Several public hospitals in Gauteng have postponed elective surgeries, some for as long as four and a half months. Sources have confirmed to Health-e News that Charlotte Maxeke Johannesburg Academic and Helen Joseph Hospitals have postponed elective surgeries. The procedures are expected to resume in April 2025. At Chris Hani Baragwanath Hospital (Bara) a source confirmed that new bookings for elective surgeries have been pushed to June.
Elective or non-emergency surgeries, while not life-threatening, are crucial to a patient’s quality of life and include procedures like orthopaedic surgery and knee and hip replacements.
This hold on surgeries will only exacerbate the province’s backlog which was estimated to be around 38 000 last year. The Gauteng Health Department was unable to provide the number of patients currently awaiting surgery. But Gauteng DA’s health spokesperson Jack Bloom says the surgical backlog could be around 30 000.
One of the patients affected is 77-year-old Merrill Joubert who has been waiting for a hip replacement for a week at Charlotte Maxeke Hospital. Speaking to Health-e News, Merrill’s daughter Charmaine says on 25 January her mother was told there were no replacement parts.
“She was admitted to the hospital on 26 December for a stomach operation. While she was recovering at the hospital, she slipped and fell from her bed breaking her hip in the process. She was immediately rushed to the theatre,” says Charmaine. “She was already inside the theatre when she was told there were no replacement parts and there would be none until the new budget. They said the government has not paid the suppliers for the replacement parts so she has to lie in bed and wait.”
Merill is still in the hospital waiting for a hip replacement.
The government’s financial year runs from 1 April to 31 March.
A doctor at Chris Hani Baragwanath Hospital, who requested anonymity because he is not allowed to speak to the media, says while elective surgeries are still being performed, the waiting list has grown substantially.
“The queues are very long, and we are now booking patients for theatre in June,” he says.
Gauteng Treatment Action Campaign (TAC) says their members have confirmed that elective surgery was postponed in some hospitals.
Gauteng health spokesperson Motalatale Modiba says there are numerous reasons for postponing elective surgeries, and these vary across Gauteng hospitals. Charlotte Maxeke is facing a shortage of orthopaedic implants due to supply delays.
He says at Helen Joseph Hospital elective surgeries are postponed because there is not enough ICU beds for post-operation recovery. He adds that emergency cases may displace an elective case if competing for the same theatre or the surgeon.
Prolonged wait for elective surgeries
Dr Phuti Ratshabedi, South African Medical Association Trade Union (SAMATU) Gauteng chairperson tells Health-e News that the impact of the elective surgery backlogs is serious. It can lead to prolonged pain and discomfort for patients, severely affecting their quality of life.
“The challenge with these delays is that a patient’s condition can worsen while waiting for surgery. For example, what may start as a precancerous condition could progress into full-blown cancer,” he says.
“It can cause anxiety and stress as uncertainty about their health persists. In some cases, this delay could impact patients’ ability to work or perform daily activities. It may also increase the risk of infections or complications related to pain management and even lead to emergencies if conditions deteriorate significantly,” he says.
This is Charmaine’s biggest concern as her mother, Merrill, had a stomach operation in December.
“The cut on her operation is gaping open and has pus all the time and now with a broken hip, she is starting to have bed sores. I am worried that the wound from the first operation is infected and it is ignored,” she says.
Ratshabedi warns that the long-term risks of delaying elective surgery include chronic pain, loss of function, or permanent disability if conditions aren’t treated timely. There could be an increased need for more intensive healthcare services down the line, which might have been avoidable with prompt surgical intervention.
He adds that postponements contribute to a growing backlog as surgeries are rescheduled, adding strain to an already stressed system. This, Ratshabedi says, could lead to even longer waiting lists and delays for new patients requiring surgical consultations, thereby extending overall patient wait times.
Gauteng’s Health financial woes
Ratshebedi says the decision to postpone elective surgery likely stems from resource constraints, including bed shortages, staff shortages, or prioritisation of emergency cases. Financial constraints or a recent surge in emergency cases might also be factors.
Gauteng’s health department often struggles with insufficient funding as the provincial budget allocated to healthcare frequently falls short of meeting the growing demand for services.
In August 2024 the department was summoned to the legislature for failing to pay R1 billion owed to suppliers.
Bloom says the budget woes are due to abysmal management and massive corruption.
The Auditor-General’s report for the 2023/24 financial year highlighted that the department had underspent its R590 million allocation for the National Tertiary Service Grant, which was intended for specialised medical treatment.
“According to budget projections, they will run out of money in about six weeks as they will be short of R4.8 billion by the end of the financial year on 31 March 2025,” Bloom says.
According to Bloom this is the current situation in some of Gauteng hospitals.
- Two theatre lists a week are being cancelled at the Chris Hani Baragwanath Hospital because half the posts for anaesthetists are empty.
- Unpaid companies have stopped supplying critical items needed for surgery at the Charlotte Maxeke.
- The orthopaedic clinic at the Helen Joseph has postponed all elective surgeries until the new financial year, so hip and knee operations will be further delayed.
Modiba says the provincial health department is engaging medical companies to fast-track the supply of orthopaedic implants.
When asked how many patients were affected by the surgical backlog, Modiba says at Helen Joseph Hospital the number fluctuates as ICU beds are given to emergency cases where necessary, affecting the performance of elective surgeries.
“At Charlotte Maxeke Hospital the postponement of elective surgeries affected a number of patients for arthroplasty, tumour and sepsis, shoulder, spine, foot and ankle. As soon as the issue of supply delays is resolved, the hospital will be able to activate the catch-up plan to ensure that all postponed surgeries are covered as soon as possible. Helen Joseph Hospital is working on increasing ICU beds and staff,” Modiba says. – Health-e News
Source:
health-e.org.za
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