SELECT COMMITTEE ON APPROPRIATIONS: HRP

DR JJ MAHLANGUHOD HEALTH :MPUMALANGA

SELECT COMMITTEE ON APPROPRIATIONS: HRP

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

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PROJECT NAME PROJECT STATUS

Ermelo Hospital Partially complete

Themba Hospital Partially complete

Rob Ferreira Hospital Partially complete

BUDGET EXPENDITUREUP TO 30 JUNE 2010

EXPENDITURE UP TO 30 SEPT 2010

R331 657 000 R72 797 000 R166 247 274

100% 22% 50%

HOSPITAL REVITALISATION PROJECTS

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CURRENT HOSPITAL PROJECTS

Name of Project

Project Description

Start date Anticipated / Actual Completion date

Progress to date & Comments

Ermelo HospitalConstruction 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 HospitalConstruction 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 HospitalConstruction 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 Completio

n 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 HospitalRenovations 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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Name of Project

Project Description Start date Completion date


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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Name of Project

Project DescriptionStart date

Completion date


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 2,3,4&8

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 MONITORINGSteering committees in place

oProvincialoLocal steering committee: Project–based link

Office structureoAppointments according to DORA

Site project managersoAll sites

Reports on monthly & quarterly basisoProvincial TreasuryoNational Department of Health

Joint sites visits with public worksProject management meetings monthly

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COORDINATION HRP PROJECTSAll projects business cases and health briefs are approved by NDoH prior to implementation.Project implementation plans submitted and approved: AnnuallyProject manager’s forums attended and reporting done: Quarterly Submission of monthly, quarterly, and annual reports to NDoH and Provincial TreasuryImplementing 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:

oWorkmanship and design inadequaciesoIrregular variation ordersoVery slow progressoThis 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 deliveryPoor performance of consultants and contractors, poor supervision of projects and slow progress. Contractors and consultants have been served with noticesMain contractor not paying sub-contractors Design architects duplicating bills of quantities in different contracts.Designs not compliant to health norms and standardsScope 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 pharmaceuticalsVery 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 monthlySite meetings held monthlyUnannounced site visits conducted: Ad HocReports and recommendations by DoH to DPWRT are forwarded

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CAPACITY TO IMPLEMENT HRP

Revitalisation unit structure is implemented according to DORAIDIP appointed 1 October 2010 to provide technical assistanceCapacity challenges for the DoH

o Absence of Infrastructure manager. The post is readvertisedo Absence of resident engineers. Recruitment is in process

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CHALLENGES

The challenges cited above have an impact on the following:Spending

oSlow moving project affect spendingPerformance and monitoring

oPoor performance of contractors and consultantsoPoor workmanship

Co-ordinationoWeak contract management by principal agent

Cost escalationsoIrregular variation orders

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NGIYABONGANGIYABONGA

THANK YOUTHANK YOU

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SELECT COMMITTEE ON APPROPRIATIONS: HRP