Dr Clean-up

Frere hospital in East London stands proud as one of the biggest regional hospitals in the Eastern Cape - but inside these walls, behind closed doors lies a discarded ward which tells a story of a department in need of a turnaround. Two decades ago this used to be a fully functioning hospital theatre at Frere: today it's a storeroom in a province in dire need of operational infrastructure. Instead of having to take in hidden cameras, the new Superintendant General of the Eastern Cape Health Department, Dr Siva Pillay, opened his doors to us.

Dr Siva Pillay (Superintendent General: Eastern Cape Health Department): 'There's no money, no surgeons and it was just closed down.'

Derek Watts (Carte Blanche presenter): 'This is the state it's gotten to?'

Dr Pillay: 'It got to this stage. Now it's used by electrical people as a storeroom.'

And the new superindendant general sees it as symbolic of the chaos that he took over 18 months ago.

Dr Pillay: 'When I came in it was a bankrupt department, riddled with corruption and with a lot of ineffective managers and a totally demoralised workforce.'

We'd exposed many stories on the beleaguered Eastern Cape Health Department over the years and Dr Pillay's take on the situation served to explain the countless instances of neglect, medical malpractice and general malaise.

Dr Pillay: 'When things are left too loose for too long there is a complacency that sets in to the extent that unacceptable behaviour just becomes a norm.'

Derek: 'When Dr Pillay started with the job, he started with the usual platitudes: 'My door is always open'; 'I'll do my very best'. But little did health department employees know that the winds of change were about to sweep through the Eastern Cape, that heads would roll - more than 800 of them!'

It's been described as one of the biggest clean-up campaigns ever undertaken in the Eastern Cape.

Dr Pillay: 'The complacency has been to such a great extent that people have now become blatantly and overtly doing things that they are not supposed to do. So my evidence is just there all the time. And so when I present evidence, people are resigning.'

Derek: 'They didn't cover their tracks too well?'

Dr Pillay: 'No one bothered to cover their tracks because there was no need to in the past.'

By trawling his own database with forensic experts, Dr Pillay uncovered that 6 000 members of his staff were doing irregular business with his department. He also found many duplicated suppliers.

Dr Pillay: 'The first thing we found - 7 569 suppliers duplicated on the database. Now why would a supplier be more than once on the database, except to get fraudulent payments?'

In addition, multiple suppliers used the same bank account. Digging deeper, he discovered these were in fact dormant companies using fictitious invoices for non-existent supplies.

Dr Pillay: 'When we went to all these companies and asked them, 'Listen, can you tell us...' They said, 'No, this is not our account.' Now you've got an innocent company that has just been used.'

Duplicate payments, including this one for nearly a million rand, simply went unnoticed. In total more than R308-million has been siphoned off. Among the heads that rolled is the Chief Financial Officer, Phumla Vazi who, from 2007, built up a supply network of companies owned by her husband, daughter, and sister - to which the department paid nearly R7-million.

Dr Pillay: 'I can either concentrate on catching these people or I can concentrate on preventing this from happening further. And my mission now is to prevent this from happening.'

These findings are being welcomed by the Public Service Accountability Monitor Acting Director - Derek Luyt.

Derek Luyt (Acting Director: Public Service Accountability Monitor): 'There has been a lot of denial in the past. So, even when it was clear to outsiders that there was a problem, the political heads, for political reasons, would deny that there is a problem.'

Derek believes that Dr Pillay's acknowledgement of the problem is a step in the right direction.

Derek: 'There's been a lot of money badly used and outright stolen in the past. So a necessary condition of getting the department to perform better is [to] crack down on financial mismanagement.'

Even the DA's John Cupido is cautiously optimistic about the new superintendent general.

John Cupido (DA: Eastern Cape): 'It's commendable to see someone with a political will and internal strength to be able to want to clean out a department and do it on such a large basis.'

Dr Pillay is also determined that suspended staff don't stay at home for months on full pay.

Dr Pillay: 'If you are going to charge somebody, and you feel it is going to interfere with the investigation, the law allows you to move that person to another place which is within 50 kilometres from where his workplace is. So I can suspend you and ask you to move to another place, I can then charge you, and you don't stay at home and collect the money.'

These radical changes and blanket disciplinaries have not made Siva popular.

Dr Pillay: 'I may not be popular with people that are corrupt, but I am very popular with the people that get a better service.'

Siva Pillay made it clear from the start that rooting out corruption would be his primary aim - no jobs for pals. But then his own conduct came under scrutiny.

MEC Sicelo Gqobane, has to date spent R2.9-million investigating links between Dr Pillay and his architect friend Edgardo Gamaleri - whom it is alleged benefited from deals with the department.

Dr Pillay: 'I want to know which lucrative contracts have I appointed him for? The easiest thing is to check whether G&F Architecture earned a cent from BAS. And there has not been one cent that has been paid to G&F Architecture from BAS.'

To date the investigation has not proved any wrongdoing and Dr Pillay believes that in fact his friend saved the department millions in East London's Cecilia Makawane hospital upgrade.

Dr Pillay: 'The last time Cecilia Makawane went out on a tender, the tender was R980-million. We re-tendered a year later but [he] did this whole workflow for us and he put a bill of quantities and he said, 'My cost for this is R840-million'. All the guys came in and tendered, and low and behold, the tender came in at R860-million. We saved R120-million in one project.'

Part of what makes Dr Pillay so successful is that he is first and foremost a businessman.

Derek: 'He is financially independent and many other heads of department have perhaps not been able to withstand political pressure and have not had the capacity to take strong action against senior staff for political reasons perhaps.'

John: 'You can view it as a person that is trying to self-actualise… that is trying to do the greater good, that feels that he has made it himself and he is now trying to help the community'.

Dr Pillay: 'I don't come to Bhisho for a salary - I donated my salary back. But you'll find it doesn't stop me from working - I'm the first one in my department...'

Derek: 'You gave back your salary?'

Dr Pillay: 'I don't bother to take it.'

As part of his turnaround strategy he has managed to reduce departmental debt substantially.

Dr Pillay: 'We came from a R2.8-billion budget deficit and, in one year, we brought it down to about R1.8-billion and this year we brought it down to R800-million.'

A major challenge to his budget remains the bloated administration.

Dr Pillay: 'We did a study and that study showed two things: in the last ten years, administrative staff has increased by 159.8%, clinical staff less than 2%. Now this is an indictment, because we have employed the wrong people.'

With new training programmes in place and out-of-the-box thinking, the staffing problems should be sorted soon.

Derek: 'Dr Pillay has achieved an incredible amount in just over 18 months. But he would be the first to admit that it is just a start. This was an operating theatre and it is going to take a lot of money to get it back into surgical condition.'

Dr Pillay: 'Infrastructure is a disaster for us. When we talk about infrastructure we talk about three things: infrastructure which is a physical infrastructure; the second infrastructure is the equipment; and the third part of the infrastructure is the IT - in all three we have a backlog.'

It's a result of a department where, for the past 16 years, they have returned money to the government, meant for infrastructure.

Dr Pillay: 'Last year was the first time in 16 years that we committed all our money for infrastructure.'

And the results are clear, with big changes at Cecilia Makiwane and Fort Grey TB hospital on the outskirts of East London. These new private wards were created for MDR and XDR patients with Dr Pillay's blessing.

Nonceba Nqini-Ntolosi (Senior Executive Officer: Fort Grey Hospital): 'We have made drastic changes here, because there are certain rooms that have been created for our patients. When they get improved, we move them to those areas so that they don't get re-infected again.'

She's delighted with Dr Pillay's no-nonsense approach.

Nonceba: 'He is a person who moves faster; he does not like delays. And I should think, to me, looking at him, he has that leadership quality.'

He's also spearheading the move towards engaging with the Carte Blanche Making a Difference Campaign - help which was previously turned down by the department. The National Minister of Health, Dr Aaron Motsoaledi was shocked to hear this.

Dr Aaron Motsoaledi (National Minister of Health): 'That should never have been allowed to happen. Nobody owns our public hospitals; they belong to South Africans.'

Dr Pillay: 'It's wrong for us to say no to anyone who wants to make that dream happen.'

So, two weeks ago, Carte Blanche executive producer George Mazarakis and the patron of the Making A Difference campaign, Karolina Andropoulus, met with Dr Pillay in East London to discuss their needs.

Dr Pillay: 'We really want to go out and say thank you to Carte Blanche. We really believe what you are doing will benefit the society, if we can get a paediatric ward upgraded and a paediatric theatre here.'

Plans are afoot to make these dreams a reality as we join hands with Dr Pillay to bring improved health care to the people of the Eastern Cape. We are pleased to announce that Nestle has given us R1-million rand to kick-start the refurbishment of paediatric theatres and wards at Frere.'

Dr Pillay: 'I have always maintained the position that when we are here, we are servants of the community. When you say ‘public servants’, people don't take this seriously. We are not here for ourselves. We are here to make a better life for the people out there.'

PART 2