By SUE MACLENNAN AND ANELE MJEKULA
An expert has warned that failure to intervene decisively to prevent further disruption of services to patients at Fort England Hospital could lead to a serious disaster.
This follows reports of more promised action today that earlier this week saw specialist clinical staff cooking meals for patients under police guard, as strikers threatened to close down the facility.
Striking staff returned to work on Wednesday after officials from the Eastern Cape Department of Health asked CEO Roger Walsh to leave his post. The instruction came four days after the delivery of the report on an investigation into allegations by employee unions against the hospital’s management.
The 150-page document is the outcome of an independent inquiry by advocate Amelia Da Silva – appointed through the Office of the State Attorney, in turn commissioned by the Eastern Cape Department of Health.
Commissioned in April and dated 8 July, the findings were presented to organised labour at Fort England on Friday 15 July.
Objecting to the conclusions, members of Nehawu, the Democratic Nursing Organisation of South Africa and the National Union of Public Sector and Allied Workers vowed to bring the hospital to a halt unless their main demand – Walsh’s axing – was met.
Grocott’s Mail has a copy of a summary of the report’s overall findings and recommendations.
In it, Da Silva says she found no evidence to support allegations against the hospital’s senior administration of mismanagement, corruption or negligence, nor that disciplinary procedures were flouted.
Her recommendations include workshops for the labour force about policies and legislation, the place in it of consultation and consensus and the respective roles of management and employees.
The report summarises the situation as one of workplace conflict and recommends independent HR and conflict management experts be engaged to resolve the impasse.
According to employees, Walsh has continued his duties at the hospital, despite the instruction to relocate to Bhisho.
Union members reportedly said last night on national radio that they would resume industrial action and escalate it, sparking fresh concern about the safety and well-being of the 300 patients at the facility.
While several people reported hearing the statement, Nehawu chairperson Thando Mtshalala last night denied Nehawu made such a statement, and said he was unaware of any reason why employees would want to strike.
Disaster
An expert has warned of potential disaster should there be further disruption at the facility today.
“Fort England has over 300 mentally unwell in-patient residents, about 250 of whom are state patients,” said the expert.
The latter were men with severe forms of mental illness, most with histories of violent offences and housed in locked wards.
Fifty of those are housed under maximum security – a national facility that houses some of the most potentially dangerous State patients in the country, together with a number of mentally ill prisoners and others undergoing psychiatric evaluation ordered by the court.
“Such patients missing meals and medications, with inadequate supervision and security is clearly a recipe for a potential disaster of significant proportions,” the expert said.
Patients at Fort England Hospital went without food or medication until nearly midday on Monday 18 July, and managers and professional staff spent two days in the facility’s kitchens, preparing and delivering meals under police protection as a work stoppage by organised labour at the facility sought to bring operations to a halt.
Early on Monday a group of around 30 people singing, carrying sticks and blowing whistles went into the hospital wards, disrupting ward routines and threatening staff, according to witnesses.
A memorandum from divisional and clinical managers at the hospital dated 19 July and addressed to Dr Thobela Nogela (deputy director-general, human resources) and Dr Litha Matiwane (deputy director general, health services cluster) alleges that violent threats to forcefully remove Walsh and burn down the hospital were made at the 15 July meeting.
They reported subsequent widespread intimidation and forceful removal of many staff from wards, offices and essential support services, including the kitchen.
On Monday, patients eventually received their first meal of the day, along with their medication, shortly before midday.
According to the memorandum, the situation escalated Tuesday 19 July, with “ongoing industrial action, widespread intimidation, forced removals of staff from wards, offices and essential services and threats of violence to clinical staff who were attempting to prepare food in the kitchen and dispense medication in the wards”.
Making food
A doctor who works at Fort England, who cannot be named to prevent victimisation said when they reported for duty on Monday they found a mob of about 30 people singing, carrying sticks and blowing whistles in the hospital wards.
“I went to my car, not sure if it was safe to come out or not,” he said.
The doctor said people were sworn at and harassed, including those going to the tuck shop to buy food for patients. He said the situation was bad because patients are used to a certain routine.
“And all of a sudden today [Monday, 18 July] by 10am and they hadn’t eaten or taken their medication,” he said.
The doctor said even for a person who is mentally stable it is easy to get agitated and irritable when they are hungry.
“Imagine what that does to a person who has an underlying mental illness risk. So we were really worried about that.”
Some staff members were eventually allowed into the kitchen at about 10am and they immediately started preparing breakfast for the patients.
“I think the patients then started eating at about 11.30am to midday, and that’s very late for the patients, because they need to go to activities like occupational therapy and gardening and so on, as part of the rehabilitation program to get them ready to go back to the community. But they were not able to do any of this today,” he told Grocott’s Mail on Monday.
The doctor said they were working by 3pm on Monday but they were not performing their actual duties.
“We are basically making food for the patients at the moment,” he said.
Another staff member said clinical staff had earlier this week stepped in to prepare and distribute food on behalf of striking kitchen and transport staff, and dispense medications/monitor patients on behalf of striking nursing and ward based staff, with great difficulty and at some risk to themselves.
Removal
When Grocott’s Mail spoke to striking employees at the hospital on Monday, two main themes emerged.
The first was that as far as they were concerned the only resolution for the impasse was the removal of Walsh, irrespective of the investigation’s finding.
The second was frustration with the slowness of grievance procedures, as well as what some said was an inadequate response by the leadership of the Eastern Cape Department of Health.
One employee who spoke to Grocott’s Mail emphasised that they were not on strike.
“We are just sharing our anger and disappointment at the fact that the Department is not able to hear our cry.”
“When the report came on Friday, it was not what we were expecting to find. It didn’t address our grievances with the CEO,” said Nehawu chairperson Thando Mtshalala.
“Instead it reduced our grievances to poor relations between management and the labour relations officer.”
Mtshalala said adding to their frustration was that they had been told the report would be completed in 30 days.
“But we’ve waited for more than 90 days… So when the report came on Friday, at the meeting we told Bhisho that if they don’t remove Dr Walsh immediately there will be a complete shutdown.”
Mtshalala said around 250 people from various departments were joining the action.
Unhappy
Grocott’s Mail asked staff to summarise their main allegations.
One employee, who spoke on condition of anonymity, said, “He is arrogant. He takes decisions without consulting. It’s his way or no way.”
Nehawu shop steward Phakamisa Soxujwa said that:
* There are cases when [an employee]will be operated on and have to return to work the next day;
* There are unfair labour practices. We have been following grievance procedures but these take time.
* People have been resigning and taking transfers because they are unhappy;
* Patients haven’t had new clothes, but money was spent on fencing, and renovating the [on-premises] house for one of the managers to live in;
* At [management]meetings we were told that the unions were observers, not [decision makers]. On other occasions we would reach a decision, only to find that a different decision had already been taken and/or implemented.
Soxujwa said, “This is our last resort. We have engaged with the Department since 2014.”
Denosa member Ntombizodidi Ngcosini said, “This [unhappiness]has been a long-standing problem since 2014. It is the culture of our employer that they don’t take people seriously.
“We have been crying for a long time.”
Another employee, speaking on condition of anonymity, also laid some of the blame at the Department’s door.
“This situation is beyond what Fort England can manage,” the employee said. “It needs decisive leadership [from the Province]to resolve this.
“Look, Roger Walsh might not be popular, but he is the best CEO the institution has had for a long time.”
Innovation
Late last year, staff at the hospital wrote a letter in response to a November 2015 petition calling for Walsh’s removal as CEO. Grocott’s Mail has a copy of the letter.
In the letter to the Health Department, the eight senior professional staff say: “Whilst there may be some that disagree with the leadership style of the CEO, we have no doubt that Dr Walsh has not expected anything beyond what is required of legislation, official institutional and Departmental policy, and individual job descriptions.”
In their 19 November letter, which is addressed to Nogela and Matiwane the staff express confidence in Walsh as CEO, saying Fort England has progressed and improved in many ways under his leadership.
“His commitment to Batho Pele principles,streamlining administrative and managerial efficiency, enriching the work conditions of all employees, and above all, improving the quality of patient care, is clear to us.”
Marginalised
The Da Silva report says: “I could not find fault with the management style at FEH. The lack of communication between management and the labour force appears to have originated from a time when the workforce stopped attending ITU meetings after November 20915. The reason for the withdrawal of the work force is that management took decisions without consultation and the workforce consequently felt marginalised and excluded.”
Eastern Cape Department of Health spokesperson Siyanda Manana Tuesday evening 19 July confirmed that Walsh had been redeployed to Bhisho and that hospital manager Jenny Holder was henceforth to work at Settlers Hospital.
“This is to ensure there is normality in the institution,” Manana told Grocott’s Mail on Tuesday.
Calls by Grocott’s Mail to obtain comment from the Department yesterday went unanswered.
Walsh told Grocott’s Mail he was in negotiation with the Department “as to the need, wisdom or legality of the proposed redeployment of managers”.
He expressed his gratitude to the hospital’s administration, nursing and clinical staff who ensured the patients received care and was grateful to SAPS for getting access for the hospital staff to the kitchen and escorting deliveries of food to the wards.
Walsh said it had been a very stressful period for him personally, as well as all employees of the hospital.
Fort England is a government funded psychiatric hospital and drug rehabilitation centre serving Makana Municipality. At a staff complement of 398 it is the third-biggest employer in Grahamstown. It can accommodate 300 patients.
The hospital departments include a rehabilitation centre, pharmacy, anti-retroviral treatment for HIV/Aids, and post trauma counselling services.
It also serves as a National Maximum Security Facility that employs 50 staff.
