In another move HIV clinics are coming under increasing threat of being closed down as they are considered part of the outpatient services which are being stopped. The Treatment Action Campaign said it also continued to receive reports from doctors who are turning critically ill patients away from their clinics because of antiretroviral shortages.

‘€œA large number of people are going to die over Christmas. These cuts immediately translate into death, that is the open and shut of it,’€ said Dr Francois Venter, President of the HIV Clinicians Society.

‘€œPoor people will be the ones paying the price because we won’€™t commit the money to solve the problem,’€ he said.

In a terse statement released yesterday (Tuesday), the province said the cost containment measures would apply to all health facilities, including its 31 hospitals, clinics and administrative officers.

All patients, except those needing ‘€œhigh acuity care’€ will be discharged, all private patients will be directed to private hospitals, only emergency referrals will be accepted and staff will be given mandatory leave ‘€œin line with reduced service levels’€.

The province announced that it would also redeploy personnel within the institution, cancel all non essential meetings and stop all non-critical appointments.

The TAC confirmed that it was receiving complaints from Free State clinicians who were panicked about the closure of antiretroviral clinics and about drug stock-outs.

In a circular sent to Bongani Hospital staff in Welkom on Monday they are informed that all admissions would be limited to dire need only and that patients would be sent home with instructions to phone ‘€œto hear if a bed is available’€.

Specialist clinics would stop seeing new patients, outreach services are terminated (with the exception of oncology), no routine laboratory tests would be requested, no routine diagnostic radiology imaging, all outpatient services, including hypertension and diabetes services, are stopped with immediate effect and all cold surgery is stopped.

The Bongani Hospital CEO said in a circular that no new staff would be appointed until April 2009 and contract services such as security, gardening and service contracts could also be suspended.

TAC head of communication Rebecca Hodes said they were currently working together with the AIDS Law Project and the HIV Clinicians Society to ascertain the effects of the shortages.  

‘€œThere are many critical public health issues currently confronting South Africa, including Zimbabwe’s cholera epidemic and a national condom shortage. The Free State ART shortages and the dire cost curtailing measures which have just been introduced in provincial healthcare facilities are being overshadowed by these and other issues,’€ Hodes said.

She warned that their extremely harmful implications for the health of all provincial inhabitants must be addressed.

‘€œThe drastic curtailment of medical services is a sign of a severe lack of capacity within the Province’s health system, and its impacts on citizens will be widely felt. This is not purely a result of the scale-up of ART programmes, but of more entrenched, structural weaknesses besetting the Free State and South Africa’s health sector at large,’€ Hodes said.

 ‘€œAlthough these measures seem to be severe, there is a trend during the run-up period to the Christmas and holiday season that the attendance of patients at outpatient clinics for non-emergencies decreases,’€ the department said in the statement.

It said that the measures were put in place to ensure that service delivery was reduced in areas where patient numbers decreased. The department said the moves would also allow for the reallocation of resources to areas in facilities, such as the emergency care areas, where the need increased due to patient load over the festive season.

The province’€™s situation came to the fore earlier this month when the TAC released correspondence from provincial managers where they ordered HIV treatment facilities to cease putting new patients onto antiretrovirals due to a lack of funds.

The province has denied that the current situation has been caused by financial mismanagement stating that Treasury has not given it adequate funds.

However, Treasury has disputed that. In the meantime, in what many believe is a short term solution, health minister Barbara Hogan has appointed a task team to try and sort out the mess with R9,5-million immediately made available.