Concerns have been raised about the Gauteng Department of Health’s (GDoH) lack of communication regarding the outcome of an important tender for the outsourcing of oncology radiation treatment.

The department issued the tender for the outsourcing of radiation services for breast and prostate cancer patients in October 2023. 

“We don’t know anything about the outcome of the tender… whether it has been awarded or even whether it will be awarded. Nothing is happening,” said Salomé Meyer from advocacy organisation Cancer Alliance. 

The tender included a compulsory briefing session which Meyer says many suppliers of oncology services were unable to attend and were thus excluded from applying for the tender.

“The manner in which they [GDoH] advertised the tender also went against the agreement that we had with them. Everything they’ve done is completely against the collaborative agreements that we had reached in terms of how we will look for solutions to solve the crisis,” she said. 

Unfulfilled promises

In March 2023, Gauteng finance MEC Jacob Mamabolo allocated R784-million to the department to address the backlog in surgical and radiation oncology services. 

Gauteng MEC for finance Jacob Mamabolo. (Photo: Gallo Images / Luba Lesolle)

Delivering his budget speech, Mamabolo said the Gauteng provincial treasury and health department had worked with civil society organisations, SECTION27 and Cancer Alliance to find ways of procuring the equipment needed for radiation therapy for those on the waiting list, particularly given that the nature of the disease required urgency.

Mamabolo also thanked Cancer Alliance and SECTION27 for working with his department to bring the problems to light and praised his department’s work with the advocacy groups.  

“This collaborative approach with civil society in addressing the crisis is expected to address the waiting lists, and I anticipate that this time next year, we will be outlining the resolution to this challenge,” he added.

However, three months later, in June 2023, concerns were voiced as very little had been done to ensure patients received the long-overdue care they needed — despite the financial allocation. 

Read more in Daily Maverick: Worrying lack of urgency as Gauteng Health sits on money earmarked to outsource urgent cancer treatment

Silence from the department

Meyer said there were communication issues with the GDoH even before the tender advertisement. 

“They [GDoH] refused to communicate with us. They just ignore our phone calls, our emails, everything… they simply do not communicate,” she said.

“We were in meetings together to decide how they are going to tackle this issue now that the money has been allocated… how the process will unfold, what the process will be — and then they stopped communicating with us.”

Read more in Daily Maverick: Reducing surgical and cancer treatment backlogs in Gauteng’s health system is an urgent priority

Meyer said the lack of communication was “very upsetting” and went against the ethos of their agreement.

“I think what they’re saying is, ‘this is our problem, we will deal with it, we will manage it, we are not going to allow anybody to tell us what to do and how to do it’. That is all you can surmise,” she said.

Backlog of thousands

The province has a backlog of roughly 3,000 patients waiting to receive potentially life-saving radiation treatment at Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital.

The backlog consists mainly of treatments for prostate cancer, breast cancer, cervical cancer and some colon cancer, according to Meyer.

“How many of these patients are still alive remains to be seen, as they will have to be recalled for re-evaluation and staging,” she said.

Meyer said she knows of a 40-year-old man who requires a radical prostatectomy.

“He cannot get this life-saving surgery at Chris Hani, for many reasons. His best option is robotic surgery and this he cannot have as none of the hospitals in Gauteng offers this type of surgery – they do not have the equipment,” she said. 

Meyer also voiced concerns about where the R784-million allocated to address the backlog has gone. It is unclear whether the tender has been awarded.

The health department had not responded to Daily Maverick’s request for comment by the time of publication.

Motalatale Modiba, Head of Communication for the Gauteng Department of Health, said the tender was advertised on 20 October 2023 and closed on 3 November 2023. 

“The Department commenced with evaluation of the Tender on the 21st November 2023 to 16th January 2024. The Department is currently awaiting the probity Auditor’s review,” he said.

The department denied that there were communication issues with Cancer Alliance. “The Departmental Supply Chain Management Directorate and Hospital Health Services say they have not received any communication from Cancer Alliance,” he said.

Regarding the progress that has been made to address the backlog in surgical and radiation oncology services since March 2023 when the MEC for Finance allocated R784-million to address the crisis, Modiba said R250-million was given by treasury for the outsourcing of the radiation oncology tender.   

Additional equipment was operationalised through staff appointments for additional patients to be treated.

“The SCM progress is as follows: Brachytherapy tender, Bid evaluation process has been concluded for Bid Adjudication Recommendation. Small Linac was advertised on 24 November 2023 and closed 8 December 2023 and Evaluation will commence from the 29 January 2024,” he said. DM