Health and Wellness

There are multiple possible reasons for an infrastructure project to be delayed. For example:
Funding and Budgetary issues – Fiscal constraints frequently hinder projects progress and result in projects having to be put on hold (usually during the planning phases) due to budgetary processes, which disrupts project timelines, forcing the department to halt work and increasing financial risk.

Poor Performance by Contractors – there have been instances of poor contractor performance, including slow progress, penalties, and quality issues. Poor contractor performance due to lack of financial resources and loss of skills in the construction sector in South Africa has also played a part. This results in poor workmanship, stalled projects, and costly remedial work.

Complexities of Working in Existing Operating Facilities - Delays can be caused by operational constraints in sensitive areas like theatres, dental units, and mental health spaces. It can be challenging to integration construction projects existing systems. Additional unforeseen scope such as asbestos ceilings, roof repairs, and air handling unit replacement can also cause a delay.

External and Community Factors - Weather-related disruptions and community protests over land use or employment contribute to unplanned stoppages.

Complex nature of Health Facilities - Construction and maintenance of health facilities require sophisticated interventions that are complex in nature, resulting in very few instances where “off the shelf” items can be utilised. Equipment and fittings in public facilities need to be extremely robust and vandal-proof, making the materials very costly.

Labour and Material Disruptions – Theft, strikes and supply chain delays—exacerbated by material shortages—impact construction progress and resource availability.

As a result, the Western Cape Department of Health and Wellness has implemented a range of measures to accelerate infrastructure projects that have experienced delays. These actions focus on improving planning, strengthening coordination, and streamlining delivery across both the design and construction phases.

Projects in the Design Phase

• Closer stakeholder collaboration is promoted to ensure timely technical input, quicker decision-making, and faster turnaround on documentation.
• Document trackers are used to prioritise delayed projects, improve oversight, and identify bottlenecks early.
• Where appropriate, the Department replaces formal Infrastructure Delivery Management System stage reviews with targeted technical workshops to align project specifications and accelerate stage approvals.
• Scope changes and design amendments are carefully assessed for cost and programme impact before implementation and are restricted to early stages unless related to occupational health and safety, essential functionality, or fire safety.
• Projects are prioritised by service need due to fiscal constraints.
• The Department is developing internal design guidelines and checklists, aligned with norms and standards, to improve design quality and reduce delays during review stages.

Projects in the Construction Phase

• The WCDHW and the Department of Infrastructure have committed to prioritising procurement engagements, shortening the time taken to finalise required processes.
• The WCDHW Management Contractor Framework is used where appropriate and has proven effective in advancing delayed infrastructure projects.
• Contract Instructions and Compensation Events are limited to prevent unnecessary extensions of time on construction programmes.
• Stakeholder engagement is strengthened to minimise disruptions that may hinder construction progress.
• The Department is fostering collaborative working relationships with contractors and suppliers to support joint risk mitigation and ensure efficient delivery.