worse
Charlene Smith
In November last year, doctors and hospital superintendents in Gauteng presented a memorandum to the province, warning that ”patients will die” if staff and budgetary cutbacks at hospitals were not halted.
The memo read: ”We cannot in good conscience accept that financial constraints will mandate the collapse of health services in Gauteng. We are tired of being held responsible by patients … for dirty wards, long queues, no beds, unfriendly and inadequate services. It is time for those in power to stand up and be accountable for this crisis in public hospitals.”
The move by the staff of 18 Gauteng hospitals came after the Gauteng Department of Health said only 50 posts would be shared among all hospitals in the new year, for doctors, nurses and all other hospital staff. After media reports, the department increased the number of posts.
At the time, hospital superintendents warned that health services were heading toward ”irreversible collapse”. Almost nothing has happened to change that – if anything, the situation is deteriorating.
Provincial budgets delivered in Parliament this week showed that for health care all the provinces went into the red – yet at many government hospitalspatients wait days for treatment, there are dangerously few nurses and bedlinen and medicines are in short supply because of pilfering.
The national Department of Finance has in place a separate budget of conditional grants to help the 10 academic hospitals in South Africa to cope with patients who don’t pay, but even that is not adequate.
While some overspending has been a result of poor administration, a considerable amount has gone to feed agrowing salary budget.
This week Gauteng MEC for Finance Jabu Moleketi condemned the ”looting of bedlinen and medicines from hospitals” and low revenue collection. His answer to complaints from hospitals that the freezing of posts had seen administrations collapse was that better management could see debt collection improve.
Doctors claim there are too few health professionals, but the province says there are enough doctors. It admits it is short of about 1 000 nurses.
Four babies at Chris Hani Baragwanath recently died of klebsiella, which results from poorly cleaned hospitals. Only four nurses were on duty to care for 35 babies in intensive care. The minimum ratio should be one nurse for every two babies.
Construction ended last year for a R40- million theatre block and maternity, paediatrics and casualty wards at Edenvale hospital, but it can’t be opened because there is no staff.
Most hospitals share staff like anaesthetists and radiographers – or they outsource and, on average, pay as much per month for an outsourced post as they would in a year for a full-time staffer.
Johannesburg hospital should be run with eight superintendents, but only two are left. In rural areas as few as three doctors (usually foreigners) cope with hospitals with 100 beds and more. Doctors complain there appears to be no strategic planning in health departments.
Said one tired medic: ”Not enough politicians seem to have any awareness of what actually happens here.”