How project management unit will help face Covid-19 head on

ANC Eastern Cape provincial boss Oscar Mabuyane
ANC Eastern Cape provincial boss Oscar Mabuyane
Image: Fredlin Adriaan

The Eastern Cape’s fight against the coronavirus is showing signs of stabilising, with 44,317 people from 63,181 confirmed cases having recovered from the virus by Sunday.

While we are fighting the virus to save the lives of our people, we are also moving with speed to address administrative, resource and clinical challenges faced by our hospitals and provincial health system.

These challenges were reported by the people of our province and  exposed by workers at our hospitals through their unions.

I took a decision to address service delivery, administrative, infrastructure facility and clinical problems in some of our hospitals and in the provincial health department to improve the health intervention of our response to Covid-19.

In line with the intergovernmental relations framework, I requested a support team of experts from the minister of health, Dr Zweli Mkhize, to assist the provincial health department with strategies and the implementation of guidelines to effectively respond to the pandemic.

The support team was led by Dr Sibongile Zungu, and included Prof Ian Sanne, Theo Lighthelm, Albert Jansen, Dr Dorman Chimhamhiwa and Wendy Ovens.

They assessed the department’s systems, administrative processes and clinical response capabilities to the coronavirus at some hospitals in the Nelson Mandela Bay and Buffalo City metros.

They submitted a report with recommendations to address identified challenges.

In the report of the assessment conducted from June 29 to July 10, the support team found that, while the metros had mobilised reasonable infrastructure to meet the surge, service delivery requirements such as adequate provision of oxygen, equipment, human resources and medicines needed attention.

Procurement delays were also hampering the surge in capacity commitments, they found.

They recommended we address inadequate co-ordination between tertiary, regional and district hospitals through the revised command and control structure.

Problems at  Dora Nginza, which was being overwhelmed by patient demand, as well as lack of infrastructure, equipment and HR to meet clinical care demand, also had to be addressed.

The support team also found labour relations was an overwhelming issue requiring a dedicated action plan; and that historic arrangements for drainage areas, resource allocation and referral routing were not addressing the significant surge in patient numbers, particularly in vulnerable populations.

The support team said Emergency Medical Services and patient transport services required intervention to ensure continued function; and that all oxygen separation plants were located in the Nelson Mandela Bay area, putting distribution of oxygen to hospitals far from the Bay at risk of lead times being too long for replenishment.

Having accepted the report, I instructed that a project management unit (PMU) — with authority to fast-track actions and decisions to address the findings of the support team, issues being raised by communities to government through customer care platforms, complaints from workers and matters reported by the media — be established at the health department.

The PMU is tasked with strengthening scientific-based interventions to reduce the transmission of Covid-19 person-to-person, maintain low levels of community transmission and protect the functioning of the province’s health system.

I appointed Dr Sibongile Zungu to head the PMU. She will lead the rapid response team focusing on the operational needs of the regional co-ordination to suppress and contain the spread of Covid-19, and strengthen PMU support for the operational clinical support units for all districts and subdistricts for Covid-19 response.

She will work closely with tracking, tracing and testing teams, and hospital support teams, and directly with regional co-ordinators, to ensure interventions are strengthened.

She will provide technical and clinical support for case management of hospitalised patients including the availability of oxygen, clinical protocols for patient management and rational use of ICU beds.

I also appointed Dr Monde Tom, a turnaround specialist, to streamline a shared service of finance, HR, supply chain, infrastructure and information system.

Tom will design and drive an integrated, organisation-wide intelligence and information system that supports decision-making, resource allocation, operational efficiency, effective interventions and impact of health systems to improve the health status of our province’ people.

The third member of the PMU is Laurence Van Zuydam, an HR management specialist employed as the head of transversal HR management in  the premier’s office.

Van Zuydam will redesign the organisational structure, functions and critical process of the department to create a central governance structure for rapid decision making, and reorganise teams into work streams.

The pandemic has exposed glaring historical and systematic challenges the health department has experienced since amalgamation of two former homeland health departments and the former republic health system into a single provincial health system.

The assessment helped us get to the root cause of the problems.

Calls for implementation of a Section 100 are misplaced because we continue supporting infected people to recover and improving health-care provision in many areas.

Through the PMU we will transform the department to improve its efficiency and effectiveness in delivering services.

Oscar Mabuyane is the premier of the Eastern Cape

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