There are 791 patients on a waiting list of six to eight weeks for radiation treatment at public hospitals in KwaZulu-Natal.
This is in stark contrast to Gauteng where thousands of cancer patients are waiting for treatment at Gauteng’s two cancer-treatment hospitals, Charlotte Maxeke Johannesburg Academic Hospital and Steve Biko Academic Hospital in Tshwane. Some have been waiting more than a year for the life-saving care.
The Gauteng health department is now squaring up for a fight in the courts to compel it to provide critical cancer treatment.
Section27, a public interest law centre that advocates for access to healthcare services and basic education, together with Cancer Alliance and the Treatment Action Campaign, last month took the fight for better treatment of state cancer patients in Gauteng to the high court.
This is similar to a situation in KZN in 2017 when the provincial health department came under fire for failing patients across the province as a result of non-functioning machines which had led to a lack of service delivery and resulted in the death of hundreds of cancer sufferers.
At the time close to 100 patients were on a waiting list of at least eight months.
Seven years later the provincial health department said there are 827 radiation treatment slots available between the three facilities and each one is able to put 40 patients on radiation per day, with each patient undergoing radiation for up to six weeks.
Treatment is done at Greys hospital in Pietermaritzburg and Inkosi Albert Luthuli Central and Addington hospitals in Durban.
KwaZulu-Natal health department spokesperson Ntokozo Maphisa told TimesLIVE Premium the province has six fully-functional radiation machines, and the seventh one is at an advanced stage of commissioning.
“Significantly, the department is in the process of building a new oncology unit at Ngwelezana Hospital in the north of the province. A chemotherapy unit has already been opened at this hospital, with a full-time radiation oncologist already appointed.”
“It is worth pointing out the administration of cancer treatment is not instant, and that radiation may require some time to work up patients and prepare them for the commencement of the treatment,” he said.
Maphisa said the prevalence of cancer globally and in South Africa has increased in recent years.
“Concurrent with this increase has been a growing number of patients who require cancer treatment, both in the private and public sectors.”
Chief whip to the DA in the KZN legislature, Imran Keeka, told a different story in his response to the state of the province address last week.
“Waiting times, speciality dependent, are also worrying and even scandalous. In KwaZulu-Natal, it can take six weeks for fractures to be repaired, six months to see a cardiologist for heart problems and up to six years to see a urologist. Cancer patients have to wait between three weeks and several months before they are seen. Their cancers don’t wait,” he said.
The Cancer Association of South Africa (Cansa) head of advocacy Zodwa Sithole said the association was unaware of any current backlogs in KwaZulu-Natal, however, there were “occasional” patients who contacted the association to report long waiting periods.
“We then escalate the information with that oncology department to assist the patients.”
Sithole added that Cansa did not have the number of cancer patients receiving treatment at public healthcare facilities in the province.
“A new initiative was launched in 2023 to assist cancer patients at state facilities. Our Cansa information and support desk project at public hospitals is staffed by our trained volunteers who provide information to patients and help with referrals to Cansa support groups, tele-counselling and other services.”
“Currently we have an information and support desk at Inkosi Albert Luthuli Hospital in Durban plus another five in other provinces — Charlotte Maxeke in Johannesburg, Steve Biko in Tshwane, National Hospital in Bloemfontein, Frere Hospital in East London and Robert Sobukwe Hospital in Kimberley,” Sithole said.
In the Western Cape, Prof Jeannette Parkes, head of radiation oncology at the Groote Schuur Hospital and University of Cape Town, said there were “adequate facilities in our two state academic hospitals to treat all patients”.
“We have four radiotherapy machines at each academic hospital with brachytherapy facilities and multidisciplinary clinics. We have human resource shortages. We struggle with human resources — the retention of radiation oncology staff, medical physics staff and therapy radiographers, as well as anaesthetists and nurses.”
Parkes said there was no standard waiting time for patients to receive radiation treatment.
“This is different in every hospital and every province. Cancer management and radiotherapy provision in particular is a complex and expensive service. Adequate infrastructure, equipment and staffing depend on a complex interplay between national and provincial health departments.”
She said while health budgets were the responsibility of the provincial treasury, high-cost items such as radiotherapy machines are sometimes procured through national funding.
Other considerations include hospital procurement and supply chain support as well as the experience of senior clinicians and medical physicists, and human resource policies.
“Western Cape is fortunate in the support offered to the oncology department compared to the other provinces. It is also different for different disease clinics. Waiting times for staging radiology scans, and oncology surgery — also part of our multidisciplinary team metrics — have recently lengthened considerably and are a far greater risk for our cancer patients currently, than radiotherapy.”
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