Sunday, October 04, 2009

Health crisis takes hold in South Africa

It continues to tumble down and like Humpty Dumpty there's no putting it back together again. How did we go from having some of the best public healthcare in the world with the finest doctors and surgeons to this? All I can say is when the poo meets the fan, when the private sector implodes due to the ANC's latest "fuck-it-up-cuz-it-ain't broken-yet" NHI exercise, I hope you have money at the ready to seek medical attention elsewhere. By elsewhere, I mean outside the country where the South African doctors have gone. The country has become a joke. Still it needs to totally break for hard lessons to be learnt.


The dire situation means that the last patient on the waiting list of 1600 people needing orthopaedic surgery at Cape Town's Tygerberg Hospital may only end up on the operating table in 2019..

..the government was warned about the crisis in 2005 but very little had been done to address the problem.

Surgical services at South African state hospitals are in crisis due to a dire shortage of anaesthetists and general surgeons.

And experts are warning that the introduction of the planned National Health Insurance (NHI) scheme could also see the private health sector affected.

The dwindling number of skilled medical professionals is causing massive backlogs, with long waiting lists for eye, hip, knee and cardiac operations.

The South African Society of Anaesthesiologists (Sasa) said there were a mere 800 anaesthetists in the country.

Since the beginning of last year, more than 110 specialist anaesthesiologists had left South Africa - 40 in just one month.
According to Sasa, South Africa has only 450 general surgeons.

The dire situation means that the last patient on the waiting list of 1600 people needing orthopaedic surgery at Cape Town's Tygerberg Hospital may only end up on the operating table in 2019 - unless his condition deteriorates and he requires emergency surgery.

A senior hospital official said the waiting list was the result of a combination of factors, including a lack of specialists and their assistants, limited budgets for implants, limited theatre time and limited beds.

"The implication is that people could wait up to 10 years for operations," said the official.

KwaZulu-Natal is the only province which claims to have no waiting period for surgery.

Information provided by other provinces indicates that some hospitals have cut down on operating time by as much as 50%, while others have stopped elective surgery completely. Figures provided indicate that:
  • Patients in the Western Cape may wait between two and three years for hernia surgery;
  • Patients of Tygerberg Hospital may wait up to two years for neurosurgery;
  • Patients in North West may wait four years for joint replacement; and
  • Eastern Cape patients stand to wait for between three and six months for cardiac surgery.
Dr Pieter Bettings, vice-president of Sasa, said that on average the country's anaesthetists work 12-hour shifts at between 1500 to 2000 operations per year. He warned that if there was no intervention to beef up numbers, there would be an increase in less experienced medical staff administering anaesthetics.

Professor Mike James, head of anaesthesiology at Groote Schuur Hospital and the University of Cape Town, attributed the shortage of anaesthetists to limited government funding and international demand for South Africa's specialists.

"Those in the public sector leave because of appalling salaries. Those in the private sector leave mainly because of crime," he said.

South Africa is way behind the international norm of one specialist to every 5000 people. The shortage, James said, resulted in about 50% of all surgical anaesthetics being administered by general practitioners. "That is scary stuff," he said.

To specialise in anaesthesia takes a minimum of 14 years - nine years for a medical degree and another four to specialise.

Professor Martin Veller, chairman of the Association of Surgeons in SA (Assa) and head of the department of surgery at the University of the Witwatersrand, said that only 40% of South Africa's surgeons worked in state hospitals.

He said at least 1000 general surgeons were needed to cope with the existing workload.

Tertiary institutions need to be training a minimum of 120 surgeons a year, he said - but only 30 general surgeons were being produced annually.

Veller said the government was warned about the crisis in 2005 but very little had been done to address the problem. In 2005, an Assa study of the remuneration and working conditions of general surgeons was presented to the national Department of Health. It warned of a total collapse of surgical services in the public sector if the issues were not addressed.

Department of Health spokesman Fidel Hadebe said the government had come up with a 10-point plan to overhaul the health system, which included improving working conditions and pay for medical practitioners. He said the plan included the introduction of the NHI as a way of improving human resources.

But Bettings said the medical profession remained uncertain about the viability of the NHI. He said its introduction might result in more doctors emigrating, exacerbating an already dire situation. - The Times

4 Opinion(s):

Anonymous said...

"The implication is that people could wait up to 10 years for operations," said the official."

Doesn't this sound like something out of soviet Russia?
Queues, queues and more queues!

Exzanian said...

Crisis, what crisis?
No, no, Gwede Mantashe, our beloved comrade will guide you all through these rapids and into a new shining dawn....Viva!

Loggi said...

But whoopee, we have billions to spend on new soccer stadiums.

Vanilla Ice said...

Reminds me of the joke:

What nursery rhyme do blondes remember most?

Hump me, dump me.