“The Gauteng health department is a poster child that is dysfunctional, and it should not be an independent department,” says Dr Aslam Dasoo of the Progressive Health Forum, an advocacy network of health workers, professionals, experts and activists.
Dasoo spoke to Health-e News after it emerged that Gauteng public hospitals recorded over 2000 cases of unintended harm to patients known as serious adverse events. These include prolonged hospital stay, death, birth defects and disability.
Recently Gauteng health MEC Nomantu Nkomo -Ralehoko revealed in a written reply to the DA’s questions in the legislature that 2273 cases of serious adverse events were recorded this year. In 2023 the department recorded 7117 cases.
According to Nkomo-Ralehoko Chris Hani Baragwanath Hospital recorded the highest number of serious adverse events (1169) and Tembisa Hospital the least (437).
She says the most common causes of these injuries were due to faulty medical equipment, healthcare associated infections, and patient accidents.
What leads to serious adverse events?
Dasoo says it’s clear that those in charge of the public healthcare facilities are responsible for the number of serious adverse events in Gauteng public healthcare facilities. He says there are two causes that could lead to this.
“It could be the fault of the health professionals themselves for neglecting their normal duties. In most instances it is the result of the lack of resources to attend to the patient. Public hospitals in Gauteng have a severe shortage of staff, one third of posts are unfilled. There were posts that were advertised which are now frozen. As a result you find three doctors dealing with 60 patients,” he says.
He says this leads to a burden on doctors who are struggling to cope.
“Recently Tom London put out a video about Helen Joseph Hospital. He was a patient, and I don’t blame him. Patients come to hospitals and look at doctors and nurses as their reference point. We know Helen Joseph Hospital has a huge shortage. Maybe even the doctor who served him was an intern or doing community service,” he says.
Dasoo says London felt that doctors were uncaring because he did not know that maybe they were coming from a 30 hour shift.
“The atrocious management of our facilities results in such damage to patients and they (management) blame everyone else. These serious adverse events are most likely the result of the poor system. There is a shortage of medical equipment, and unfortunately you can’t say to a sick patient they should wait for next week as the machine that will be used to test them has been sent for repairs,” he says.
Medico legal claims
DA’s Gauteng health spokesperson Jack Bloom says if nothing is done to solve the serious adverse events patients will continue to suffer and the department will be faced with the financial burden of medical negligence claims.
According to a presentation by the Special Investigating Unit (SIU) in parliament early last month, medico-legal claims against the Department of Health in all nine provinces grew by 10% between 2017/18 and 2022/23.
A recent report by the SIU shows that KwaZulu-Natal has the highest medico legal claims of R29 billion followed by Gauteng with R24 billion and Eastern Cape with R22.3 billion.
Gauteng accounted for the highest number of patient complaints brought before the Health Ombudsman in the 2022/23 financial year. Fifty-eight percent of the complaints were received from Gauteng. There were 1565 (11%) complaints from KwaZulu Natal and 1420 (10%) from the Western Cape.
Investigation and recommendations
Last week Nkomo-Ralehoko released a statement saying investigations into serious adverse events were conducted at affected hospitals last year, and recommendations were made in order to improve on patient care.
“The hospitals’ supervisors will conduct a regular clinical audit. There will be development of circulars to address identified gaps. Staff will be reallocated according to competency. We will strengthen handover between shifts. There will also be training reorientation of staff to close the skills gap,” Nkomo-Ralehoko says.
She adds last year 29 officials from 10 public hospitals were subjected to disciplinary action.
Nkomo-Ralehoko says the department has also launched awareness campaigns targeting hospital and district health services staff to promote vigilance in identifying clinical risks and ensuring prompt reporting and decision making.
“We are dedicated to implementing the recommendations from investigations to improve safety protocols across our facilities,” Nkomo-Ralehoko says.
But Dasoo maintains that leadership is the root cause of the problems, and the department is led by an MEC with no experience in the healthcare sector. – Health-e News
Source:
health-e.org.za
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