Eight alarm bells at South African state hospitals
Public hospitals have become a death-trap for the poor‚ says Refiloe Nt’sekhe of the Democratic Alliance.
The party has produced this checklist of the top eight problems that it says require urgent intervention‚ following inspection visits to hospitals and clinics over the past month by DA provincial health spokespersons Jack Bloom MPL (Gauteng)‚ Dr Imran Keeka MPL (KwaZulu-Natal)‚ Dr Tutu Faleni MPL (North West) and Langa Bodlani MPL (Limpopo).
Here is a summary of their report:
1. Chronic staff shortages and long waiting times
All the facilities lacked staff in critical positions.
At the Bongani Hospital in the Free State‚ they found that the facility only had one nephrology Sister to attend to patients suffering from kidney diseases. This was despite health norms and standards indicating that hospitals should have nine.
While inspecting the Paediatric Ward in Taung District Hospital in North West‚ the DA found that there was no qualified resident paediatrician to treat children and that the ward is severely understaffed‚ including nurses‚ cleaning staff and cooks.
Tembisa Hospital in Gauteng only has 40% of the nurses that are required‚ they found. According to international norms and standards‚ the hospital should have at least 628 more nurses to provide proper health services to patients.
The Soweto-on-Sea Clinic in Port Elizabeth is only visited once a week for four hours by a doctor while the clinic services 3‚000 patients per month. This was mirrored in the visit to KwaZulu-Natal’s St Mary’s and RK Khan Hospitals‚ where KZN’s Health Department has vacancies of 5‚926 critical staff.
2. Equipment shortages
At the RK Khan Hospital in KZN‚ the DA found that the X-ray department still has no defibrillator despite MEC Sibongiseni Dhlomo being alerted in 2014 that it was broken.
At Bongani Hospital in the Free State‚ the hospital has nine theatres but only three are operational due to ineffective equipment. The renal plant has not been operational since its inception.
3. Oncology crisis
There is not a single radiation oncologist in Limpopo or Mpumalanga.
At the RK Khan Hospital in KZN‚ waiting times for CT scans are as long as three months while the next available mammogram appointment is in 2019.
4. Shortages of consumables and medicine
While inspecting various hospitals in Nelspruit and Barberton in Mpumalanga‚ Emergency Medical Care personnel told the DA that they have resorted to buying vital medical equipment such as high blood pressure machines out of their own pockets due to the department failing to provide such equipment.
In the Northern Cape at the Kimberly Hospital‚ there are shortages of basic supplies such as toilet paper.
For the past two months at Maphutha Malatji Hospital in Limpopo‚ the pharmacy has not had an iron supplement drug‚ a vital medicine for pregnant women and HIV patients as well as Panado Syrup - a painkiller for children.
At St Mary’s Hospital in KZN‚ doctors and nurses complained of shortages of simple and everyday disposables such as syringes‚ needles and "jelcos" which are used for intravenous access to set up drips.
5. Negligence and claims
Medical negligence claims have led to large payouts which have put a strain on the health budget. Last year‚ the Gauteng Health Department had R18.6-billion in negligence claims‚ Eastern Cape had R16.7-billion and KZN had over R9.2-billion.
6. Transport and ambulance related issues
In a Mpumalanga hospital‚ only two out of four ambulances were operational. The other two had mechanical problems. “Many of the ambulances had travelled more than 400‚000 kilometres and posed a risk to patients and medical personnel‚” the inspection team said.
7. Infrastructure/Lack of Maintenance
The Department’s Annual Report shows that out of the 44 community health centres which were to be constructed and revitalised‚ only 22 were completed‚ the DA said.
Out of the eight hospitals that were supposed to be constructed or revitalised‚ only three were completed.
“No maintenance has taken place at the Bongani Hospital since it was built 20 years ago. Shockingly at our visit to the Schoemansdal Clinic in Mpumalanga‚ the toilets haven't been working for a very long time causing embarrassment to both patients and staff. The pit toilet which is currently being used leaves an unbearable stench which is aggravated by rain.”
8. Mental health crisis
“Following the Life Esidemeni tragedy in Gauteng‚ government is yet again failing to stop future mental health tragedies in South Africa‚” the politicians asserted.
At Tembisa Hospital‚ psychiatric patients are kept for long periods of time as there are not enough beds for them at Weskoppies Mental Hospital - they should only be at Tembisa Hospital for 72-hour observation before they are discharged or sent to a longer-term facility.
While at Life Esidimeni in Limpopo; rather than increasing their budget to assist with the maintenance of the facility‚ a decision has been made to halt the funding of the non-profit and for the Limpopo Department of Social Development (DSD) to take over the management and functions of the centre.
Given the bad track record of the DSD in Limpopo‚ its financial constraints and record of mismanagement‚ every effort must be made to ensure that the mental health centre in Shiluvana remains in the hands of Life Esidimeni.
“The findings from our #HospitalHealthCheck oversight inspection campaign makes it clear that all is not well in our public health sector. Although there are financial constraints facing the Department‚ it is evident that at the heart of our failing health system is maladministration (and) poor oversight‚” said Nt’sekhe.
The party offered to assist national government tackle these issues.