Times of scarcity in the North West
It was a hard, cold winter in the North West where hospitals reported everything from pillows to hot water was in short supply. The province’s financial crisis has left some patients out in the cold as moratoriums on everything from hospital maintenance to new appointments stretch the health system thin.
In June, Maritha Coetzee got the call every parent dreads – her son had been involved in a terrible motorcycle accident and was in hospital. Her first thought was to race to his side.
Her second thought was to pack the pillows and blankets.
Heading to the hospital, Coetzee knew better than most about the Klerksdorp/Tshepong Hospital Complex’s shortages of not only blankets and pillows, but also hot water as temperatures dipped into below zero in June.
She also knew that the hospital had also been forced to send its laundry about 50km away Potchefstroom’s Witrand Hospital for washing because Coetzee is not only a mother but also a hospital board member and the local Democratic Alliance ward councillor.
At the time, Klerksdorp / Tshepong Hospital Complex Spokesperson Nico Masiu confirmed that the hospital was procuring a new boiler to address hot water shortages, but disputed claims that the hospital only had one working boiler and that the facility was running short of linen. North West Health MEC Dr Magome Masike condemned the lack of hot water for patients and said he had requested funds to address hospital issues from the National Department of Health and provincial treasury.
According to Coetzee, the Klerksdorp / Tshepong hospital and others in the province had budgets slashed as the North West Department of Health tried to extricate itself from the R600 million deficit with which it entered this financial year.
“The hospital has not received its full budget because the Department of Health in the North West province is under financial administration,” Coetzee told Health-e News. “(The department) has a budget deficit of half a billion rand.”
In April, the provincial Treasury placed the North West departments of health, public works and education under administration, allowing treasury to take over the day-to-day financial management of the departments for 18 months. According to the Rural Health Advocacy Project (RHAP), Treasury’s decision was prompted by departments’ inability to effectively manage budgets and pay creditors, which resulted in massive unpaid debt.
According to North West MEC for Finance, Economy and Enterprise Development MEC Wendy Nelson, the department had R750.7 million in accruals for the 2014/15 financial year and an overdrawn account of R216 million.
The North West Department of Health is the third provincial department of health to be placed under financial administration in the last five years.
Coetzee has alleged overspending on salaries and medical misconduct claims against the health department have exacerbated the financial crisis, which resulted in a moratorium on routine maintenance, new medical equipment and staff appointments.
“The freezing of posts in the North West province has had a huge impact on service delivery, especially under served rural facilities,” said RHAP Programme Manager Daygen Eagar. “If you can’t fill a post, that means there are fewer doctors and fewer nurses to provide services for patients.”
RHAP is expected to hold a roundtable discussion on the consequences of hiring freezes in provinces like the North West today.
Province’s nurses work longer, harder amid freeze on new hires
Provincial legislature visits to not only Klerksdorp/Tshepong but also the Lehurutshe, Mafikeng Provincial and Thusong district hospitals have found that facilities are battling shortages of nurses and emergency medical equipment, late medicine deliveries and improper record keeping.
[quote float= right]We use to work three months of night shifts per year but because we cannot hire new nurses, we have had to move to four months of night shifts…”
Health workers say they have already felt the strain of staff shortages.
The clinic manager of one 24-hour clinic said his staff has to work longer hours and more frequent night shits to compensate for a lack of health workers.
“We use to work three months of night shifts per year but because we cannot hire new nurses, we have had to move to four months of night shifts to cover for the shortage,” said the clinic manager, who asked not to be named for fear of victimisation.
He added that the increased workload has led more nurses to resign.
“When I lose more nurses and when the department does not replace (them), this then results in patients suffering as clinics pile up with long queues and shortage of staff members,” he told Health-e News.
The province has lost about 160 professional nurses and about 160 student nurses since 2014, according to the latest South African Health Review.
Eagar cautions that unfilled posts may not only strain health workers but may also compromise quality of care.
“When a senior person leaves, and those post are not filled, it becomes a major challenge as that person could have provided support to the junior staff,” he added. “(If junior staff) have no one supervising them, they are more likely to make mistakes.”
Patients wait more than one year for amputations
Prudence Maseko* lives in Jouberton and cares for her diabetic husband, Steven. Eighteen months ago, doctors recommended Steven have his leg amputated because of an infection that had gone into the bone – a complication often seen in some diabetic patients.
But Prudence says that although the couple regularly visits the Klerksdorp/Tshepong Hospital Complex to collect Steven’s treatment, he still has not been allocated a date for surgery. In the meantime, his entire body is in danger of being poisoned by the infection. She asked that she and husband not be named for fear that it would compromise his care at the hospital.
Prudence says every time they visit, it can take hours for nurses to locate his file. When her husband must be admitted, she makes sure to pack blankets.
“Whenever he gets admitted, I have to make sure I go home and collect pillows and blankets for him as the hospital wards do not have them,” she said.
Meanwhile, Sibongile Mashudu says her husband has spent 17 months awaiting surgery to amputate his leg since June 2014.
North West Department of Health Spokesperson Tebogo Lekgethwane had not responded to requests for comment at the time of going to print. – Health-e News.
*Name withheld upon request
An edited version of this story was also published in The Star newspaper.