EDITORIAL | Health department playing Grim Reaper in 'state-sanctioned' cancer deaths

While the battle between GNU coalition partners the ANC and the DA over the national health insurance (NHI) continues, our broken healthcare system continues to fail South Africans.

The bill signed into law by President Cyril Ramaphosa in May, which aims to provide universal access to quality healthcare for all South Africans, is still aeons away from staving off unnecessary cancer mortalities or to save thousands of cancer patients waiting for radiation 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.

For the second time in two years, the Gauteng health department is fighting a legal bid to compel it to provide critical treatment that for many patients is their last chance for survival. 

Early last year a court application by the Cancer Alliance resulted in Gauteng health receiving R250m from the provincial Treasury for urgent cancer care.

In April, the health department said R534m was to be invested in equipment and R250m in outsourcing radiation for one year.

But the department’s failed and empty promises fly in the face of its own guidelines which advocate radiotherapy for breast cancer must be done within 60 days of surgery, and no later than 90 days after it. Instead its response contributes to cancerous cells metastasising to the point of no return.

Figures released by the Gauteng health department reveal there are now 2,637 patients on the waiting list: 1,440 prostate cancer patients and 848 with other cancers waiting for treatment at Charlotte Maxeke, and a further 189 patients waiting for scanning and 166 waiting for planning at Steve Biko.

In the Western Cape, patients are generally accommodated for a mark-up scan within 1-4 weeks, depending on the urgency of the case. From the time of planning the scan, patients started receiving treatment an average of four weeks later.

In KwaZulu-Natal there are 791 patients on a waiting list of six to eight weeks for radiation treatment at public hospitals, according to the provincial health department.

But this wasn’t always the case.

In June 2017 the South African Human Rights Commission issued a 68-page report which found the KwaZulu-Natal health department, under the leadership of then health MEC Sibongiseni Dhlomo, had failed its cancer patients‚ that it posed a serious threat to their lives and was denying them their right to life and human dignity.

The report revealed black South Africans experience greater barriers than whites as 70% of cancer specialists in the public sector are white and often not understood by their patients due to language barriers

Cancer treatment in the province’s public system was a mess — oncology specialists and other medical staff had left in droves, there were no oncology machines (or they did not work) in most hospitals. Patients waited for about five months before seeing an oncologist and about eight months for radiotherapy.

A year later, the SAHRC said it would “compel” Dhlomo to appear before it to answer questions about the “oncology crisis” in the province.

This is tragically similar to the situation playing out in Gauteng.

Cancer is a growing public health burden in South Africa, with cases projected to rise from about 62,000 in 2019 to 121,000 in 2030.

A report by the Union for International Cancer Control warned public sector patients are not only diagnosed late, often resulting in treatment failure, poor quality of life, and death, but prejudiced by factors such as gender and education levels when accessing cancer treatment. 

The report revealed black South Africans experience greater barriers than whites as 70% of cancer specialists in the public sector are white and often not understood by their patients due to language barriers. 

As Ann Steyn, president of Reach for Recovery International — an umbrella body for cancer organisations — summed it up, the “healthcare system in the country shows significant disparities, despite a progressive constitution that recognises human rights”. 

But as cancer patient Thato Moncho, who was among thousands on the Gauteng waiting list and who has now been removed from it because her cancer has progressed too far for radiation to be effective, bluntly put it, this “is basically state-sanctioned murder”.

The health department’s arguments to the contrary are cold comfort to the loved ones of cancer patients who died before they could be treated, and arrogance in defending the ongoing legal action can been likened to the Grim Reaper.

While the disease burden statistics are terrifying, there are ways to close the cancer care gap, including implementing routine screening for common cancers to ensure timely treatment, or by using mobile units to provide access to those in remote areas.

This cruel repeat of history is a waste of money, but more importantly it is an unforgivable waste of life. The department of health cannot be allowed to continue playing the role of the Grim Reaper.