Baby Ikho’s death sparked a national campaign to fix the Eastern Cape health system. Here Eastern Cape Head of Health Dr. Thobile Mbengashe accepts a memorandum following a 2013 march by the civil society Eastern Cape Health Crisis Coalition in Bisho, Eastern Cape.

“Baby Ikho”* died shortly after his first birthday because Holy Cross Hospital had run out of oxygen, but his death has not been entirely in vain.

A new state entity charged with upholding health standards recently inspected the Eastern Cape hospital and issued a damning report, while the hospital CEO has been transferred.

Acting on complaints, the Office of Health Standards Compliance (OHSC) sent a six-person team to the hospital.

Its report, which Health-e News has seen, confirmed that Holy Cross failed to meet basic standards, and it scored a dismal 43 percent.

The report describes hospital management as weak, staff lacking in critical skills and facilities and equipment as poorly maintained. Some of the medicine in the pharmacy had expired. The fridge that was supposed to store laboratory specimens was set at 21 degrees, rendering it useless.

Last month, the findings were sent both to the hospital and the Eastern Cape Crisis Action Coalition, an alliance of organisations formed to fight for better healthcare in the province.

The hospital management was given 60 days to develop a “quality improvement plan”.

OHSC head Carol Marshall confirmed that the hospital’s plan was “inadequate” and her office requested the province to intervene.

Last week, the provincial head of health submitted a new turnaround plan with time frames, said Marshall.

New body could put muscle back into health standard enforcement

The OHSC was officially established in 2013 as one of government’s weapons against dysfunctional health facilities.

It is an independent public entity that is legally empowered to monitor and enforce norms and standards in all health facilities, including private hospitals.[quote float= right]The report describes hospital management as weak, staff lacking in critical skills and facilities and equipment as poorly maintained. Some of the medicine in the pharmacy had expired

In order to operate, all health facilities will have to get a certificate from the OHSC showing that they comply with the norms and standards, and the OHSC has to inspect all facilities at least once every four years.

A yet-to-be-appointed national Ombudsman will hear complaints from the public and is obliged to report back to complainants on action taken to rectify the problems.

Sasha Stevenson, an attorney with Section27 involved in the Eastern Cape coalition, said the OHSC “has a potentially vital role to play in improving the quality of health care services” by “monitoring norms and standards” and “responding to complaints and concerns about health care facilities”.

“Its investigation and clear and detailed report on Holy Cross Hospital demonstrate the Office’s dedication to fulfilling its mandate and are to be welcomed in particular given the crisis that the hospital and its patients and staff have been facing for some time,” said Stevenson.

Marshall admits that public expectation is huge while her staff complement is small.

But the Office will only get its teeth once national norms and standards for facilities have been adopted. A draft of these was published in February and people have until 18 May to submit comments.

The draft regulations cover areas including patients’ rights, leadership and facility upkeep. They make it a duty of facilities to treat patients and their families in a caring and empathetic manner.

The composition of the OHSC’s 12-person board is an indication of business unusual, as it includes former Treatment Action Campaign secretary general Vuyiseka Dubula. Professor Lizo Mazwai, formerly from the SA Medical Research Council is chairperson and Professor Laetitia Rispel from the Wits School of Public Health, is his deputy.

Improving standards is a huge and daunting task. There are over 4000 public health facilities in the country.

In 2011, a national Health Facilities Audit was conducted and uncovered serious weaknesses.

Facilities were assessed on six criteria – cleanliness, infection control, staff attitudes, safety and security, patient waiting times and availability of medicine. The majority of clinics scored below 50 percent, while few hospitals scored above 60 percent. – Health-e News.

*not his real name

Edited versions of this story first appeared in the Pretoria News and Mercury newspapers.