/ 12 May 2009

Cape of medical storms

An influx of patients from other regions is putting the Western Cape health system under intolerable strain — and reducing one of Cape Town’s major hospitals to ”a crisis waiting to happen”, doctors warn.

The Red Cross War Memorial Children’s Hospital has seen a 40% increase in patients over the past four years and a 25% increase in 2008 alone, according to Anthony Westwood, a senior specialist at the hospital’s emergency unit and coordinating clinician for Western Cape child health services.

Westwood said the explosion in patients is not being met with an expansion of medical staff doctors, who are ”battling to cope”.

”The problem is bigger than the Red Cross,” said Thomas Blake, a senior superintendent at the hospital. ”It’s related to social conditions, to the influx of patients coming into the Western Cape.”

Dudley Horner, former deputy director of the South African Labour and Development Research Unit (Saldru) at the University of Cape Town, confirmed the ”huge influx of people [into the province]”. Cape Town’s population had tripled in 30 years.

This had placed enormous pressure on all systems, including health, Horner said.

Saldru researchers have found that most migrants came to Cape Town from the poverty-stricken Eastern Cape in search of work.

Westwood said a significant proportion of new patients at the Red Cross hospital come from outside the province and the numbers of children needing hospital care were well beyond the hospital’s capacity.

The Red Cross and other Western Cape public hospitals have increased the number of doctors and beds available, but services are ”nowhere near adequate”.

Patients are waiting up to 12 hours for care, when previously the norm was between four and six hours. ”Even emergencies are having to wait. We’ve even had to turn ambulances away,” Westwood said.

The Red Cross is intended as a tertiary referral hospital, where patients gain access to specialised services only after receiving primary care elsewhere.

However, Westwood said he has the impression that ”peripheral services are inadequate and that the patient overload is a symptom of overload in other areas”.

”If other hospitals and clinics were up to speed, it would help to take some of the burden off us.” Blake agreed, saying ”we need to beef up our primary care institutions”.

Red Cross treats more than 250 000 patient a year from across South Africa and the continent.

The Western Cape government is planning to build new hospitals in Khayelitsha and Mitchell’s Plain to alleviate the burden on the Red Cross and other Western Cape facilities.

But Westwood said the Khayelitsha facility will only open in 2011, and, because of funding constraints, the Mitchell’s Plain hospital would not be operational before 2012.