Patient safety concerns in public hospitals in South Africa’s richest province

Gauteng’s public hospitals have recorded an increase in patient cases of harm, with Serious Adverse Events (SAEs) rising to 7,386 in 2024.

This figure has increased significantly since 2019, when 4,170 incidents were reported.

The data was provided in a written reply from Gauteng Health and Wellness MEC Nomantu Nkomo-Ralehoko to the Democratic Alliance’s Gauteng shadow MEC for Health, Dr Jack Bloom.

SAEs are incidents of harm inflicted on patients unintentionally, resulting in injury, permanent disability, or even death.

These incidents can arise from various factors, but Bloom said are often linked to substandard hospital conditions and medical negligence.

In the past, the Gauteng Department of Health said that contributing factors to SAEs include:

• Faulty medical equipment;
• Healthcare-associated infections;
• Patient accidents;
• Staff shortages;
• High patient volumes in some referral hospitals, leading to staff being overburdened.

Yet, despite the thousands of incidents in 2024, Bloom pointed out that only 55 disciplinary actions have been taken.

The Chris Hani Baragwanath Hospital in Soweto recorded the highest number of SAEs in 2024 at 1,257 — more than double that of other major academic hospitals.

For instance, the George Mukhari Hospital recorded 600 SAEs, the Steve Biko Hospital 592, and the Charlotte Maxeke Johannesburg Hospital 498.

However, this is to be expected, given that it is the third-largest hospital in the world.

Other hospitals in the province recorded fewer SAEs, including the Helen Joseph Hospital at 434, Weskoppies Hospital at 426, and Leratong Hospital at 414.

Examining smaller district hospitals, he identified the Bheki Mlangeni Hospital in Soweto as a facility with significantly more SAEs than others — 109, compared to 51 at the Tshwane District Hospital.

“The department claims they implement a wide variety of measures to reduce SAEs, but these are clearly failing as they go up year by year,” Bloom said.

“Patients should be healed in hospitals, not suffer injury and even death because of poor care. High payouts for medical negligence are another outcome of SAEs.”

He argued that there should be management changes at problem hospitals that account for a disproportionate number of SAEs.

In addition, the government needs to step in to rectify staff and equipment shortages and implement robust disciplinary measures to curb poor performance that harms patients.

In 2024, the Gauteng Department of Health said that it is addressing SAEs in hospitals by implementing a new five-point plan.

These include mandating 24-hour reporting and thorough investigations, specialized staff training, facility self-assessments, establishing specialist governance structures, and continuous monitoring.

Newsday contacted the Department for comment, but could not get a response by the time of publication. Comment will be added when received.