Day: July 4, 2025

Categories : Healthcare Politics and Regulations HospitalsTags :

Questions Over Tripling of Gauteng Health’s Security Budget

On By ModernMedia
Photo by Markus Spiske on Unsplash

By Ufrieda Ho

In just two years, the Gauteng health department’s spending on security has more than tripled. We try to get to the bottom of the ballooning bills and what it means for governance in the department.

The Gauteng Department of Health’s projected R2.54 billion spend on security contracts for 2025/2026 has received the thumbs up, fuelling suspicion in various quarters. It comes as the department claims to lack the funds to fill vacancies, pay all suppliers on time, or continue fulfilling doctors’ overtime contracts.

The R2.54 billion is more than three times the R838 million the department spent two years earlier in 2023/2024. This was revealed at the end of May in response to questions raised in the Gauteng Legislature by the Democratic Alliance (DA), the official opposition in the province. In 2024/2025, the department’s security spending was just over R1.76 billion.

Jack Bloom, the DA’s shadow MEC for health in Gauteng, calls the proposed expenditure “unjustified”, given that the department is failing to meet its health service delivery targets.

According to him, security companies charge R77 million per year for guarding services at Chris Hani Baragwanath Hospital, and over R72 million annually at Charlotte Maxeke Hospital.

At Tara Hospital, the new security contract costs R14 million per year – a sharp increase from the previous year’s R4.2 million contract, which had provided 21 guards for the facility. Bloom says that, according to the department’s own assessment, only five additional guards were needed at Tara Hospital, increasing the total to 26. However, the current contract pays for 46 guards. “This means they are paying about R5 million a year for 20 guards they do not need,” Bloom says. “They could better use this money to fill the vacancies for 13 professional nurses, as Tara Hospital cannot use 50 of its 137 beds because of staff shortages. It is a clear example of excessive security costs squeezing out service delivery,” he says.

    “The numbers simply don’t add up,” Bloom says. He points out that the written responses provided in the Gauteng Legislature – signed off by MEC for Health and Wellness, Nomantu Nkomo-Ralehoko – cite an internal security assessment and compliance with Private Security Industry Regulatory Authority (PSIRA) salary increases for guards as reasons for the higher costs. However, the internal assessment has not been shared with either Bloom or Spotlight, despite requests from both.

    The PSIRA-approved annual increase is 7.38%. In contrast, the department’s security spending rose by over 100% from 2023/2024 to 2024/2025, and it’s projected to increase by another 40% from 2024/2025 to 2025/2026.

    According to a statement released by the Gauteng health department in April 2024, it had 113 security companies under contract at the time, providing a total of 6000 guards across 37 hospitals and 370 clinics and institutions in the province.

    ‘Very fishy’

    Bloom says security guarding contracts have been “very fishy for at least the past 10 years”. He claims: “There are certain security companies that keep popping up. These companies will get two-year contracts, then have their contracts extended for something like 10 years. Then we have these new contracts which have soared in costs. The auditor general has said that there is irregular expenditure. Security contracts have always been suspect and have always been corruption territory.”

    In March this year, the DA lodged a complaint with the Public Protector over a R49 million guarding contract for five clinics in Tshwane and the MEC’s offices. The contract was awarded to a company called Triotic Protection Services. The DA alleges that the company was founded by City of Tshwane’s deputy executive mayor, Eugene Modise, who also previously served as its director. When the company was awarded the contract, it was allegedly in the crosshairs of the South African Revenue Service because it owed R59 million in tax over five years. This has raised concerns about the company’s tax compliance status and its eligibility to tender for the contract. Spotlight approached Modise for comment through Samkelo Mgobozi, spokesperson for the office of the executive mayor, but had not received a response by the time of publication.

    Other security companies that have contracts with the department have also made headlines for allegedly flouting labour laws. These include not paying guards for months and withholding employees’ pension and provident fund contributions. It leaves questions about due diligence and the proper vetting of companies.

    A review underway?

    In the weeks since Bloom’s questions were answered in the legislature, he says Nkomo-Ralehoko conceded to a review of the security spend at the province’s hospitals.

    However, the Gauteng health department has not announced anything formally and no further details have been provided.

    The department has also not responded to Spotlight’s questions or provided supporting documentation of their assessment criteria for the security contracts, the tender requirements, tender processes and how they measure value for money and the impact of increased guarding in improving safety and security for patients, staff and visitors to its hospitals. They have also not made available a list of the companies with successful contracts and what their services entail.

    As Spotlight previously reported in some depth (see here and here), there are serious security problems at many health facilities in Gauteng. It ranges from cable theft disrupting hospital operations to healthcare workers being assaulted. The department has also been criticised from some quarters for its plans to train healthcare workers to better handle violent situations.

    That steps need to be taken to better secure the province’s health facilities is not controversial. But our previous reporting has also shown a pattern of questionable contract management, with, for example, contracts being extended on a month-to-month basis for years after the original tenders had technically expired. It appears that the widespread use of these month-to-month security contracts came to an end when the department finally awarded a series of new security tenders in 2024 but it also seems likely that these new contracts are driving the department’s ballooning security spending.

    ‘Has to be justified’

    The department’s massively increased security spend must be fully explained and is essential for transparency, say several experts Spotlight spoke to.

    “This kind of escalation in cost has to be justified, especially when the department has no money,” says Professor Alex van den Heever, chair of social security systems administration and management studies at the University of Witwatersrand.

    He says the specifics of the tender process and the contracts that were awarded need to be publicly available to be openly scrutinised. The processes must meet Treasury’s procurement guidelines and must follow the Public Finance Management Act, which regulates financial management within the national and provincial governments. Where there is wilful non-compliance, Van den Heever says criminal charges should be laid.

    “This is a department that has routinely had around R3 billion a year in irregular expenditure. It means procurement procedures have been bypassed. This is not an isolated incident; it’s systematic,” he adds.

    The latest Auditor General report into the Gauteng health department was released in September last year for the 2023/24 financial year. It showed that of its R60 billion budget, the department underspent by R1.1 billion, including R590 million on the National Tertiary Service Grant that was meant to help fund specialist services. The report highlighted R2.7 billion in irregular expenditure, which is R400 million more than the previous year, and R17 million in fruitless and wasteful spending – an increase of R2 million from the year before.

    Equally damning, the report highlighted the lack of credible information provided. “This is likely to result in substantial harm to the operations of the department as incorrect data is used for planning and budgeting and the effectiveness of oversight and monitoring are reduced as a result of unreliable reported performance information on the provision of primary healthcare services,” wrote the Auditor General.

    Van den Heever says the leadership and management within the health department need to be seriously questioned. Questions should be asked of why “bad apples” are not being removed, why there are no consequences for conflicts of interests and collusions, and why webs of enablers within the department are not exposed for insulating wrongdoers, he says.

    Van den Heever says that over nine years of monitoring, the Gauteng Health Department’s irregular and wasteful spending ranged between 3.6% and 6.6% of its total budget. In contrast, during the same period, the Western Cape’s irregular spending ranged from 0% to just 0.1%.

    Lack of transparency

    The Gauteng health department’s spike in security spending demands deeper investigation, says Advocate Stephanie Fick. She is executive director for accountability and public governance at the Organisation Undoing Tax Abuse and serves on the Health Sector Anti-Corruption Forum. This forum was launched in 2019 as an initiative to combat corruption within the healthcare system. It falls under the Special Investigations Unit and brings together a range of stakeholders, including law enforcement agencies, government departments, regulators, and the private sector.

    Fick says the health department’s failure to provide easy access to information on tenders, contracts, and contracted companies undermines transparency and accountability. She encourages more people to come forward with insider information.

    “We want to see the details right down to line items and who signed off on things. We encourage people to use our protected whistleblower platforms to share information,” Fick says.

    “For civil society, there is a growing role to mount strategic challenges to things like this kind of excessive and irregular expenditure; to demand transparency and to expose people who are responsible.

    “This must be done so ordinary people can better understand what’s been happening with their tax money and so they choose more carefully when they go to the ballot box, starting with next year’s municipal elections,” she says.

    Republished from Spotlight under a Creative Commons licence.

    Read the original article.

    Categories : Mental HealthTags :

    Addictive Screen Use, Not Time, Linked to Youth Suicide Risk

    On By ModernMedia
    Photo by Steinar Engeland on Unsplash

    New research shows that youth who become increasingly addicted to social media, mobile phones or video games are at greater risk of suicidal thoughts, suicide attempts and emotional or behavioural issues. The study, published in JAMA, was led by researchers at Weill Cornell Medicine, Columbia University and University of California, Berkeley.

    Unlike previous studies that focused on total screen time at one point in a child’s life, this study looked at how young people’s patterns of compulsive or “addictive” use changed over time. These patterns included feeling unable to stop using a device, experiencing distress when not using it or using it to escape from problems. In contrast, simply spending more time on screens at 10 years old wasn’t associated with worse suicide-related and mental health outcomes.

    “For parents and educators, the discussion around mobile phones and social media has focused on limiting or banning use, but our results indicate more complex factors are involved,” said first author Dr Yunyu Xiao, assistant professor of population health sciences at Weill Cornell Medicine. “Clinical trials have shown that limiting cell phone use, for instance during school hours, was not effective in reducing the risk of suicidal behaviour or improving other aspects of mental health.”

    This study could signal a paradigm shift in how the impact of screen time on youth mental health is addressed. “Testing interventions that work against other types of addiction may be one way to approach this type of social media and mobile phone use,” Dr Xiao said.

    Quantity Versus Quality

    Over four years, the researchers tracked nearly 4300 youths aged 9 to 10 when they first started the study. Using machine learning and data from participant interviews, the researchers characterised three addictive use trajectories for social media and mobile phone usage and two for addictive use with video games. When graphed, these trajectories depicted relative levels of addictive behaviours.

    By age 14, almost one in three participants had a high addictive use trajectory for social media and one in four for mobile phones. More than 40% of the youths had a high addictive use trajectory for video games. These adolescents were significantly more likely to report suicidal thoughts or behaviours, as well as symptoms of anxiety, depression, aggression or rule-breaking.

    The researchers also found that each type of digital activity showed unique patterns of association with suicide-related behaviours and mental health symptoms. For social media and mobile phones, the high and increasing addictive use trajectories were associated with a two to three times greater risk of suicidal behaviours and suicidal ideation compared with the low addictive use trajectory. The higher use trajectories were also associated with either internalising symptoms such as anxiousness and depression, or externalising symptoms, including aggressiveness or inattentiveness.

    “Parents may want to pay more attention to how their kids are using their digital devices and consider having them evaluated for signs of addictive use, said co-first author Dr Yuan Meng, postdoctoral associate in population health sciences at Weill Cornell. “If an addiction is identified, limiting use of mobile phones and social media for part of the day, may potentially reinforce addictive behaviors, so seeking professional advice is essential.”

    Source: Weill Cornell Medicine

    Categories : GastrointestinalTags :

    Genetic Link Found Between Iron Deficiency & Crohn’s Disease

    On By ModernMedia
    Source: Pixabay CC0

    A study led by biomedical scientists at the University of California, Riverside School of Medicine shows how a genetic mutation associated with Crohn’s disease can worsen iron deficiency and anaemia — one of the most common complications experienced by patients with inflammatory bowel disease, or IBD. The research is published in the International Journal of Molecular Sciences.

    While IBD — a group of chronic inflammatory disorders that includes Crohn’s disease and ulcerative colitis — primarily affects the intestines, it can have effects beyond the gut. Iron deficient anaemia is the most prevalent of these effects, contributing to chronic fatigue and reduced quality of life, particularly during disease flare-ups.

    The study, performed on serum samples from IBD patients, reports that patients carrying a loss-of-function mutation in the gene PTPN2 (protein tyrosine phosphatase non-receptor type 2) exhibit significant disruption in blood proteins that regulate iron levels. This mutation is found in 14-16% of the general population and 19-20% of the IBD population. A loss-of-function mutation is a genetic change that reduces or eliminates the normal function of a gene or its product, a protein.

    “This discovery sheds light on a critical mechanism that links a patient’s genetics to their ability to absorb and regulate iron, which is essential for maintaining healthy blood and energy levels,” said Declan McCole, a professor of biomedical sciences at UCR who led the study. “Our findings offer an explanation for why some IBD patients remain iron-deficient despite oral supplementation.”

    When the researchers deleted the PTPN2 gene in mice, the animals developed anaemia and were unable to absorb iron effectively. The team found this was due to reduced levels of a key iron-absorbing protein located in the intestinal epithelial cells — the cells responsible for taking up dietary nutrients.

    “The only way the body can obtain iron is through intestinal absorption from food, making this discovery particularly significant,” said first author Hillmin Lei, a doctoral student in McCole’s lab. “Disruption of this pathway by genetic variants like those in PTPN2 could help explain why some IBD patients fail to respond to oral iron therapy, a commonly prescribed treatment for anaemia.”

    McCole stressed that the study is a vital step toward understanding how genetic risk factors for IBD can compound patient symptoms by interfering with nutrient absorption.

    “It opens new avenues for targeted therapies that go beyond inflammation control to address systemic complications like anaemia,” he said. “This includes prioritising patients who carry loss-of-function PTPN2 variants to be treated for anaemia with systemic intravenous iron supplementation rather than oral iron, which may be poorly absorbed.”

    The study, , was performed in collaboration with researchers at the City of Hope, University Hospital Zurich, and the Swiss IBD Cohort.

    Source: University of California, Riverside

    Categories : Neurodegenerative Diseases New Compounds and TreatmentsTags :

    Royalty-based Method Offers New Model for ALS Drug Development

    On By ModernMedia
    Photo by Rodion Kutsaiev on Unsplash

    A team of researchers from the MIT Sloan School of Management, the Sean M. Healey & AMG Center for ALS at Massachusetts General Hospital (MGH), Questrom School of Business at Boston University, and QLS Advisors have introduced a new approach to funding clinical trials for amyotrophic lateral sclerosis (ALS) therapies. The study, “Financing Drug Development via Adaptive Platform Trials,” published today in PLOS One, outlines a financing model that merges the efficiencies of adaptive platform trials — lower costs and shorter durations — with an innovative, royalty-based investment structure designed to accelerate therapeutic development for ALS and other serious diseases.

    ALS — also often called Lou Gehrig’s disease — is a progressive, neurodegenerative disease with no cure. Despite its devastating impact, the pace of new therapy development has remained sluggish—largely due to the high cost, duration, and risks associated with traditional clinical trials. This bottleneck has often discouraged conventional investors, leaving promising research to languish.

    To tackle this challenge, the authors propose an investment fund that finances half the cost of an adaptive platform trial in exchange for future royalties from successful drugs that emerge from the trial. Adaptive platform trials allow multiple drug candidates to be tested simultaneously under a single master protocol, and results are interpreted on a real-time basis to determine efficacy or futility. Drawing on data from the HEALEY ALS Platform Trial administered by the Healey & AMG Center for ALS at MGH, and realistic assumptions, their simulated fund generated an expected return of 28%, with a 22% probability of total loss, which may be attractive to more risk-tolerant and impact-driven investors such as hedge funds, sovereign wealth funds, family offices, and philanthropists. Their findings suggest that generating returns more palatable for mainstream investors could be achieved by funding multiple platform trials simultaneously and by employing financial tools such as securitization — a method that bundles future income from assets like loans or royalties into investment products.

    “ALS clinical trials face significant hurdles — from high costs and long timelines to limited funding pools,” said Merit E. Cudkowicz, MD, MSC, Executive Director at Mass General Brigham Neuroscience Institute and Director of the Healey & AMG Center for ALS. “Our platform trial model has already shown that we can test more therapies more efficiently. What’s still missing is sustainable financing. This novel approach could be a game-changer, enabling us to launch trials faster, include more promising therapies, and bring us closer to our shared goal: delivering effective treatments to people with ALS as quickly as possible.”

    While their study focused on ALS, the authors believe such a funding model could be applied to other disease areas as well, especially those with well-defined endpoints, where treatment success can be measured clearly and reliably.

    Source: Mass General Brigham

    Categories : Mental HealthTags :

    Why Frequent Nightmares May Shorten Your Life by Years

    On By ModernMedia
    Photo by Kahfiara Krisna on Unsplash

    Timothy Hearn, Anglia Ruskin University

    Waking up from a nightmare can leave your heart pounding, but the effects may reach far beyond a restless night. Adults who suffer bad dreams every week were almost three times more likely to die before age 75 than people who rarely have them.

    This alarming conclusion – which is yet to be peer reviewed – comes from researchers who combined data from four large long-term studies in the US, following more than 4,000 people between the ages of 26 and 74. At the beginning, participants reported how often nightmares disrupted their sleep. Over the next 18 years, the researchers kept track of how many participants died prematurely – 227 in total.

    Even after considering common risk factors like age, sex, mental health, smoking and weight, people who had nightmares every week were still found to be nearly three times more likely to die prematurely – about the same risk as heavy smoking.

    The team also examined “epigenetic clocks” – chemical marks on DNA that act as biological mileage counters. People haunted by frequent nightmares were biologically older than their birth certificates suggested, across all three clocks used (DunedinPACE, GrimAge and PhenoAge).

    The science behind the silent scream

    Faster ageing accounted for about 39% of the link between nightmares and early death, implying that whatever is driving the bad dreams is simultaneously driving the body’s cells towards the finish line.

    How might a scream you never utter leave a mark on your genome? Nightmares happen during so-called rapid-eye-movement sleep when the brain is highly active but muscles are paralysed. The sudden surge of adrenaline, cortisol and other fight-or-flight chemicals can be as strong as anything experienced while awake. If that alarm bell rings night after night, the stress response may stay partially switched on throughout the day.

    Photo by Andrea Piacquadio

    Continuous stress takes its toll on the body. It triggers inflammation, raises blood pressure and speeds up the ageing process by wearing down the protective tips of our chromosomes.

    On top of that, being jolted awake by nightmares disrupts deep sleep, the crucial time when the body repairs itself and clears out waste at the cellular level. Together, these two effects – constant stress and poor sleep – may be the main reasons the body seems to age faster.

    The idea that disturbing dreams foreshadow poor health is not entirely new. Earlier studies have shown that adults tormented by weekly nightmares are more likely to develop dementia and Parkinson’s disease, years before any daytime symptoms appear.

    Growing evidence suggests that the brain areas involved in dreaming are also those affected by brain diseases, so frequent nightmares might be an early warning sign of neurological problems.

    Nightmares are also surprisingly common. Roughly 5% of adults report at least one each week and another 12.5% experience them monthly.

    Because they are both frequent and treatable, the new findings elevate bad dreams from a spooky nuisance to a potential public health target. Cognitive behavioural therapy for insomnia, imagery-rehearsal therapy – where sufferers rewrite the ending of a recurrent nightmare while awake – and simple steps such as keeping bedrooms cool, dark and screen free have all been shown to curb nightmare frequency.

    Before jumping to conclusions, there are a few important things to keep in mind. The study used people’s own reports of their dreams, which can make it hard to tell the difference between a typical bad dream and a true nightmare. Also, most of the people in the study were white Americans, so the findings might not apply to everyone.

    And biological age was measured only once, so we cannot yet say whether treating nightmares slows the clock. Crucially, the work was presented as a conference abstract and has not yet navigated the gauntlet of peer review.

    Despite these limitations, the study has important strengths that make it worth taking seriously. The researchers used multiple groups of participants, followed them for many years and relied on official death records rather than self-reported data. This means we can’t simply dismiss the findings as a statistical fluke.

    If other research teams can replicate these results, doctors might start asking patients about their nightmares during routine check-ups – alongside taking blood pressure and checking cholesterol levels.

    Therapies that tame frightening dreams are inexpensive, non-invasive and already available. Scaling them could offer a rare chance to add years to life while improving the quality of the hours we spend asleep.

    Timothy Hearn, Senior Lecturer in Bioinformatics, Anglia Ruskin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.