Tag: violence

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 : Ethics and Law Injury & TraumaTags :

    Male Murder Rate is a National Health Priority, say Researchers

    On By ModernMedia
    Photo by Maxim Hopman on Unsplash

    By Daniel Steyn

    A study by researchers at the South African Medical Research Council (MRC) recommends that the murder of men in South Africa deserves an urgent national response.

    Richard Matzopoulos of the MRC’s Burden of Disease Unit and his team, which included scientists from the UCT School of Public Health, studied postmortem reports from 2017 to compare murders of women and men. Among the factors looked at were cause of death, age, geographic location and whether alcohol played a role.

    The study, published in PLOS Global Public Health, found that 87% of people murdered in 2017 were men. The authors note similar percentages in 2009 (86%) and 2000 (84%). 

    According to the researchers, this is the first study on male murders in South Africa. Previous studies have focused mainly on femicide (the killing of women). The study focused on 2017 to coincide with the third national femicide study (previous femicide studies were in 2000 and 2009).

    The researchers faced challenges getting the paper published in a peer-reviewed journal. Dr Morna Cornell, one of the study’s authors, told GroundUp that men’s health is generally understudied. Cornell believes “we are living in an outdated paradigm which regards all men as powerful and able to navigate health systems etc, and therefore less deserving of care”.

    The most common causes of death among male murder victims were sharp stabbings and shootings. For people between the ages of 15 and 44, rates of male murders were more than eight times higher than female murders. The Western Cape has the biggest gap between male and female victims: for every female killed, 11.4 men were killed.

    Male murders peaked over December and weekends, suggesting the role alcohol plays.

    The study aims to challenge the idea that men are “invulnerable”.

    “The fact that men are both perpetrators and victims of homicides masks the strong evidence that men are extremely vulnerable in many contexts,” the study reads.

    Murder in South Africa is concentrated in poor neighbourhoods where the effects of poverty and inequality are most significant. According to the study, “violence has been normalised as a frequent feature of civil protest and political discourse”.

    High levels of firearm ownership and imprisonment also contribute to violence in South Africa.

    “Men are socialised into coping by externalising through anger, irritability, violence against intimate partners and others, and increased engagement in risk-taking behaviours. This, alongside the high levels of violence to which males are exposed across [life], [causes] a continuous, and often intergenerational cycle of violence,” the study says.

    While the study acknowledges that “violence against women is endemic in South Africa, with rates almost six times the global figures”, it argues that “men’s disproportionate burden of homicide has not resulted in targeted, meaningful prevention”.

    Interventions recommended by the researchers include stricter control of alcohol and firearms, programs to address societal norms that drive physical violence, and efforts to overcome the root causes of poverty and inequality.

    Professor Richard Matzopolous, the main author of the study, told GroundUp that more research is needed to understand risks and interventions, especially in a South African context.

    “Phase 2 of this study will explore victim/perpetrator and situational contexts,” said Matzopolous.

    Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

    Source: GroundUp

    Categories : General Interest Mental HealthTags :

    No Evidence of Videogame and Violence Link in the Real World

    On By ModernMedia

    New research finds no evidence that violence increases after the release of a new video game.

    Violent video games like Call of Duty are often linked by the media and public to real-life violence, although there is limited evidence to support the link. Debate on the topic generally intensifies after mass public shootings, with some commentators linking these violent acts to the perpetrators’ interests in violent video games. But different factors have been pointed out as more likely explanations, such as mental health issues and/or easy access to guns.

    Before governments introduce any policies restricting access to violent video games, it is important to establish whether violent video games do indeed increase players’ violence in the real world.

    Taking data from the US, Dr Agne Suziedelyte at University of London, provides evidence of the effects of violent video game releases on the violent behaviour of children. Dr Suziedelyte examined the effects of violent video games on two types of violence: aggression against other people, and destruction of objects or property.

    Appearing in the Journal of Economic Behavior & Organization, the study focused on boys aged 8 to 18 years: the group most likely to play violent video games.

    By using econometric methods which identify plausibly causal effects of violent video games on violence, rather than only associations, Dr Suziedelyte found no evidence that violence against other people increases after the release of a new violent video game. Parents reported, however, that children were more likely to destroy things after playing violent video games.

    Dr Suziedelyte said: “Taken together, these results suggest that violent video games may agitate children, but this agitation does not translate into violence against other people — which is the type of violence which we care about most.

    “A likely explanation for my results is that video game playing usually takes place at home, where opportunities to engage in violence are lower. This ‘incapacitation’ effect is especially important for violence-prone boys who may be especially attracted to violent video games.

    “Therefore, policies that place restrictions on video game sales to minors are unlikely to reduce violence.

    Source: City University London

    Categories : Ethics and Law HospitalsTags :

    Violence in the ED: A Critical Issue in Healthcare

    On By ModernMedia
    Phot by Mulyadi on Unsplash

    A study by the Mayo Clinic found that most healthcare workers experience violence in emergency departments (EDs), but they seldomly report it to anyone.

    Over six months prior to being surveyed, 72% of healthcare workers and other ED staff said they had personally experienced violence (71% verbal abuse and 31% physical assault), Sarayna McGuire, MD, chief resident of Mayo Emergency Medicine in Rochester, Minnesota, reported in a series of three studies at the American College of Emergency Physicians annual meeting.

    Nurses and clinicians, along with security personnel, bore the brunt of the attacks: 94% of nurses and 90% of clinicians reported experiencing verbal abuse, and 54% of nurses and 36% of clinicians reported instances of physical assault.

    “The whole team is impacted by workplace violence,” Dr McGuire said to MedPage Today. “Even people coming in to draw blood are being assaulted physically and verbally abused.”

    Despite this prevalent violence and 58% reporting at least moderate awareness of reporting policies, 77% of all respondents said they never or rarely report violence, while only 10% said they often or always do.

    A possible explanation could be that only 7% of non-security staff said they were “extremely familiar” with the procedures. And when participants were asked why ED abuse is not usually reported, the top four reasons given were:

    • No physical injury was sustained (53% of respondents)
    • “It comes with the job” (47%)
    • Staff are too busy (47%)
    • Reporting is inconvenient (41%)

    The violence is not without consequences; 18% of respondents said they are considering leaving their position due to the violence, and 48% said violence has changed the way they view or interact with patients.

    Men and more experienced staff reported feeling significantly better prepared compared with women. When asked which factors staff thought were most responsible for the violence, the following feature in at least 70% of responses: alcohol, illicit drugs, and significant mental illness.

    A total of 86% of respondents said they felt at least moderately prepared to handle verbal abuse, while 68% said they felt prepared to handle physical assault.

    “Everyone’s feeling right now that violence has increased in healthcare [during the pandemic], and our data have showed that,” Dr McGuire said. “How is this sustainable? …There is a critical issue in healthcare.”

    She added that since reporting of violence is so low, true exposure to violence is probably much higher than the study found.

    Study co-author Casey M. Clements, MD, PhD, also of Mayo Emergency Medicine, added that “we know this isn’t isolated to emergency departments.”

    He explained that while the study encompassed the pandemic era, violence “has been a problem for some time in healthcare” – violence is a major threat to the healthcare workforce, Dr Clements said. He added that another problem is that physicians typically do not receive any training in de-escalation — “we learn this on the job.”

    For the study, the researchers sent an anonymous survey to ED staff at 20 EDs. Also included were social workers, management, and security staff. Women made up 73% of the 833 respondents. Nursing staff (31%) made up the largest medical discipline, and 16% were clinicians.

    Dr McGuire suggested that a centralised reporting system would help augment reporting of violence.

    “We need to change the mindset that it’s anybody’s job to be assaulted at work,” Dr Clements said. “We cannot go on having our emergency department workers being abused and assaulted on a daily basis.”

    Source: MedPage Today