Training hospital on brink of crisis

Mass resignations of doctors and medical specialists at one of South Africa's flagship hospitals are threatening to jeopardise patient care.

Health professionals this week said the exodus of medical practitioners from the Universitas Academic Hospital in Bloemfontein had reached "crisis level".

And the imminent departure of the hospital's two remaining cardiologists could cripple the cardiology department, which caters for patients from the entire Free State and Northern Cape.

There are also fears that the training of doctors could be severely compromised because Universitas is a teaching hospital for medical students from the University of the Free State.

Staff blamed some of the resignations on the poor managerial style of the hospital's new chief executive, Dr Sehularo Gaelejwe.

Gaelejwe was a senior clinical executive at Gauteng's Chris Hani Baragwanath Hospital before joining the Universitas Academic Hospital in October.

The Sunday Times was prevented by the provincial department of health from interviewing Gaelejwe.

It said it would comment on his behalf. A department spokesman, Mondli Mvambi, said the department was not aware of the allegations concerning Gaelejwe.

Professor Danie Marx, the former head of cardiology, who retired in October, said if there were no cardiologists at the beginning of next month, procedures such as inserting a stent in a heart or doing a coronary angiogram could not be performed.

Between 10 to 12 patients go for coronary angiograms every day.

Marx, who has worked in the state sector for 40 years, said the training of the three cardiologists would also be disrupted because it could not be done without the supervision of a qualified cardiologist.

"Universitas Academic Hospital has always been a well-regarded training centre for cardiologists. It will be a huge tragedy if the whole thing collapses," said Marx.

He said cardiothoracic surgery would also be threatened because patients had to be diagnosed and evaluated by a cardiologist before they could be referred for surgery.

A staff member in cardiology said: "If a cardiologist is not appointed at the beginning of next month, it will be a total disaster. You will have a lot of patients dying unnecessarily.

"If you get a heart attack, they rush you to the cathlab [an examination room]. If an artery is blocked, they unblock it. You won't lose muscle, you won't die."

But the cathlab has suspended its after-hours service and closes daily at 4pm because of the shortage of cardiologists.

The staffer said: "Something is wrong because too many people are leaving.

"There's a finger pointing at the management style of Dr Gaelejwe."

A general surgeon, who left to go into private practice last month, said he did so because the public service salaries were far lower than those in the private sector.

"I did not see a big future for myself there [at Universitas]."

He said the situation was "quite dire. It's heading towards a crisis."

Dr Deon Menge, a general surgeon and the immediate past president of the South African Medical Association in Free State, said the province struggled to attract doctors.

"Some private hospitals in the province can take up to three years to appoint a surgeon to a vacant post, so just imagine how long a government hospital will take.

"Health in the Free State is in a desperate situation and patients do suffer."

He said doctors called him daily, telling him they wanted to resign.

A staff member, who penned a lengthy document on the goings-on at the hospital, described the situation as the "biggest crisis in the history of the faculty of health sciences".

University of the Free State spokesman Lacea Loader said the university was in constant discussion with Gaelejwe, the medical school leadership and the province's health MEC, Dr Benny Malakoane, and the head of department, Dr David Motau.

"We are optimistic that any outstanding problems will be resolved," said Loader.

Provincial health department spokesman Mvambi said: "Where people feel they want to resign, there's nothing you can do to prevent them. I can't speculate on why they are leaving."

Mvambi denied that patient care, teaching and research would be compromised because of the recent flood of resignations.

He said recruitment, which included headhunting, was taking place continuously to replace staff who left.

"We have people checking the outputs of the universities [medical school students].

"We keep records of people who apply for posts so that whenever there's any vacancy, we are aware of the possible available skills."

He could not say how long it took for his department to fill a post.

The department advertised several posts in February.

govenderp@sundaytimes.co.za