SELECT COMMITTEE ON APPROPRIATIONS: HRP

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SELECT COMMITTEE ON APPROPRIATIONS HRP

DR JJ MAHLANGUHOD HEALTH MPUMALANGA
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HRP GRANT OBJECTIVES Provision of funding to
enable provinces to plan manage modernise
rationalise and transform the infrastructure,
health technology, monitoring and evaluation of
hospitals in line with national policy.To
transform hospital management and improve quality
of care

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MPUMALANGA HRP PROJECTS
HOSPITAL REVITALISATION PROJECTS
PROJECT NAME PROJECT STATUS
Ermelo Hospital Partially complete
Themba Hospital Partially complete
Rob Ferreira Hospital Partially complete

BUDGET EXPENDITURE UP TO 30 JUNE 2010 EXPENDITURE UP TO 30 SEPT 2010
R331 657 000 R72 797 000 R166 247 274
100 22 50
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CURRENT HOSPITAL PROJECTS
Name of Project Project Description Start date Anticipated / Actual Completion date Progress to date Comments
Ermelo Hospital Construction of new OPD Casualty and Theatre 21-Nov-08 07-Jul-10 Main building is complete. Project is on retention pending approval of the adjustment of provisional sums by the Department of Health Practical completion was achieved on the 07-Jul-10.Variation order received after practical completion
Ermelo Hospital Renovations to existing Intensive Care Unit(ICU), and Maternity Ward.(Phase 4) 21-Nov-08 30-Nov-10 Main building is outstanding of theatre lights and snag list. The gate-house is 48 complete. V'O for abnormal foundation is still outstanding.
Ermelo Hospital Construction of a new Paediatric ward. (Phase 4) 21-Nov-08 30-Nov-10 Contractor on penalties for 30 days. Progress on staff parking is 55 complete. Air-conditioning commissioned. Poor workmanship applied vinyl sheeting on uneven floor.
Ermelo Hospital Construction of a new Health Support Block. 21-Jan-09 07-Jul-10 Practical Completion was done on the 07-Jul-10.

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CURRENT HOSPITAL PROJECTS CONT....
Name of Project Project Description Start date Completion date Progress to date Comments
Ermelo Hospital Construction of new Medico Laboratory 21-Sep-07 02-Feb-10 The practical hand over was done on the 02-Feb-10. There is pending approval on the adjustment of the provisional sums. Fire certificate was submitted. Project is 100 complete. Variation order received after practical completion date
Themba Hospital Construction of Doctor's accommodations x 30 units 05-Jun-06 TBA Contractor have been terminated due to poor performance. The department is in a process to appoint a new contractor w ho will complete the outstanding work. Progress was at 98.
Themba Hospital Construction of Bambanani Clinic and garages 10-Nov-08 22-May-10 Project on retention. Workmanship very good
Themba Hospital Construction of CE Workshop and New General Ward. 22-Jan-09 30 Nov-10 Contractor is failing to complete the works. Third warning letter have written to the contractor on the 23rd September 2010 and has been put on terms. Progress is at 98.
Themba Hospital Renovations and Upgrading of Allied, Postnatal and chronic wards 26-Mar-09 30 Nov-10 Two floors were handed over on the 18-02-10 and 13-07-10. Transformer room is complete and equipment is awaiting delivery on the 15th October 2010. Progress is at 79. Main contractor not paying sub-contractors

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CURRENT HOSPITAL PROJECTS CONT....
Name of Project Project Description Start date Completion date Progress to date Comments
Themba Hospital New Medico Legal Laboratory 05-Jun-08 30-Jun-10 Project is on retention.
Themba Hospital Renovations and Upgrading of Ophthalmic, Orthopedic, Female , Male Surgical and Female Male Medical Wards. 19-Mar-09 30-Dec-10 A handful of the Wards were completed prior handing over Sectional units by mid June 2010 to the Contractor for upgrading. The other units are still to be handed over to the contractor mid October 2010.Progress is 61.
Themba Hospital Renovations and Upgrading of ICU / High Care, Trauma unit, Casualty, CSSD, Theatre and Children's ward. 04-Mar-10 04-Mar-11 Progress is at 15, delays have been caused by conflict in the re-scoping of work as design architects have duplicated bills of quantities between two projects and omitted roof replacement.

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CURRENT HOSPITAL PROJECTS CONT....
Name of Project Project Description Start date Completion date Progress to date Comments
Rob Ferreira Phase 4A Renovations of Existing Units and construction of cafeteria. Renovations of crèche, Laboratory, theatre, and ICU block. Renovations to specialist OPD and Rehabilitation unit. Renovation to x-ray department, Office block and wards 2,3,48 08-Dec-08 31-Dec-10 Progress is at 95. Remainder of the theatres have been handed over on the 01-Oct-10. Specialist OPD, and Victim Empowerment unit will be handed over on 29 October 2010.
Rob Ferreira Phase 4B Rob Ferreira Hospital Construction of a basement, short stay ,day private wards, admin block and helipad. 19-Oct-09 31-Dec-10 Progress is at 50. Currently busy with brickwork in between the floors. Windows on the Second floor have been installed. Delays were due to world cup and materials delivery.
Rob Ferreira Phase 4C Rob Ferreira Hospital Construction of OPD, Casualty and Pharmacy, upgrading of OPD dental unit , Electrical upgrade, roads, storm water and sewer, roads, roof ,gutter, mechanical work, External work, landscaping, and demolition of double story building. 01-Nov-04 18-Dec-10 Project is complete, however there is minor works to be done. Existing four lifts still needs to be removed and replaced as part of the scope. Contractor busy with snag list on former phase 2 , water and sewer connection. Electrical upgrade done. Three generators have been installed. Progress is at 100.

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PERFORMANCE AND MONITORING

• Steering committees in place
• Provincial
• Local steering committee Projectbased link
• Office structure
• Appointments according to DORA
• Site project managers
• All sites
• Reports on monthly quarterly basis
• Provincial Treasury
• National Department of Health
• Joint sites visits with public works
• Project management meetings monthly

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COORDINATION HRP PROJECTS

• All projects business cases and health briefs are
  approved by NDoH prior to implementation.
• Project implementation plans submitted and
  approved Annually
• Project managers forums attended and reporting
  done Quarterly
• Submission of monthly, quarterly, and annual
  reports to NDoH and Provincial Treasury
• Implementing agent is DPWRT and IDT (Rob
  Ferreira) Project list of phases with available
  budgets are forwarded to DPWRT

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PERFORMANCE OF CONTRACTORS AND CONSULTANTS Rob
Ferreira Hospital

• Phase 2
• Termination of non performing contractors and
  consultants implemented at Rob Ferreira for the
  following reasons
• Workmanship and design inadequacies
• Irregular variation orders
• Very slow progress
• This project has since been implemented with
  phase 4 and is now complete
• Phase 4 consultants and contractor progress very
  well, good workmanship, improved project
  management, but renovations very costly compared
  to new construction

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PERFORMANCE OF CONTRACTORS AND CONSULTANTS
Themba Hospital

• Poor project management by principal agent
  approving extension of time to more than doubling
  the actual contract period and seriously impeding
  service delivery
• Poor performance of consultants and contractors,
  poor supervision of projects and slow progress.
  Contractors and consultants have been served with
  notices
• Main contractor not paying sub-contractors
• Design architects duplicating bills of quantities
  in different contracts.
• Designs not compliant to health norms and
  standards
• Scope inadequacies leading to variation orders

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PERFORMANCE OF CONTRACTORS AND CONSULTANTS
Ermelo Hospital

• The pharmacy is complete but has leaking roof.
  The principal agent is unwilling to instruct
  contractors to repair it even though the roof
  still under guarantee. This is affecting the life
  span of pharmaceuticals
• Very large variation orders for OPD, casualty and
  medico-legal mortuary that were submitted after
  completion of the projects. These have not been
  budgeted for.

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REPORTING AND COORDINATION BETWEEN DPWRT AND DoH

• There is a collaborative interdepartmental
  approach between DoH and DPWRT implemented as
  follows-
• Joint DoH and DPWRT meetings are held monthly
• Site meetings held monthly
• Unannounced site visits conducted Ad Hoc
• Reports and recommendations by DoH to DPWRT are
  forwarded

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CAPACITY TO IMPLEMENT HRP

• Revitalisation unit structure is implemented
  according to DORA
• IDIP appointed 1 October 2010 to provide
  technical assistance
• Capacity challenges for the DoH
• Absence of Infrastructure manager. The post is
  readvertised
• Absence of resident engineers. Recruitment is in
  process

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CHALLENGES

• The challenges cited above have an impact on the
  following
• Spending
• Slow moving project affect spending
• Performance and monitoring
• Poor performance of contractors and consultants
• Poor workmanship
• Co-ordination
• Weak contract management by principal agent
• Cost escalations
• Irregular variation orders

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NGIYABONGA

• THANK YOU