Doctors warn that Johannesburg hospital is terminally SICK!

Doctors at Charlotte Maxeke Johannesburg Academic Hospital - one of South Africa's foremost public health institutions - are being forced to risk patients' lives.

A shocking picture of a major public hospital falling apart emerges from letters written by 12 of its heads of department earlier this month.

The letters and other documents in The Times's possession tell horror stories of doctors forced to play God and decide which patients are resuscitated and which patients needing trauma surgery are turned away. They tell of pregnant mothers forced to wait three to four months before having ultrasound scans that might detect foetal abnormalities.

The situation is so dire that doctors are unable to control the amount of blood pumped into patients undergoing heart bypass surgery because of a shortage of blood transfusions bags.

In some cases, including emergency heart surgery, doctors have to compromise patients' safety because they do not have the equipment required. An example is heart surgeons having to use camp lights because theatre lights are broken.

"I now use a camping headlight for paediatric cardiac surgery. God forbid I am spotted by the media conspicuous in the hospital today," writes a heart surgeon.

"Apparently the administrators are accusing us of not performing our duties as consultants, but they do not provide us with adequate theatre equipment and consumables." Added to a chronic shortage of life-saving equipment are exhausted and overburdened nurses and other medical staff, who, at times, are forced to rush between critically ill patients.

In one letter, a paediatrician says that if vacant posts are not filled as a matter of urgency, "further major outbreaks of infection in our neonatal unit are inevitable". This is in reference to a norovirus outbreak that killed babies two years ago.

Most letters show that the Gauteng health department had been made aware that the situation was spiralling out of control, but had failed to act.

Desperate doctors stress that, without urgent intervention, patients' safety and health will be severely compromised.

"Nurses are unable to follow proper nursing care procedures due to shortages of nurses per shift, resulting in the cutting corners, sub-optimal care being given to patients and poor record keeping," wrote nursing manager MM Pule.

Though poor supply-chain management at provincial level and non-payment of suppliers are blamed for the shortage or non-availability of equipment, many of the difficulties can be attributed to a moratorium on hiring staff.

Charlotte Maxeke CEO Barney Selebano explained the many vacant positions in a presentation to staff. He said he had been told by the health department that the department had overspent in previous years and needed to cut costs.

Charlotte Maxeke was given a budget of only R1.7-billion for the 2012/2013 financial year, even though it spent R2-billion in 2011.

Selebano has been prevented from filling posts without the approval of the Gauteng health department head.

The hospital requested 30 doctors, 19 specialists, five heads of units and 40 registrars. But the presentation shows only 25 registrar posts were approved.

In sheer desperation, the 12 heads of department at the hospital wrote letters to the head of the Gauteng health department, Dr Nomonde Xundu, in July. She has failed to respond to them, according to a doctor at the hospital.

Xundu was invited to meet five of the senior heads at the hospital on July 27 but cancelled.

More than 153 nurses have resigned since the beginning of the year, many citing "unconducive working conditions [sic]".

Professor Kenneth Boffard, head of surgery, warns: "There is a dramatic restriction in services, including cancer and antenatal services. Delay in treatment could be fatal."

Boffard added that it appeared as though the government was saying: "You have the right to basic healthcare, you don't have the right to advanced healthcare. For that you must pay."