC grant could 'be leveraged for future sustainability of the project, personnel or unit,' he said. AN ENDLESS BACK AND FORTH The job of the SAMRC steering committee will likely be made a lot more complicated by the erratic policy changes within the NIH. On 25 March, the body sent a memo to staff, – leaked to Nature and Bhekisisa – instructing them to hold all funding awards to researchers in South Africa. After this, numerous researchers in the country said they couldn't renew their grants. However, last month, Science reported that a new memo had been sent to NIH staff which said that while South African researchers still couldn't get new grants, active awards could be resumed. Since then, some funds appear to be trickling back into the country, but certainly not all. For instance, Spotlight and GroundUp spoke to one researcher who had two active NIH awards before the cuts. He stated that one of these was resumed last month, while the other is still paused. Bekker also told us that she had heard of one or two research grants being resumed in the last week, though she said the bulk of active awards to South Africa are still pending. 'Where people are the prime recipients [of an NIH grant] without a subawardee, there seems to be a queue and backlog but some [of those awards] are coming through,' said Bekker. 'But how long this is going to take and when it might come through we're waiting to hear.' She said a strategy might be to apply for the SAMRC bridging funding and 'if by some miracle the [NIH funding is resumed]' then researchers could then presumably retract their SAMRC application. In the meantime, health researchers will have to continue spending their time working out how to respond to the abrupt and increasingly confusing changes to funding guidelines that have dogged them since Trump assumed office. 'It's such a dreadful waste of energy,' said Bekker. 'If we were just getting on with the research, it would be so much better.' Co-published by Spotlight and GroundUp
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