Gauteng: 38,000 on Surgery Waiting List

Gauteng Health MEC Nomantu Nkomo-Ralehoko

In March, the Gauteng Department of Health triumphantly declared it had cleared a surgical backlog of 37 000 cases. Last week,  Gauteng Health MEC Nomantu Nkomo-Ralehoko admitted there remains a waiting list of 38 000 surgeries, in response to legislature questions by the DA’s MEC for Health, Jack Bloom. He criticized the provincial government for ‘failing to run a decent health service’ despite a R64.8 billion budget, warning of the potential disaster of implementing the NHI.

A shortage of high-care beds, limited theater time, increased trauma cases, infrastructure problems, and water and power cuts are among the issues contributing to the surgical backlog in Gauteng.

In July 2023, the department launched a campaign to conduct surgical marathons to clear the backlog. In a statement last week it said:

It is important to highlight that while the historic surgical backlog has been eliminated, there is a distinction between the backlog list and the waiting lists, comprising of new cases, which is being managed on an ongoing basis as a priority for the department.

As of end of April 2024, there were 38,000 patients on the waiting list which is a dynamic entity that is managed daily. The Department remain committed to ensuring timely access to surgical care for all patients in need. Already 14,000 patients have undergone their scheduled surgeries since the beginning of May 2024 to date. This reduces the number of patients on the normal surgical waiting list to 24 000.

Multi-sectoral issues

Dr. Tshilidzi Sadiki, Deputy President of the South African Medical Association Trade Union (SAMATU) and a neurosurgeon at Dr. George Mukhari Academic Hospital, highlights multi-sectoral issues leading to ever-increasing waiting lists in public hospitals. He told Health-e News trauma operations, due to violence and road incidents, often take precedence over elective operations, contributing significantly to the backlog.

“The burden of disease has increased compared to the past, and hospitals were initially intended to handle different volumes and types of cases. Trauma injuries from violence and road incidents have become a pandemic for theaters,” says Sadiki. Hospitals prioritise trauma cases over elective ones, and the lack of ICU beds further exacerbates the problem. 

“To run a surgical procedure is not like walking into a theatre and operating. There are things to be considered, like post operative care. However the ICU beds are not readily available due to increased disease burden,” he says. 

Late presentation of patients and transportation issues also contribute to the backlog.

“Even when they (patients) are given a date to come back to the hospital, they are unable to transport themselves to the healthcare facility. At times hospitals are battling with new consumables (theatre equipment) not readily available due to limitation of stock or budget issues,” he says. 

He says another problem is that patients sometimes seek tertiary hospital services that could be provided by district and regional hospitals. The population served by major hospitals like Chris Hani Baragwanath and Dr. George Mukhari Academic Hospitals has grown tremendously, with over five million patients visiting public health facilities in Gauteng annually.

In a reply to Bloom’s questions, Health MEC Nomantu Nkomo-Ralehoko cited patients lost to follow-up and a shortage of ICU capacity for complex cases as reasons for the backlog. Infrastructure challenges, such as extreme theater temperature changes, and consumable shortages due to non-payment to suppliers, further extend waiting times. 

“In some hospitals like Helen Joseph there is an increased number of patients awaiting surgeries because of infrastructure problems and limited theatre time. At Rahima Moosa Mother and Child Hospital water shortages cause cancellation of cases and increases in waiting times,” she said. 

Waiting Lists

Steve Biko Hospital has the largest waiting list of 7366 patients

Chris Hani Baragwanath Hospital – 4958 patients

George Mukhari Hospital- 4627 patients

Charlotte Maxeke Johannesburg Hospital – 3777 patients

Tshwane District Hospital – 2531 patients

Kalafong Hospital  – 1982 patients

Tembisa Hospital – 1950 patients

Helen Joseph Hospital – 1657 patients

Mamelodi Hospital – 1565 patients

Sebokeng Hospital – 1402 patients

-Health-e News

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