Count the ways SA state hospitals are 'badly managed'
Babies are not safe from kidnappers due to a lack of security outside maternity wards.
Adult patients face risks including a lack of oxygen and adrenalin on emergency trolleys that are needed for life-threatening situations. Supplies not being ordered timeously‚ poor infection controls as well as inadequacies in cleanliness and medical waste disposal are also revealed by inspections of 485 state clinics and hospitals by the Office of Health Standards Compliance.
Johann Serfontein‚ from the privately owned healthcare consultancy Healthman‚ explained the results show: “The health system is failing. It is management problem and you can’t fix management with money.”
This is despite the fact the health budget has climbed by over R100 billion in ten years from R71.4 billion in 2007/08 to R181 billion in this financial year.
- None of SA’s largest hospitals scored above 70% for basic hospital cleanliness. Charlotte Maxeke Johannesburg Academic Hospital was dusty‚ short of cleaning materials and had cockroaches in the medicine store room. Nelson Mandela Academic Hospital in Port Elizabeth didn’t have disposable sponges and liquid soap. At Pelanomi Hospital in Bloemfontein‚ the toilets were dirty and smelt bad and the hospital was also short of cleaning supplies. The storeroom at Durban’s King Edward Hospital was dirty and badly packed.
- No security in many hospitals’ high risk wards such as maternity wards‚ neonatal units and ICUs.
- At Charlotte Maxeke‚ there was no paper for the ECG machine used to measure heart problems meaning basic heart tests could not be done. Nelson Mandela Academic Hospital didn’t have essential equipment used to help women in labour.
- Frere Tertiary Hospital in the Eastern Cape scored only 42.4% for infection control even though a pass is 80%. This means a patient could get a bacterial infection in hospital while being treated for another illness. At Pelanomi Hospital‚ there was a lack of isolation facilities for infectious TB patients.
In many cases there was a lack of paperwork done by doctors and management even in high risk cases such a pregnant mother with complications who may have difficulty in labour. This means the Department of Health facilities are opening themselves up for lawsuits when the department is already facing R48-billion in medico legal claims – a third of the annual budget.
Werksmans lawyer Neil Kirby said: “The lack of proper paperwork‚ in all cases‚ makes it very easy for a plaintiff to succeed in either winning a medical negligence case against the State or obtaining a monetary settlement.”
Fixing the issues raised by the audits can be complicated‚ said Dr Grace Labadarious from the Office of Health Standards Compliance. Some of infrastructure problems must be fixed by different government departments.
The issues raised in the audit “almost universally relate to management issues and supply chain problems – no accountability and no responsibility. It is what demoralizes people‚” commented Dr Mark Sonderup of the South African Medical Association.
Democratic Nursing Organisation of South Africa spokesman Sibongiseni Delihlazo said: “As a result of these compounding problems‚ nurses see leaving as the only escape.”
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