In a hard-hitting report released today (MON) SECTION27 reveals that the province has experienced a debilitating range of operational difficulties, especially in 2012, which has directly resulted in increasing morbidity, disability, stillbirth and death.

The hard-hitting 31-page report paints a grim picture where the dignity and health of state patients in Gauteng’€™s 33 hospitals and clinics is compromised on a daily basis with services deteriorating in both hospitals and clinics.

Released on the eve of the delivery of the Gauteng budget speech, Monitoring Our Health. An analysis of the breakdown of health care services in selected Gauteng facilities states, details the systematic semi-collapse of the provincial health system, marked by shortages of medicines, collapsing infrastructure, broken equipment and inadequate staff.

‘€œSubsequent official investigations and inquiries have found clear deficiencies in both the systems and operations in hospitals and clinics run by the Gauteng Department of Health. Instead (of acting), the focus has been on putting out fires and the crisis has been addressed on piecemeal basis,’€ the report says.

SECTION27 director Mark Heywood said it was critical to hold the politicians and government accountable, describing the system as a ‘€œnest of snakes where nobody can hold nobody accountable’€.

The report lists a number of health system failures, among others:

–               Paediatricians have reported cases of children with diseases they should have been immunized against.

–               Tertiary hospitals are reporting that they are increasingly unable to offer specialized care as a result of not having the medicines they require.

–               Broken equipment has had a significant impact on medical interventions that are equipment dependent such as anaesthetics, radiology and oncology.

–               A lack of wheelchairs, stretchers and beds is common in many Gauteng hospitals.

–               Power outages at Chris Hani Baragwanath have led to instances where surgeons operated using headlights and cellphone lights.

–               At Charlotte Maxeke the delays in appointing critical staff caused the cancellation of between 20 and 25% of surgeries due to a shortage of anaethetists. At another regional hospital surgeries were reduced from six a week to four.

–               Newborn babies died or were left disabled at Chris Hani Baragwanath hospital as the understaffed maternity unit struggled to cope.

SECTION27 director Mark Heywood accused the Gauteng health department and government of aiding and abetting a ‘€œculture of impunity’€ when it came to taking responsibility for the failure of the health system.

‘€œNobody is ever held accountable and people (heads of department and MECs) are shuffled in and out of their positions without any question asked or consequences,’€ Heywood, adding that the only ones who faced the consequences were the patients and those working in the institutions.

‘€œAt the hard end, the health system abuses these people and those who suffer are forgotten.’€

Heywood added that the critical mechanism of accountability was missing and that there needed to be a big push to establish co-governance structures that added these accountability elements.

He said SECTION27 is also discussing whether senior health officials in the government can be held individually liable for incidents of negligence that occur leading to death and disability of patients. ‘€œWe ought to be able to follow the chain of responsibility and hold officials with statutory responsibility personally liable for the cost of damages and disability suffered. Instead responsible officials are cushioned by a system that fails taxpayers twice: first they contribute for health services that are mismanaged and when patients take legal action they pay again as the government forks out money in legal fees, damages and settlements,’€ he said.

SECTION27 cautions that unless the documented failures are addressed, National Health Insurance (NHI) and the transformation of the health system are set to fail.

‘€œAcute crises in these facilities, left unaddressed are likely to render ineffective any regulatory reforms aimed at improving care and have the potential to undermine the NHI reforms,’€ the report states.

In a veiled threat at possible legal action, SECTION27 states that the ‘€œgross disregard’€ for the legal obligations of the Gauteng health department and the vital oversight function of the National health department ‘€œis extremely worrying and cannot be allowed to continue unchallenged.

SECTION27 also claims that there is evidence of corruption with the health department making several multiyear commitments and expenditure decisions that were corrupt and were not directly related to the delivery of healthcare services.  – Health-e News Service

Critical meds not in stock

The following medicines were unavailable in hospitals in Gauteng at different points in 2012:

Paracetamol: A basic painkiller (analgesic)

Aspirin: A basic analgesic

Ibuprufen: A basic analgesic

Morphine: Narcotic painreliever

Augmentin: A basic antibiotic

Ceftriaxone: An important antibiotic used for meningitis

Nitrocine: An important vasodilator used in patients with cardiac emergencies

Metformin: A basic oral agent for Diabetes

Insulin: Critical medication for Diabetes

Salmeterol: An important bronchodilator for Asthmatics

Furosemide: A basic and critical diuretic for cardiac patients

Phenytoin: A basic anti-epileptic medication

Warfarin: a basic oral anti-coagulant

Related stories:

Gauteng: Patient’€™s five weeks of hell and death

Gauteng: Core areas of service collapse

Gauteng: Causes of the crisis

Gauteng: Helen Joseph and Leratong a disaster

Gauteng: ‘€˜A dream gone wrong’€™