/ 20 March 2015

The cost of health upkeep

Alaric Hunt has been jailed since 1988.
Alaric Hunt has been jailed since 1988.

The GPG has placed particular emphasis on the installation of natural gas boilers and tri-generation plants at Gauteng’s hospitals, as its key energy efficiency drive. The province is also constructing natural gas pipeline infrastructure to enhance this initiative.  

The GPG has over the past year implemented appropriate systems to deal with the additional workload, such as the e-maintenance system (a just-in-time maintenance materials management system in partnership with Builders Warehouse) and a rotational system for appointing contractors from a maintenance term contractor database. 

The e-maintenance system was rolled out to all health facilities on May 12 2014. The date coincided with the signing of a supply of maintenance materials agreement with Builders Warehouse and the commissioning of the maintenance term contractor panel. From the pilot at Chris Hani Baragwanath Hospital, the GPG was able to develop the e-maintenance system using internal capacity and proved that artisans are able to respond timeously to maintenance requests received on their mobile phones. 

The e-maintenance system has been a resounding success in the department of health. A total of 22 561 defects have been logged by staff at hospitals and clinics and the department of infrastructure had managed to repair 11 930 defects (53%) by July 16 2014.  The maintenance backlog in the e-maintenance system has assisted management to identify the bottlenecks and opportunities for efficiencies in its processes and human resources, such as a shortage of chief artisans and inspectors; the incorrect placement of staff, especially painters and carpenters; and an inefficient method of scheduling preventative maintenance programmes. 

All regional heads and directors at the maintenance department are hard at work implementing measures to eradicate the maintenance backlog in the second quarter of the 2014/2015 financial year.

Maintenance projects

There are a number of maintenance projects on chillers, lifts and boilers that are at various stages of implementation. These are: 

The replacement of 19 chillers at GPG health institutions, valued at R35-million in the following institutions: Rahima Moosa Hospital (two chillers), Kalafong Hospital (one chiller), Tshwane Rehab Hospital (one chiller), Hilbrow Hospital (two chillers), Dr George Muhkari Hospital (two chillers), Johan Heyns Hospital (two chillers), Bara Maternity Hospital (two chillers), Chris Hani Bara Hospital (three chillers), Tambo Memorial (two chillers) and Carletonville Hospital (two chillers).

The replacement of 35 lifts, valued at R30-million, in the following institutions: Helen Joseph Hospital (21 lifts), Kopanong Hospital (five lifts), Edenvale Hospital (two lifts), Pretoria West Hospital (six lifts) and Dr George Mukhari Academic Hospital (one lift). 

The replacement of boilers. Just over R26-million was spent on the replacement of 25 boilers, 19 of which fell under the department of health and the remaining six under the department of social development.

The green agenda rollout

Natural Gas Programme: The Gauteng department of infrastructure is the custodian of 77 boilers in health institutions in Gauteng that were previously fuelled by coal. A retrofit programme is under way to replace all boilers with natural gas/diesel boilers. A total of 21 boilers are being converted to dual fired (gas and diesel) boilers and will be commissioned in this financial year (2014/15). A tender for the natural gas to supply these boilers was advertised on July 13 2014.

Energy Efficiency Retrofit Programme: The department of infrastructure development is responsible for the maintenance of the following institutions: department of health (26 hospitals, 314 clinics and 35 community health centres); department of social development (59 facilities); department of community safety (26 facilities); department of transport (39 facilities); department of agriculture, conservation and environmental institutions (7 nature reserves); the precinct buildings (10) and five Tshwane buildings.

As part of the maintenance programmes on these facilities, the government is planning to retrofit energy efficient technologies in buildings to reduce energy consumption and energy costs.

The maintenance department replaces thousands of light bulbs and hundreds of split unit air-conditioners monthly. By centralising the material stores and stocking only energy efficient replacements technologies, the project will be conducted through day-to-day maintenance and completed over five years, with no additional budget and no additional resources.

Other initiatives that will benefit healthcare in Gauteng

Rollout Programme

Gauteng enjoys excellent solar irradiation levels between 1900 – 2100 kWh/m2 throughout the year. At these levels, solar photovoltaic (PV) technologies can be easily employed to generate electricity throughout the province. 

The estimated project costs: for the rollout of 300MW in approximately 8 million m2 of rooftops will cost approximately R6-billion. The entire cost can be funded through energy savings, with a payback period of about seven years. The feasibility of the project is further improved by the introduction of the carbon credits which are being considered. The government plans to invite solar PV manufacturers to set up manufacturing facilities in Gauteng. The Gauteng provincial government (GPG) and the Green Fund Agency appointed a transactional advisor, Pamoja, to conduct a feasibility study for the implementation of rooftop solar PV. 

Property management 

The government has to date verified 37 339 assets in the asset register.  Out of the total verified, 6 890 represents assets were registered.  

During 2013/14 fiscal year, 19 lease agreements were reviewed with a view to charging market-related rentals out of 20. Further, there were 22 commercial properties that were leased out of a target of 15. This followed strict measures to evict illegal occupants in government properties. 

Gauteng revenue optimisation strategy

The provincial government is developing strategies to optimise revenue generated by leveraging off government buildings. To this effect the GPG is looking at exploring its space for advertising purposes. A further strategy is being developed to look at optimising revenue in other facilities hosted in government-owned properties, for instance communication masts, towers and dishes hosted on government infrastructure.

To achieve market consultation, terms of reference are complete to invite the market to submit proposals on the initiatives. It is estimated that strategic partners will be appointed by end of September to assist the government with rollout of the programmes.

Gauteng government precinct

The Kopanong Precinct Project is a concept initiated by the executive committee in 2001 to consolidate all administrative processes of government departments for efficient service delivery. This project aims to provide accommodation facilities for government departments within the Johannesburg central business district (CBD). 

The GPG is leading the implementation of this initiative through public-private partnerships (PPPs), with assistance from the Gauteng provincial treasury. A transaction advisor who will be responsible for the feasibility and the PPP process implementation of the precinct project has now been appointed. The appointment of the project officer was expected by the end of September 2014. 

Expanded Public Works Programme (EPWP)

The government is rolling out the Zivuseni Poverty Alleviation Programme, which has targeted 4 000 beneficiaries for the current financial year. The types of projects considered in the programme include minor maintenance services for hospitals and clinics, the environment and culture sectors projects, water and sanitation and social development projects.

Tshepo 500 000 Programme

Furthermore, the government will be working with all key stakeholders in the province to develop and implement the Tshepo 500 000 Programme, as announced by the premier. This programme, which is intended to create massive work opportunities for the targeted groups, will be launched soon. 

During this financial year, the GPG will recruit 2 500 youth beneficiaries to participate in the National Youth Service Programme (NYS). This programme provides opportunities for the youth to gain skills and experience in the workplace. To resolve the historic challenges of the payment of stipends to EPWP beneficiaries, the government will introduce a payroll system supported by biometrics. To this effect R63-million has been allocated for payment of stipends to these beneficiaries.