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Charlotte Maxeke Academic Hospital Roof Collapse: Who Must Be Held Accountable?

Charlotte Maxeke Academic Hospital Roof Collapse: Who Must Be Held Accountable?
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On Thursday afternoon, this past week, there was an unfortunate accident whereby a section of the roof of the main entrance to the Charlotte Maxeke Academic Hospital (renamed Johannesburg General Referral Hospital) collapsed resulting in the injuries to several hospital staff members, patients and employees of a building construction company.

Dr Gwen Ramokgopa, Dr Aaron Motsoaledi and David Makhura at Charlotte Maxeke Hospital (Picture: Bhekikhaya Mabaso)

The Members of the Executive Committee (MECs) of the Departments of Health and Infrastructure Development from the Gauteng Provincial Government, Dr Gwen Ramokgopa, and Mr Jacob Mamabolo respectively advised the public that the accident was as a result of the contracted construction company accumulating excess concrete slabs or rubble weight on the roof, exceeding its weight bearing capacity, that then collapsed the structures resulting in the unfortunate accident, which luckily did not result in any fatalities, although it caused injuries to a number of people who were in the accident vicinity.

As I watched and listened to the numerous media interviews relating to the above accident at Charlotte Maxeke Academic Hospital, I was bothered by the way the respective MEC’s were so quick to allocate blame solely to the external service provider for the accident.

Gauteng Department of Infrastructure Development MEC : Mr Jacob Mamabolo

To this extent, the MEC of the Department of Infrastructure in the Gauteng Provincial Government announced during the television interview, that the contract of the external service provider was cancelled with immediate effect, based on their department inspectors’ high-level investigation which has fingered the construction company as the culprit in the causation of the unfortunate accident.

During that media interview, there was the National Minister of Health, the MEC for the Department of Health, and the MEC for the Department of Infrastructure Development. In my view, from a leadership and job responsibility point of view, all three of these government officials were in one way or the other accountable directly or indirectly to the situation that eventually led to this unfortunate accident.

Let me explain my thinking to support the above critical statement. The National Minister of Health is overall responsible for the national health portfolio, with sole or concurrent powers that he shares with his MEC’s at the provincial level. It is no secret that when one looks at the public health system in South Africa, one identifies several key historic challenges, since the formation of the single national department of health, from the amalgamation of the numerous health authorities from the apartheid era.

Charlotte Maxeke Hospital Collapse (Pic via Huffington Post)

One of the key challenges of the public health system in South Africa is the fact that the infrastructure in most of the public hospital facilities, both urban and rural is crumbling as a direct result of poor or inadequate preventative maintenance, over a very long period of time.

This in my humble view is the direct responsibility or competency of the National Department of Health, although it may also be argued that it is an indirect responsibility for National Department of Health, with the Provincial Health Departments being the ones that are directly responsible. What makes me point at the National Department of Health, is the fact that the priority national health programme called Hospital Revitalisation Programme is the responsibility of the National Department of Health, and run through the respective Provincial Health Departments.

If indeed it is the direct responsibility of the National Health Department, then in looking at who is accountable for the unfortunate accident, the National Minister who should be aware of the massive infrastructural maintenance backlog nationally, should shoulder some of the blame for the status quo, which is prevalent in many hospitals nationally.

It would have been an exercise in good leadership to hear him acknowledging the prevalent national facilities infrastructural backlog problem, as well as taking the public into his confidence about what the National Department of Health (working hand in glove with Provincial Health Departments) is doing to deal with the massive challenge, in the context of many competing interests and limited financial resources.

With regards the new MEC of the Gauteng Department Of Health (GDoH), having taken oversight and responsibility of this tough portfolio a few weeks ago, as the political head of the provincial health department, she should have contextualised this unfortunate hospital accident within the broader hospital facilities infrastructure backlog, and should have shared what her provincial department is doing in collaboration with the Gauteng Department of Infrastructure Development (GDID) to deal with the challenge, and not simply concur with GDID sole accusation of the contractor.

This Roof Collapse accident at Charlotte Maxeke Academic Hospital should also be viewed from an Occupational Health and Safety (OHSA) point of view. As an employer, the GDoH has a legal obligation in terms of the Occupational Health and Safety Act No 85 of 1993 to provide a safe and healthy work environment for its staff, as well as other persons (stakeholders e.g. patients) who make use of their facilities.

Safety First

The accountability and responsibility for compliance of the GDoH with the act rests with the accounting officer of the department, meaning the new Acting Head Of Department, (with the Hospital CEO being a delegated person) is fully accountable for any OHSA compliance breaches that may have been applicable, that may have led to the employees and patients being exposed to a hazardous hospital environment, as a result of construction work that was being undertaken. The big question is how complaint or non-complaint. The MEC of GDoH, conveniently said nothing with regards to the Occupational Health and Safety prescripts, that are meant to ensure a work environment that is both safe and healthy, with no hazard exposure to employees and other non-staff persons.

With regards to the MEC for GDID, his department is also accountable and responsible to some extent, because, in since around 2008, the Gauteng Provincial Government decided to outsource and centralise all matters that deal with infrastructure maintenance and development to the then newly created GDID.

This meant that all buildings maintenance work needs from each of the 14 provincial government departments in the province are commissioned and executed via by GDID. It is GDID that responds to the departments’ maintenance or development needs, draft tender specifications, advertise tenders, select and ultimately contract external service providers.

As the department that selected and contracted the external service provider that they are now accusing of being fully responsible for the accident at Charlotte Maxeke Academic Hospital, questions need to be asked about the processes that were followed to advertise, select and contract that construction company to execute the maintenance work at Charlotte Maxeke Academic Hospital. What are the capabilities of this company, what is the level of oversight of their work by the GDID experts from the Chief Engineering Directorate?

Occupational Health and Safety is the responsibility of the Employer

In view of the above unanswered questions, one cannot simply absolve GDID from accountability in this roof collapse debacle, they are the ones who selected and appointed this company. Therefore, GDID needs to be transparent in terms of how they went about selecting and appointing them, and the measures that they put in place to ensure that the project was executed professionally, on time and within budget, without compromising the quality of service, and that the work was done is of the highest possible standards.

As the three leaders that in one way or the other are directly or indirectly have oversight responsibilities on Charlotte Maxeke Academic Hospital, some level of accountability is expected of them. Hereinbelow, I will, therefore, zoom in deeper on the issue of accountability in leadership, which I am demanding of the three government leaders from both national and provincial government departments.

Let us begin by defining the concept of accountability. There are many definitions that I came across, however, the one I got from Wikipedia was more relevant to the issue under discussion. It says “In leadership roles, accountability is the acknowledgment and assumption of responsibility for actions, products, decisions, and policies, including administration, governance, and implementation within the scope of the role or employment position, and encompassing the obligation to report, explain and be answerable for resulting consequences.”

In my accountability literature review, I came across the following accountability quotations that I found relevant:

1. “You cannot talk about leadership without talking about responsibility and accountability, in fact, you cannot separate the two. A leader must delegate responsibility and provide the freedom to make decisions, and then be held accountable for the results”. Buck Rodgers

2. “Accountability is not only what we do, but also what we do not do, for which we are accountable”. Moliere

3. “Leadership is taking responsibility while others are making excuses”. John C Maxwell

In the media reports that have since emerged after this roof collapse, we are told that an expert report was compiled in 2012, which raised serious concerns about the structural integrity of the Charlotte Maxeke Academic Building, especially the X-Ray Department on the 5th Floor, wherein they advised that it be evacuated because it posed a risk of collapse. We are also advised that the Chief Engineer from GDID, downplayed and dismissed the said report as alarmist, as a result it was not acted upon.

In conclusion, I believe that even though the construction company may have been clearly responsible for directly causing the collapse of the roof, and consequent injuries to several people, it would be very disingenuous and opportunistic for all the blame to be put only on their shoulders. The people who selected and appointed them, as well as the people who are custodians of the crumbling infrastructure also should take a share of the blame for the chronic infrastructural neglect, and not simply wash their hands clean of this debacle.

A commission of enquiry must be appointed to comprehensively look at all the relevant factors that may have directly and indirectly contributed to this unfortunate accident, with a view to identifying leadership, management, and compliance lapses, in order that recommendations for their closure in future projects can be made, otherwise if the focus is only on the external service provider, there will be zero learning by all concerned, as all blame will have been conveniently shifted.

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