Monday, November 09, 2009

The cost of affirmative action.

Fears over ‘appalling’ hospitals


FEARS are mounting over the “appalling” state of Nelson Mandela Bay’s public hospitals and the city’s critical shortage of doctors with the 2010 World Cup just months away.

And despite Eastern Cape Health MEC Phumlo Masualle’s promise to urgently initiate improvements at the city’s busy Livingstone Hospital after being “shocked” at its state during a recent surprise visit, reports of the continued absence of doctors on weekend duty at state hospitals have led to calls for immediate action.

The severity of the situation was acknowledged by the provincial Health Department, with a spokesman reacting angrily this week when told of a near tragedy during which a badly injured Port Elizabeth man was rushed from one public hospital to another without being attended to by a doctor and eventually had to undergo surgery at a private institution.

The Health Department has put the blame squarely on the shoulders of hospital management and doctors. Spokesman Sizwe Kupelo said the department was ready to prosecute and take action against people who were not doing their job properly.

Doctors say if anyone has blood on their hands, it is top management in Bhisho. One doctor who has worked at all three state hospitals in the city said the absence of doctors was “unacceptable” and that there should be two doctors at all times in a functional casualty unit.

The DA, which is investigating the state of provincial hospitals, allegations of “gross mismanagement” and hundreds of millions of rands worth of accounts carried over from last year, has warned of a potential hospital crisis during the World Cup.

“Can you imagine the damage to South Africa’s international reputation if a prominent person – or even a tourist – is in an accident and has to be rushed to the likes of Provincial or Livingstone hospitals during the World Cup?” said DA leader in the Legislature, Bobby Stevenson. “The appalling state of our hospitals would make world headlines.”

His outburst came after having to field complaints twice this month about there being no duty doctors in the casualty unit at Provincial Hospital. “The politicians, health MEC and top-brass must take full responsibility for what is happening in our hospitals,” Stevenson said, adding it was time to stop fobbing off blame onto doctors and nurses.

Masualle said he was “shocked” when he saw the chaos at Livingstone in a surprise visit three weeks ago. He saw hundreds of patients without beds lying on chairs and in the corridors of the packed casualty unit. He also pledged the situation would be rectified.

Doctors said Masualle would not have been shocked if he had taken the time to investigate the situation.

“(He) can’t come once in five years and say he is shocked – he wouldn’t be shocked if he knew what was actually happening in the health sector,” fumed one doctor, who declined to be named. “We have reached a stage in the public sector where things have become intolerable. There is major incompetence and failure to do the right thing at the provincial level.”

The issue was driven home last weekend when well-known Algoa FM deejay Charl Leslie experienced first-hand conditions at the city’s public hospitals.

Leslie’s brother, Neil, accidently sliced his arm open from wrist to elbow on a glass window on Saturday night. Neil, who is not on medical aid, was taken first to Provincial Hospital and when there was no casualty doctor on duty, to Livingstone, where 20 people were waiting to see a solitary junior doctor.

Leslie said he and Neil, who was bleeding profusely, had waited for 45 minutes without being attended to before they were advised to seek help elsewhere.

“My brother was going into shock at this stage: nauseous, shaky, pale. We rushed to PEGP at Greenacres where the doctor on duty said the injury required surgery.” Replies to Leslie’s on-line blog about the incident revealed further bedlam experienced by others: blood-covered blankets, corpses left in corridors, families resorting to do-it-yourself nursing, and bins overflowing with medical and other trash.

Kupelo was furious when he heard of Leslie’s incident, blaming hospital management and doctors. “These managers are supposed to manage – they are being paid more than R700000 a year to run these institutions. They have a responsibility to retain and attract the skills needed.”
He said the Eastern Cape had 600 doctors but needed more than 1000. “There is a severe shortage of health professionals – we are open about it. We love doctors and want them, but this isn’t just a provincial problem, it’s a global one.

“If managers are not recruiting and retaining doctors, then they are not doing their job. What it means is they are stealing from the government, because that is what they are paid to do. We are ready to prosecute and take action against these people.” He said four provincial managers had been suspended for negligence, alleged nepotism and abuse of government funds.

Kupelo said doctors were paid extra money every month in committed overtime, even if they did not do the overtime. “They are also stealing if they don’t go to work.”

Doctors, however, claimed they were “repeatedly ignored” and that Kupelo had “no idea” of what was happening on the ground.

To add insult to injury, Stevenson said, the Health Department was carrying over a colossal R700-million worth of accounts from the last financial year and was saddled with a crisis of hundreds of millions in back-payments to administration staff related to the 1994 merger of the Ciskei, Transkei and old Cape Province.

“They (Health Department) are not paying proper attention to filling the critical empty posts. Instead of focusing on their core business, they are busy servicing the back-payments,” Stevenson said.

Numerous attempts to obtain comment from hospital management were unsuccessful.

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