But Health Minister Dr Aaron Motsoaledi stressed that ‘€œno one is going to be fired’€ when he made the announcement in Pretoria yesterday.

Among those who will have to vacate or re-apply for their positions are the CEOs of all government’€™s 10 central hospitals, including Chris Hani Baragwanath, Charlotte Maxeke and Groote Schuur hospitals.

‘€œCEOs have to be appointed at an appropriate level. A CEO of a central hospital needs to be at the level of a Deputy Director General and there is no one at that level,’€ said Motsoaledi.

However, he stressed that some CEOs ‘€œmight be fit, but not at the right level’€. But he said an analysis of hospital CEOs’€™ skills led by the Development Bank of SA had found that ‘€œthose without health backgrounds were struggling’€.

In addition, the heads of some hospitals were at a level eight ‘€œwhich is the equivalent of a clerical position but they are running a hospital’€.

Meanwhile, an independent audit of all health facilities in the country conducted by Health Systems Trust found that three-quarters failed cleanliness standards, the staff at almost 70 percent failed to show positive, caring attitudes and two-thirds failed patient safety standards.

The audit has surveyed 82 percent of the country’€™s facilities so far, a total of 3 370.

Mostsoaledi said the worst facilities were satellite clinics and primary healthcare clinics.

‘€œThis explains why our hospitals are so congested because people vote with their feet and go to hospitals,’€ said the minister.

However, he stressed that ‘€œit looks quite ugly in some institutions but that is because we have set the standards very high’€.

 ‘€œWhen we launched the NHI Green Paper, we said a precondition for the NHI to survive and be successful is that the quality of healthcare in public institutions has to improve. It is non-negotiable that we overhaul and improve quality,’€ said Motsoaledi.

In the next two weeks, specially trained teams were going to go to health institutions in four of the districts where the audits were complete and sit down at each institution and see why there were problems and what could be done.

The four are Sedibeng (Gauteng), Motheo (Free State), Zululand (Ulundi, KZN) and Pixley ka Seme (Northern Cape). From there, the teams will move through the country to all facilities.