EDITORIAL: The SIU has exposed the Tembisa Hospital rot: now heads must roll

An interim report into corruption at Gauteng’s Tembisa Hospital has exposed how a sprawling network of syndicates syphoned off more than R2bn that should have been spent on patients. What it doesn’t explain is how and why the Gauteng health department let it happen.

The Special Investigating Unit (SIU) probe builds on the brave work of whistle-blower Babita Deokaran, who was assassinated in August 2021, three weeks after sounding the alarm about a suspicious surge in contracts awarded by the hospital’s management, and equally fearless reporting by investigative journalist Jeff Wicks.

On Monday, the SIU released initial findings revealing how the masterminds behind nine syndicates roped in mainly low-level staff and compliant Gauteng health department officials to exploit state procurement processes and line their own pockets.

Much of the plunder wasn’t terribly sophisticated: goods that should have been procured via existing government tenders were instead acquired by awarding grossly overpriced contracts that were split between multiple suppliers, many of which were entities run by the same people. Medical supplies were obtained from companies that were not registered with the SA Health Products Regulatory Authority, and many items that were ordered and paid for were never delivered.

Three of the syndicates raked in almost R1.7bn between them and clearly felt no compunction in flaunting their ill-gotten gains. Take, for example, the syndicate headed by President Cyril Ramaphosa’s previous nephew by marriage, Hangwani Maumela, which accumulated a string of luxury properties from Sandton to Bantry Bay and a collection of sports cars, including a Bentley and four Lamborghinis.

Officials profited too, pocketing at least R122m, according to the SIU. At least 15 former and current Gauteng health department officials were linked to the syndicates’ activities, ranging from clerks to managers.

The SIU scrutinised thousands of contracts and set out in detail how the syndicates used over 200 companies, conduit accounts, family members and corrupt officials to extract wealth. It concluded that Tembisa Hospital’s supply chain was tainted by corruption at every step.

But the findings completely side-step the Gauteng health department’s culpability. It is simply not plausible that top officials were unaware that something had gone terribly awry at the hospital and that it was being bled dry over a sustained period.

At the very least, the department’s internal controls should have red-flagged the hospital’s astonishing surge in expenditure on medical supplies, which rose from R315m in 2018/19 to R598m in 2019/20 and to more than R800m the following year.

While the increase coincided with the Covid-19 pandemic — when facilities might reasonably be expected to spend more on supplies — no other hospital in the province saw expenditure jump on such a scale. Syndicate activity only slowed after the Gauteng Premier’s office released a report on its own preliminary investigation into the hospital in December 2022.

It also beggars belief that no one in authority was aware of the complete lack of due diligence on suppliers or the patently absurd prices they were charging.

Health minister Aaron Motsoaledi said he was baffled by the crooks’ focus on Tembisa Hospital. But he shouldn’t be. The Gauteng health department is ripe for plunder: it gets the biggest provincial health budget in SA and serves more than 16-million patients, yet has suffered from chronic leadership instability for years, lurching from one crisis to the next.

The rot exposed at Tembisa Hospital may be on an egregious scale, but it is highly unlikely to be unique to that facility. An investigation by the health ombud into Helen Joseph Hospital concluded that the facility was not fit for purpose and identified “serious weaknesses” in its supply chain management — a polite way of saying it was vulnerable to corruption.

If the collective betrayal of patients by criminals and corrupt officials intent on feathering their own nests is ever to stop, the Gauteng health department’s top leadership must be held to account and heads must roll.