7 July 2005
You will recall that earlier this year, I visited the two psychiatric hospitals in this area, Fort Napier and Townhill Hospitals after there were media reports about inappropriate patient care at these hospitals.
With regard to Fort Napier Hospital , we should allow the criminal justice process to take its course. However, the internal investigation has highlighted the need to provide training and clear guidance to all staff members involved in restrain related procedures where patients are unstable.
With regard to Townhill, I appointed a Committee of Inquiry to investigate the reported allegations and to report back to me as a matter of urgency. The investigation has established that there is reasonable evidence supporting the following allegations:
The Committee went further to establish other challenges in addition to those listed in its terms of reference including:
The Committee of Inquiry concluded that most of these problems are as a result of poor management over a number of years and the absence of an effective hospital board. The Committee also made recommendations on how each of these challenges should be addressed.
The National and provincial Department of Health will consider these recommendations as we take a number of steps to address the challenges facing this health facility. What is certain is that we will act to both improve patient care and the working conditions of the staff. Indeed we have already commenced with some of these.
The interim advisory board has been appointed. As part of strengthening management capacity, we have also appointed managers for nursing and human resources. These appointments should ensure that there are performance agreements and adherence to service standards as guided by the Patients’ Right Charter and Mental Health Care Act. There should also be an ongoing training programme focused on improving patient care.
Understanding that the management of mental health patients is a major challenge, we should strengthen the employee assistance programme for the staff. The programme should also assist us in identifying factors behind alcohol abuse and absenteeism and address these. However, this intervention does not exempt anyone from being subjected to disciplinary and law enforcement processes when rules and regulations have been violated.
Cases of racism, nepotism and favouratism will clearly not be tolerated and we expect the provincial Department of Health to take immediate action to ensure integration and equal treatment of patients, staff and candidates for jobs. The provincial Department and management will also fast track the recruitment process for funded posts which remain vacant.
To deal with the problem of patients sleeping on the floor, fixed beds appropriate for psychiatric patients have been installed in seclusion rooms. The procurement section will also ensure that there is an adequate supply of appropriate underwear for female patients.
There has also been improvement of the facility with installation of aluminium ceiling and the refurbishment and tiling of toilets and bathrooms.
In improving security, closed circuit television has been installed and this should also assist in addressing the problem of patients who are likely to abscond. Criminal offences that have been reported including sexual and physical assault will be referred to the South African Police Service. There are clear medical protocols which have to be followed in cases of rape and sexual abuse and these will have to be adhered to.
I would like to thank the members of the Committee of Inquiry and all those who have made submissions to it for assisting us in clearly identifying the challenges facing this hospital.
For us at National and Provincial Departments as well as the management, staff and the union at this hospital, we have to intensify our efforts already underway to improve the conditions in this hospital. We have to work together in addressing these challenges. We have a collective responsibility to ensure that the Mental Health Care Act is effectively implemented and its objectives of strengthening human rights and treatment of mental health patients with dignity and respect are realized.
I am expecting regular reports on the interventions being made in addressing the challenges here as reported to me and we will make such progress reports available to the public who can also monitor the progress.
Dr Manto Tshabalala-Msimang
Minister of Health